SELF-LIMITED EPILEPSY WITH AUTONOMIC SEIZURES (SeLEAS)

Overview
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Seizure Classification
Generalized onset seizure
- Motor Onset
- Non-Motor Onset
Focal Onset Seizure
- By Onset Feature
- Focal to Bilateral Tonic-Clonic
- Hemispheric lateralization
- Lobar localization
  - Frontal
  - Temporal
  - Parietal
  - Occipital
Unknown Onset Seizure
Neonatal Seizure
Epilepsy Classification
Generalized Epilepsy
Focal Epilepsy
Generalized and Focal Epilepsy
Unknown Epilepsy
Epilepsy Syndromes
Neonate/Infant
- Self-limited
- With developmental and epileptic encephalopathy
Childhood
- Self-limited focal epilepsy syndromes
  - Remission expected in all cases by adolescence
    - Self-limited epilepsy with centrotemporal spikes
    - Self-limited epilepsy with autonomic seizures
  - Remission expected in most cases by adolescence
    - Childhood occipital visual epilepsy
    - Photosensitive occipital lobe epilepsy
- Genetic generalised epilepsy syndromes
  - Epilepsy with eyelid myoclonia
  - Epilepsy with myoclonic absence
- Idiopathic generalised epilepsy syndrome
  - Childhood absence epilepsy
- With developmental and/or epileptic encephalopathy
Variable Age
- Idiopathic generalised epilepsy syndromes
- Focal epilepsy syndromes
- Combined generalised and focal epilepsy syndrome
  - Epilepsy with reading-induced seizures
- With developmental and/or epileptic encephalopathy or progressive neurological deterioration
  - Progressive myoclonus epilepsies
  - Rasmussen syndrome
Epilepsy Etiologies
Genetic Etiologies
- Chromosomal abnormalities
- Gene abnormalities
Structural Etiologies
- Malformations of cortical development
- Vascular malformations
- Hippocampal sclerosis
- Hypoxic-Ischemic
- Traumatic brain injury
- Tumors
- Porencephalic Cyst
Metabolic Etiologies
Immune Etiologies
Infectious Etiologies
Unknown Etiologies
Encephalopathy
Epilepsy imitators

SELF-LIMITED EPILEPSY WITH AUTONOMIC SEIZURES (SeLEAS)

Mandatory seizures

Focal autonomic seizure - the most frequent autonomic symptom is gastrointestinal (~75%, including nausea, retching, vomiting), such that the seizure can mistaken for acute gastroenteritis or migraine. Other symptoms can be pupillary (e.g. mydriasis), thermoregulatory, circulatory (e.g. pallor, cyanosis) or cardiorespiratory (breathing and heart rate). There may be incontinence and excessive salivation. Apnoea, cardiac asystole and/or syncope can occur.

More than 70% of seizures occur from sleep. Seizures are often prolonged i.e. autonomic status epilepticus, lasting minutes to hours.

May have

Seizures can progress to include head and eye deviation, loss of tone, impaired awareness, clonic (including hemiclonic) motor activity or to a focal to bilateral tonic-clonic seizure.

Exclusionary

All other seizure types.