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brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \sb0 \sa300 \sl240 \slmult1 \
shading0 \rtlch \fcs1 \afs52 \ltrch \fcs0 \f24 \fs52 \cf5 \expnd1 \expndtw5 \
sbasedon0 \snext0 \slink24 \spriority10 \sqformat Title;}{\*\cs24 \rtlch \fcs1 \
afs52 \ltrch \fcs0 \f24 \fs52 \cf5 \expnd1 \expndtw5 \sbasedon10 \spriority10 Title
Char;}{\s25 \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \
sb0 \sa0 \sl240 \slmult1 \shading0 \rtlch \fcs1 \ai \afs24 \ltrch \fcs0 \f24 \i \
fs24 \cf2 \expnd3 \expndtw15 \sbasedon0 \snext0 \slink26 \spriority11 \sqformat
Subtitle;}{\*\cs26 \rtlch \fcs1 \ai \afs24 \ltrch \fcs0 \f24 \i \fs24 \cf2 \
expnd3 \expndtw15 \sbasedon10 \spriority11 Subtitle Char;}{\*\cs27 \rtlch \fcs1 \ai
\ltrch \fcs0 \i \cf6 \sbasedon10 \spriority19 \sqformat Subtle Emphasis;}{\*\cs28 \
rtlch \fcs1 \ai \ltrch \fcs0 \i \sbasedon10 \spriority20 \sqformat Emphasis;}{\*\
cs29 \rtlch \fcs1 \ai \ab \ltrch \fcs0 \i \b \cf2 \sbasedon10 \spriority21 \
sqformat Intense Emphasis;}{\*\cs30 \rtlch \fcs1 \ab \ltrch \fcs0 \b \sbasedon10 \
spriority22 \sqformat Strong;}{\s31 \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \sb0 \sa0 \sl240 \slmult1 \shading0 \rtlch \fcs1 \ai \ltrch \
fcs0 \i \cf7 \sbasedon0 \snext0 \slink32 \spriority29 \sqformat Quote;}{\*\cs32 \
rtlch \fcs1 \ai \ltrch \fcs0 \i \cf7 \sbasedon10 \spriority29 Quote Char;}{\s33 \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrs \brdrw10 \brdrcf2 \brsp80 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li936 \lin936 \ri936 \rin936 \
fi0 \sb200 \sa280 \sl240 \slmult1 \shading0 \rtlch \fcs1 \ai \ab \ltrch \fcs0 \i \b
\cf2 \sbasedon0 \snext0 \slink34 \spriority30 \sqformat Intense Quote;}{\*\cs34 \
rtlch \fcs1 \ai \ab \ltrch \fcs0 \i \b \cf2 \sbasedon10 \spriority30 Intense Quote
Char;}{\*\cs35 \rtlch \fcs1 \ltrch \fcs0 \ul \cf8 \scaps \sbasedon10 \spriority31 \
sqformat Subtle Reference;}{\*\cs36 \rtlch \fcs1 \ab \ltrch \fcs0 \b \ul \cf8 \
expnd1 \expndtw5 \scaps \sbasedon10 \spriority32 \sqformat Intense Reference;}{\*\
cs37 \rtlch \fcs1 \ab \ltrch \fcs0 \b \expnd1 \expndtw5 \scaps \sbasedon10 \
spriority33 \sqformat Book Title;}{\s38 \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li720
\lin720 \ri0 \rin0 \fi0 \sb0 \sa0 \sl240 \slmult1 \shading0 \rtlch \fcs1 \ltrch \
fcs0 \sbasedon0 \spriority34 \sqformat List Paragraph;}{\s39 \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \sb0 \sa0 \sl240 \slmult1 \
shading0 \rtlch \fcs1 \afs20 \ltrch \fcs0 \fs20 \sbasedon0 \slink40 \spriority99 \
sunhideused \ssemihidden Footnote text;}{\*\cs40 \rtlch \fcs1 \afs20 \ltrch \fcs0 \
fs20 \sbasedon10 \spriority99 \ssemihidden Footnote Text Char;}{\*\cs41 \rtlch \
fcs1 \ltrch \fcs0 \super \sbasedon10 \spriority99 \sunhideused \ssemihidden
Footnote reference;}{\s42 \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \sb0 \sa0 \sl240 \slmult1 \shading0 \rtlch \fcs1 \afs20 \ltrch \fcs0
\fs20 \sbasedon0 \slink43 \spriority99 \sunhideused \ssemihidden Endnote text;}{\*\
cs43 \rtlch \fcs1 \afs20 \ltrch \fcs0 \fs20 \sbasedon10 \spriority99 \ssemihidden
Endnote Text Char;}{\*\cs44 \rtlch \fcs1 \ltrch \fcs0 \super \sbasedon10 \
spriority99 \sunhideused \ssemihidden Endnote reference;}{\*\cs45 \rtlch \fcs1 \
ltrch \fcs0 \ul \cf9 \sbasedon10 \spriority99 \sunhideused Hyperlink;}{\s46 \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \sb0 \sa0 \
sl240 \slmult1 \shading0 \rtlch \fcs1 \afs21 \ltrch \fcs0 \f3 \fs21 \sbasedon0 \
slink47 \spriority99 \sunhideused \ssemihidden Plain Text;}{\*\cs47 \rtlch \fcs1 \
afs21 \ltrch \fcs0 \f3 \fs21 \sbasedon10 \spriority99 Plain Text Char;}{\s48 \brdrt
\brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0
\brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \sb0 \sa0 \sl240 \slmult1 \shading0 \rtlch \fcs1 \ltrch \fcs0 \sbasedon0 \
slink49 \spriority99 \sunhideused Header;}{\*\cs49 \rtlch \fcs1 \ltrch \fcs0 \
sbasedon10 \spriority99 Header Char;}{\s50 \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \sb0 \sa0 \sl240 \slmult1 \shading0 \rtlch \fcs1 \
ltrch \fcs0 \sbasedon0 \slink51 \spriority99 \sunhideused Footer;}{\*\cs51 \rtlch \
fcs1 \ltrch \fcs0 \sbasedon10 \spriority99 Footer Char;}}\fet0 {\info {\author HP
USER}{\doccomm unknown}{\subject unknown}{\title unknown}}\deftab720 \viewbksp0 \
margtsxn15 \margbsxn15 \pgbrdropt16 \pgbrdrt \brdrs \brdrw90 \brdrcf7 \brsp480 \
pgbrdrl \brdrs \brdrw90 \brdrcf7 \brsp480 \pgbrdrb \brdrs \brdrw90 \brdrcf7 \
brsp480 \pgbrdrr \brdrs \brdrw90 \brdrcf7 \brsp480 \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \qj \sb0 \sa0 \sl240 \
slmult1 \shading0 \plain \rtlch \fcs1 \af26 \afs22 \ltrch \fcs0 \f28 \fs22 \dbch \
af25 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \
fi0 \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \rtlch \fcs1 \af26 \afs22 \ltrch \
fcs0 \f28 \fs22 \dbch \af25 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-
1440 \lin-1440 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28
\rtlch \fcs1 \af26 \ai \ab \afs96 \ltrch \fcs0 \f12 \i \b \fs96 \dbch \af25 \cf10 \
lang16393 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs96 \ltrch \fcs0 \f12 \
i \b \fs96 \dbch \af25 \cf10 \highlight7 \lang16393 BIOLOGY INVESTIGATORY PROJECT\
plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs96 \ltrch \fcs0 \f12 \i \b \fs96 \dbch \
af25 \cf10 \lang16393 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs96 \ltrch \
fcs0 \f12 \i \b \fs96 \dbch \af25 \cf10 \lang16393 \par \pard \brdrt \brdrnone \
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brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \qr \sb0 \sa0 \sl240 \
slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs96 \ltrch \fcs0 \
f12 \i \b \fs96 \dbch \af25 \cf10 \lang16393 {\*\shppict {\pict {\*\picprop {\sp {\
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piccropl0 \piccropr0 \piccropt0 \piccropb0 \picwgoal9182 \pichgoal6019 \pngblip
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171eddab56bd6ac71b95ced7c525c2cdacd67f1437ae9bcce9452a3d1c88f72dde192919a9a9a9f9fdf
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ee743ab3b2b23efdf4d3d2d2d2868686ad5bb78e1e3d3a3d3d7df7eedde515e57575753b76ece01a347
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e1ec297241008ae238424090482eb88ff0705bd19f69e935f2f0000000049454e44ae426082}}\plain
\cs28 \rtlch \fcs1 \af26 \ai \ab \afs96 \ltrch \fcs0 \f12 \i \b \fs96 \dbch \af25 \
cf10 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-
1440 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \
fcs1 \af26 \ai \ab \afs144 \ltrch \fcs0 \f10 \i \b \fs144 \dbch \af25 \cf10 \
highlight7 \lang16393 EPILEPS\plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs144 \ltrch
\fcs0 \f10 \i \b \fs144 \dbch \af25 \cf10 \highlight7 \lang16393 Y\plain \cs28 \
rtlch \fcs1 \af26 \ai \ab \afs144 \ltrch \fcs0 \f10 \i \b \fs144 \dbch \af25 \
cf10 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-
1440 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \
fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf10 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0
\rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \
af26 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \fs48 \dbch \af25 \cf10 \
lang16393 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \
b \fs48 \dbch \af25 \cf10 \lang16393 Submitted by :- Sneha Priyadarshini\plain \
cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \fcs0 \f20 \i \b \fs56 \dbch \af25 \
cf10 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-
1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \
fcs1 \af26 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \fs48 \dbch \af25 \cf10 \
lang16393 STD :- XII\plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \fcs0
\f10 \i \b \fs56 \dbch \af25 \cf10 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs48 \ltrch \fcs0 \
f10 \i \b \fs48 \dbch \af25 \cf10 \lang16393 Section:- \u8216 ?A\u8217 ?\
plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \fcs0 \f10 \i \b \fs56 \dbch \
af25 \cf10 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-
1440 \lin-1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28
\rtlch \fcs1 \af26 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \fs48 \dbch \af25 \cf10 \
lang16393 Roll No.:- 21\plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \
fcs0 \f10 \i \b \fs56 \dbch \af25 \cf10 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \fcs0 \
f10 \i \b \fs56 \dbch \af25 \cf10 \lang16393 School :- \plain \cs28 \rtlch \fcs1
\af26 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \fs48 \dbch \af25 \cf10 \lang16393
BMPS Takshila \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \fcs0 \f10 \i \
b \fs56 \dbch \af25 \cf10 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \shading0 \
plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \fcs0 \f10 \i \b \fs56 \dbch \
af25 \cf10 \lang16393 Submitted to:- \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \
afs48 \ltrch \fcs0 \f10 \i \b \fs48 \dbch \af25 \cf10 \lang16393 Mrs.Sneha
Ganguly \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs56 \ltrch \fcs0 \f10 \i \b \
fs56 \dbch \af25 \cf10 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \shading0 \
plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \
af25 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-
1440 \lin-1440 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28
\rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \
lang16393 AKNOWLEDGEMENT\plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \
fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs72 \ltrch \fcs0 \f12 \
i \b \fs72 \dbch \af25 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl
\brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \
ab \afs72 \ltrch \fcs0 \f12 \i \b \fs72 \dbch \af25 \lang16393 \plain \cs28 \rtlch
\fcs1 \af26 \ai \ab \afs48 \ltrch \fcs0 \f17 \i \b \fs48 \dbch \af25 \lang16393 \
plain \rtlch \fcs1 \afs48 \ltrch \fcs0 \f17 \fs48 \cf12 \lang1033 I would like to
express my sincere gratitude to the biology teacher \plain \rtlch \fcs1 \afs48 \
ltrch \fcs0 \f17 \fs48 \cf12 \lang1033 Mrs.\plain \rtlch \fcs1 \afs48 \ltrch \
fcs0 \f17 \fs48 \cf12 \lang1033 Sneha \plain \rtlch \fcs1 \afs48 \ltrch \fcs0 \
f17 \fs48 \cf12 \lang1033 Ganguli\plain \rtlch \fcs1 \afs48 \ltrch \fcs0 \f17 \fs48
\cf12 \lang1033 \plain \rtlch \fcs1 \afs48 \ltrch \fcs0 \f17 \fs48 \cf12 \lang1033
ma\u8217 ?am and the lab assistant \plain \rtlch \fcs1 \afs48 \ltrch \fcs0 \f17 \
fs48 \cf12 \lang1033 Mr.\plain \rtlch \fcs1 \afs48 \ltrch \fcs0 \f17 \fs48 \cf12 \
lang1033 Biranchi sir for giving me support and guidance during the conduct of
investigations and providing me all necessary apparatus and assistance \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \
ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \
fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \
i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0
\brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \
fs60 \dbch \af25 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \
af25 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26
\ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \
ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \
ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \
fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
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00834fffd9}}\plain \cs28
\rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \
cf11 \lang16393 CONTENTS\plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs72 \ltrch \fcs0
\f10 \i \b \fs72 \dbch \af25 \cf11 \lang16393 \plain \rtlch \fcs1 \afs56 \ltrch \
fcs0 \f10 \fs56 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \ltrch \fcs0 \f16 \fs18 \cf12 \lang1033 \plain \rtlch \fcs1 \afs40 \
ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u10146 ? INTRODUCTION \plain \rtlch \fcs1 \
afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033
\u10146 ? SIGNS AND SYMPTOMS\plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \
cf12 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u10146 ? CAUSES \plain \rtlch
\fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033
\u10146 ? PARTHOPHYSIOLOGY \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12
\lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \
ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u10146 ? CLASSIFICATION\plain \rtlch \
fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033
\u8226 ? SEIZURE TYPES\plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \
ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u8226 ? EPILEPSY SYNDROMES\
plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt
\brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40
\cf12 \lang1033 \u10146 ? MANAGEMENT \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \
f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u8226 ?
MEDICATION\plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \
fcs0 \f17 \fs40 \cf12 \lang1033 \u8226 ? SURGERY\plain \rtlch \fcs1 \
afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033
\u8226 ? OTHERS \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \
ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u10146 ? DEATH \plain \rtlch \fcs1 \afs40 \
ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u10146
? HISTORY\plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \
fcs0 \f17 \fs40 \cf12 \lang1033 \u10146 ? SOCIETY AND CULTURE \plain \rtlch \
fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033
\u8226 ? LEGAL IMPLICATION \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12
\lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \
ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u8226 ? NOTABLE CASES\plain \
rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \
cf12 \lang1033 \u10146 ? CASE STUDY \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \
fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \plain \rtlch \fcs1 \afs40 \
ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u10146 ?CONCLUSION\plain \rtlch \fcs1 \
afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033
\plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \u10146 ?
BIBLIOGRAPHY \plain \rtlch \fcs1 \afs40 \ltrch \fcs0 \f17 \fs40 \cf12 \lang1033 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab
\afs40 \ltrch \fcs0 \f17 \i \b \fs40 \dbch \af25 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs72 \ltrch \fcs0 \
f12 \i \b \fs72 \dbch \af25 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10
\brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \
ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \
slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \
f10 \i \b \fs60 \dbch \af25 \lang1033 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab \
afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \highlight7 \lang1033 INTRODUCTION\
plain \cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \
af25 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-
1440 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \
fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang1033
\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl
\brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \af26 \ai \ab
\afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \cf11 \lang1033 EPILEPSY\plain \
cs28 \rtlch \fcs1 \af26 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \dbch \af25 \
cf11 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs32 \ltrch \
fcs0 \f17 \fs32 \cf7 \lang1033 Epilepsy (from the\plain \rtlch \fcs1 \ab \afs32 \
ltrch \fcs0 \f17 \b \fs32 \cf7 \lang1033 \plain \rtlch \fcs1 \ab \afs32 \ltrch \
fcs0 \f17 \b \fs32 \cf13 \lang1033 Ancient Greek (epil\u275 ?ps\u237 ?a)\plain \
rtlch \fcs1 \afs32 \ltrch \fcs0 \f17 \fs32 \cf7 \lang1033 \u8212 ? "seizure") is a
common and diverse set of \plain \rtlch \fcs1 \ai \ab \afs32 \ltrch \fcs0 \f17 \i \
b \fs32 \ul \cf13 \lang1033 chro\plain \rtlch \fcs1 \ai \ab \afs32 \ltrch \fcs0 \
f17 \i \b \fs32 \ul \cf13 \lang1033 nic \plain \rtlch \fcs1 \ai \ab \afs32 \ltrch \
fcs0 \f17 \i \b \fs32 \ul \cf13 \lang1033 neurological\plain \rtlch \fcs1 \ai \
afs32 \ltrch \fcs0 \f17 \i \fs32 \cf13 \lang1033 \plain \rtlch \fcs1 \afs32 \ltrch
\fcs0 \f17 \fs32 \cf7 \lang1033 disorders characterized by \plain \rtlch \fcs1 \
ai \ab \afs32 \ltrch \fcs0 \f17 \i \b \fs32 \ulnone \cf13 \lang1033 seizures\
plain \rtlch \fcs1 \afs32 \ltrch \fcs0 \f17 \fs32 \ulnone \cf13 \lang1033 .\plain \
rtlch \fcs1 \afs32 \ltrch \fcs0 \f17 \fs32 \cf7 \lang1033 Some definitions of
epilepsy require that seizures be recurrent and unprovoked, but others require only
a single seizure combined with brain alterations which increase the chance of
future seizures.\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs32 \ltrch \fcs0 \f17 \fs32 \cf7 \lang1033 Epileptic seizures result from
abnormal, excessive or \plain \rtlch \fcs1 \ai \ab \afs32 \ltrch \fcs0 \f17 \i \b \
fs32 \ul \cf13 \lang1033 hyper synchronous neuronal activity\plain \rtlch \fcs1 \
afs32 \ltrch \fcs0 \f17 \fs32 \cf13 \lang1033 \plain \rtlch \fcs1 \afs32 \ltrch \
fcs0 \f17 \fs32 \cf7 \lang1033 in the brain. About 50 million people worldwide have
epilepsy, and nearly \plain \rtlch \fcs1 \ai \ab \afs32 \ltrch \fcs0 \f17 \i \b \
fs32 \ulnone \cf13 \lang1033 90% \plain \rtlch \fcs1 \afs32 \ltrch \fcs0 \f17 \fs32
\cf7 \lang1033 of epilepsy occurs in\plain \rtlch \fcs1 \ai \ab \afs32 \ltrch \fcs0
\f17 \i \b \fs32 \ulnone \cf13 \lang1033 developing countries\plain \rtlch \fcs1 \
afs32 \ltrch \fcs0 \f17 \fs32 \cf7 \lang1033 . Epilepsy becomes more common as
people age. Onset of new cases occurs most frequently in infants and the elderly.
As a consequence of brain surgery, epileptic seizures may occur in recovering
patients.\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs32 \
ltrch \fcs0 \f17 \fs32 \cf7 \lang1033 Epilepsy is usually controlled, but not
cured, with medication. However, over \plain \rtlch \fcs1 \ai \ab \afs32 \ltrch \
fcs0 \f17 \i \b \fs32 \ulnone \cf13 \lang1033 30% \plain \rtlch \fcs1 \afs32 \ltrch
\fcs0 \f17 \fs32 \cf7 \lang1033 of people with epilepsy do not have seizure control
even with the best available medications. \plain \rtlch \fcs1 \ai \ab \afs32 \ltrch
\fcs0 \f17 \i \b \fs32 \ulnone \cf13 \lang1033 Surgery\plain \rtlch \fcs1 \afs32 \
ltrch \fcs0 \f17 \fs32 \cf7 \lang1033 may be considered in difficult cases. Not
all epilepsy syndromes are lifelong \u8211 ? some forms are confined to \plain \
rtlch \fcs1 \afs32 \ltrch \fcs0 \f17 \fs32 \cf7 \lang1033 particular stages of
childhood. Epilepsy should not be understood as a single disorder, but rather as
syndromic with vastly divergent symptoms, all involving e\plain \rtlch \fcs1 \afs28
\ltrch \fcs0 \f17 \fs28 \cf7 \lang1033 pisodic \plain \rtlch \fcs1 \afs32 \ltrch \
fcs0 \f17 \fs32 \cf7 \lang1033 abnormal electrical activity in the brain and \plain
\rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 numerous seizures.\plain
\rtlch \fcs1 \afs26 \ltrch \fcs0 \f17 \fs26 \cf7 \lang1033 \plain \rtlch \fcs1 \
afs26 \ltrch \fcs0 \f17 \fs26 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 \cf14 \par
\pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-1440 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \fcs1 \ai \ltrch \
fcs0 \f17 \i \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li-1440 \lin-
1440 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \shading0 \plain \cs28 \rtlch \
fcs1 \ai \ab \afs32 \ltrch \fcs0 \f28 \i \b \fs32 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \
fs48 \cf15 \highlight7 \lang16393 CLASSIFICATION AND EXTERNAL \plain \cs28 \rtlch \
fcs1 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \fs48 \cf15 \highlight7 \lang16393
SOURCES\plain \cs28 \rtlch \fcs1 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \fs48 \cf15
\lang16393 \plain \cs28 \rtlch \fcs1 \ai \ab \afs48 \ltrch \fcs0 \f10 \i \b \
fs48 \cf15 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
ltrch \fcs0 \f28 \i \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \ltrch \fcs0 \f28 \i \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \ltrch \fcs0 \f28 \i \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \ab0 \afs52 \ltrch \fcs0 \f10 \i \b0
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008abfffd9}}\plain \cs28 \rtlch \fcs1 \ai \ab0 \afs52 \ltrch \fcs0 \f10 \i \b0 \
fs52 \cf11 \lang16393 SIGNS AND SYMPTOMS \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \rtlch \fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7 \lang1033 Epilepsy
is characterized by a long term risk of recurrent \plain \rtlch \fcs1 \ai \ab \
afs34 \ltrch \fcs0 \f17 \i \b \fs34 \ulnone \cf13 \lang1033 seizures\plain \rtlch \
fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7 \lang1033 . These seizures may present in
a number of different ways. \plain \rtlch \fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7
\lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb
\brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i
\fs32 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb
\brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i
\fs32 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs32 \ltrch \fcs0 \f28 \i \fs32 {\*\shppict {\pict {\*\picprop {\sp {\sn
shapeType}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn
fLockRotation}{\sv 0}}{\sp {\sn fLockAspectRatio}{\sv 1}}{\sp {\sn
fLockAgainstSelect}{\sv 0}}{\sp {\sn fLockCropping}{\sv 0}}{\sp {\sn
fLockVerticies}{\sv 0}}{\sp {\sn fLockText}{\sv 0}}{\sp {\sn fLockAdjustHandles}{\
sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}}\picscalex100 \picscaley100 \
piccropl0 \piccropr0 \piccropt0 \piccropb0 \picwgoal6511 \pichgoal3059 \jpegblip
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547aa8f551eaa3d547aa8f551eaa3d547aa87ff00951ea63fffd9}}\plain \cs28 \rtlch \fcs1 \
ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \ab \afs52 \ltrch \fcs0 \f10 \i \b \fs52 \cf11 \
lang16393 CAUSES \plain \cs28 \rtlch \fcs1 \ai \ab \afs52 \ltrch \fcs0 \f10 \i \b \
fs52 \cf11 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 The diagnosis of epilepsy usually requires
that the seizures occur spontaneously. Nevertheless, certain epilepsy syndromes
require particular precipitants or triggers for seizures to occur. These are termed
\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 reflex epilepsy\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 . For example,
patients with \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
primary reading epilepsy \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 have seizures triggered by reading. \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf13 \lang1033 Photosensitive epilepsy\plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 can be limited to seizures triggered by
flashing lights. Other precipitants can trigger an epileptic seizure in patients
who \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 otherwise
would be susceptible to spontaneous seizures. For example, children with
childhood \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
absence epilepsy \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
may be susceptible to \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \
lang1033 hyperventilation\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 . In fact, flashing lights and hyperventilation are activating procedures
used in clinical \plain \rtlch \fcs1 \ab \afs30 \ltrch \fcs0 \f17 \b \fs30 \cf13 \
lang1033 EEG \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 to
help trigger seizures to aid diagnosis. Emotional stress, sleep deprivation, sleep
itself, heat stress, alcohol and febrile illness are examples of precipitants cited
by patients with epilepsy. Notably, the influence of various precipitants varies
with the epilepsy syndrome. Likewise, the \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf13 \lang1033 menstrual cycle\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 in women with epilepsy can influence patterns of seizure
recurrence. Catamenial epilepsy is the term denoting seizures linked to \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 the menstrual cycle. There are different causes of
epilepsy that are common in certain age groups. \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
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a0d0ff00c5a25128ea57fd7fffd9}}\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10
\brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \u9642 ? During late infancy and early
childhood, febrile seizures are fairly common. These may be caused by many
different things, some thought to be things such as CNS infections and trauma.\
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 \u9642 ? During childhood, well-defined epilepsy
syndromes are generally seen.\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \u9642 ? During
adolescence and adulthood, the causes are more likely to be secondary to any CNS
lesion. Further, idiopathic epilepsy is less common. Other causes associated with
these age groups are stress, trauma, CNS infections, brain tumors, and illicit drug
use and alcohol withdrawal.\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \u9642 ? In older adults
\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 cerebro-vascular
disease is a very common cause. Other causes are CNS tumors, head trauma, and other
\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 degenerative
diseases that are common in the older age group, such as\plain \rtlch \fcs1 \ab \
afs30 \ltrch \fcs0 \f17 \b \fs30 \cf13 \lang1033 dementia. \plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 When
investigating the causes of seizures, it is important to understand physiological
conditions that may predispose the individual to a seizure occurrence. Several
clinical and experimental data have implicated the failure of \plain \rtlch \fcs1 \
ab \afs30 \ltrch \fcs0 \f17 \b \fs30 \ul \cf7 \lang1033 blood\u8211 ?brain barrier\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 (BBB) function in
triggering chronic or acute seizures, some studies implicate the interactions
between a common blood protein\u8212 ?\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf13 \lang1033 albumin and atrocities\plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 . These findings suggest that acute seizures are a
predictable consequence of disruption of the BBB by either artificial or
inflammatory mechanisms.\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \plain \rtlch \
fcs1 \afs36 \ltrch \fcs0 \f17 \fs36 \cf7 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 {\
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1dd511eb72da412174a0f7b830fa2d18945ab81b338a94997110143444d0e601932b0caddd92c5e91d5
53708740b86f45b9562b9cc07ca9aa56a1c2e58b818c1404a25128947133caae98700f4128947e33646
12988c0f371556f0567ce03d99819143e22bb1317de658b0b239538555554459c046ea150bdb13a516d
9a534b5c94ab62fdbbd5cddd8952f5293ab55b54a0c13145705c00190ddd0382aa98a884069ab678794
48150bac0e7a6e585d19a2cc01f322a914e0290a18e4324756eb72dadd0de455c2f2dba9949d6238bcb
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ca3d42c45069609f8013191570ac1148d5750c0a624bdac1ff009d7fffd9}}\plain \cs28 \rtlch \
fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard
\brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \
ltrch \fcs0 \f10 \i \fs60 \cf11 \lang16393 PATHOPHYSIOLOGY \plain \cs28 \rtlch \
fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf13 \lang1033 Mutations\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 in several \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf13 \lang1033 genes\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 have been linked to some types of epilepsy. Several genes that code for \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 protein\plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 subunits of \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf13 \lang1033 v\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
oltage-gated\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 and\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 ligand-gated ion
\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 channels have
been associated with forms of generalized epilepsy and infantile \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 seizure syndromes.\par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 One speculated mechanism for some forms of inherited epilepsy are
mutations of the genes that \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7
\lang1033 code for sodium channel proteins; these defective sodium channels stay
open for too long, thus making the neuron hyper excitable. \plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 Glutamate,\plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf13 \lang1033 an excitatory neurotransmitter,\plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 may, therefore, be released
from these neurons in large amounts, which \u8212 ? by binding with nearby
glutamatergic neurons \u8212 ? triggers excessive calcium (Ca2+) release in these
post-synaptic cells. Such excessive calcium release can be neurotoxin to the
affected cell. The hippocampus, which contains a large volume of just such
glutamatergic neurons (and NMDA receptors, which are permeable to Ca2+ entry after
binding of both glutamate and glycine), is especially vulnerable to epileptic
seizure, subsequent spread of excitation, and possible neuronal death. Another
possible mechanism involves mutations leading to ineffective \plain \rtlch \fcs1 \
ab \afs30 \ltrch \fcs0 \f17 \b \fs30 \cf13 \lang1033 GABA\plain \rtlch \fcs1 \afs30
\ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 (the brain's most common inhibitory
neurotransmitter) action. Epilepsy-related mutations in some non-ion channel genes
have also been identified. Much like the \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \rtlch \fcs1 \ab \afs30 \ltrch \fcs0 \f17 \b \fs30 \ul \cf13 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \ab \
afs30 \ltrch \fcs0 \f17 \b \fs30 \ul \cf13 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \ab \afs30 \ltrch \fcs0 \f17 \b \fs30 \ul \
cf13 \lang1033 channelopathies\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf7 \lang1033 in voltage-gated ion channels, several ligand-gated ion channels
have been linked to some types of frontal and generalized epilepsies. \plain \rtlch
\fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 Epileptogenesis\plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 is the process by which a
normal brain develops epilepsy after trauma, such as a lesion on the brain. One \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 interesting finding in animals is that repeated low-level \par \pard
\brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 electrical stimulation to some brain
sites \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 can lead
to \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 permanent decrease in seizure "threshold." This
phenomenon, known as kindling (by analogy with the use of burning twigs to start a
larger fire) was discovered by Dr. Graham Goddard in 1967. It is important to note
that these "kindled" animals do not experience spontaneous seizures. Chemical
stimulation \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 can
also induce seizures; repeated exposures to some pesticides have been shown to
induce seizures in both humans and\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 animals. One mechanism proposed for this is called \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf13 \lang1033 excito-toxicity\plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 . The roles of kindling and excite-toxicity, if any,
in human epilepsy are currently hotly debated. \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \
fs60 \cf11 \lang16393 {\*\shppict {\pict {\*\picprop {\sp {\sn shapeType}{\sv 0}}{\
sp {\sn fFlipV}{\sv 0}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fLockRotation}{\sv 0}}{\
sp {\sn fLockAspectRatio}{\sv 1}}{\sp {\sn fLockAgainstSelect}{\sv 0}}{\sp {\sn
fLockCropping}{\sv 0}}{\sp {\sn fLockVerticies}{\sv 0}}{\sp {\sn fLockText}{\sv 0}}
{\sp {\sn fLockAdjustHandles}{\sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}}\
picscalex100 \picscaley100 \piccropl0 \piccropr0 \piccropt0 \piccropb0 \
picwgoal6390 \pichgoal3600 \jpegblip
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1ccee611825310276c0d67cb3334f0cceb3aa9972ab5b8a750e9290bd0e80e60d0a0f6ae49947e22b3d
0e786b24cc885264743a5c608c654cb6298e84433f9e7ec171d2de58a767bcccad585c875a6662ee7a0
3994c3ec00900b079440083641a832444e841bc3475268d1e2a0cd8c70399560acf8eec036b6f74f6d5
bd6a1f922e2cd176cbc92df50daef94a8acb2e8018a4684e709ac06f44b7a9ccb9e9254a7c3302236a5
98f12cb6c3bbacba823fae8c1c86b94c58870590b17099d643ea2d9095783f748e6de2ef2561f107b74
032f173ae430d1734520d470a5baf050c648e392d24a322a6b40a3372295e31fbce15cc0eacf3484485
c78723ec58b061744a0e74ccc0435ee0d89da043dca3172d46f3a534847f0561dbe8c2f9f2dcb1768ca
c0e3607e5122fb4095d824c4ae8b6975e7b93a1870c1db5513d51a38c0af646eb491ea7071284d3dc54
a4a4a25129292894801ece8ff00e0ff00ffd9}}\plain \cs28 \rtlch \fcs1 \ai \ab \afs60 \
ltrch \fcs0 \f10 \i \b \fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0
\rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \
fcs1 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \cf11 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \ab \afs60 \ltrch \
fcs0 \f10 \i \b \fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \
cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \cf11 \lang16393 \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \ab \afs60
\ltrch \fcs0 \f10 \i \b \fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10
\brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \ab \afs60 \ltrch \fcs0 \f10 \i \b \fs60 \
cf11 \lang16393 CLASSIFICATION \plain \cs28 \rtlch \fcs1 \ai \ab \afs60 \ltrch \
fcs0 \f10 \i \b \fs60 \cf11 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 Epilepsies are classified
in five ways:\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 1.By their first cause (or \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 etiology)\plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 . \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 2.By the observable manifestations of the seizures, known as semiology.\
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 3.By the location in the brain where the seizures
originate. 4.As a part of discrete, identifiable medical syndromes.\par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 5.By the event that triggers the seizures, such as reading or music\
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 In 1981, the\plain \rtlch \fcs1 \ab \afs30 \ltrch \
fcs0 \f17 \b \fs30 \cf7 \lang1033 \plain \rtlch \fcs1 \ab \afs30 \ltrch \fcs0 \f17
\b \fs30 \cf7 \lang1033 International League Against Epilepsy (ILAE)\plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 proposed a classification
scheme for individual seizures that remains in common use. This classification is
based on observation (clinical and EEG) rather than the underlying pathophysiology
or anatomy and is outlined later on in this article. In 1989, the ILAE proposed a
classification scheme for epilepsies and epileptic syndromes. This can be broadly
described as a two-axis scheme having the cause on one axis and the extent of
localization within the brain on the other. Since 1997, the ILAE have been working
on a new scheme that has five axes: \plain \rtlch \fcs1 \afs28 \ltrch \fcs0 \f17 \
fs28 \cf7 \lang1033 ictal phenomenon, (pertaining to an epileptic seizure), seizure
type, syndrome , \plain \rtlch \fcs1 \afs28 \ltrch \fcs0 \f17 \fs28 \cf7 \lang1033
etiology\plain \rtlch \fcs1 \afs28 \ltrch \fcs0 \f17 \fs28 \cf7 \lang1033 ,
impairment \plain \cs28 \rtlch \fcs1 \ai \afs34 \ltrch \fcs0 \f17 \i \fs34 \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \
ltrch \fcs0 \f28 \i \fs36 \cf16 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f28 \i \fs36 \cf16 \
lang16393 SEZIURE TYPE\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f28 \i \fs36 \cf16 \lang16393 \plain \cs28 \
rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f28 \i \fs36 \cf16 \lang16393 {\*\shppict {\
pict {\*\picprop {\sp {\sn shapeType}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn
fFlipH}{\sv 0}}{\sp {\sn fLockRotation}{\sv 0}}{\sp {\sn fLockAspectRatio}{\sv 1}}
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fLockVerticies}{\sv 0}}{\sp {\sn fLockText}{\sv 0}}{\sp {\sn fLockAdjustHandles}{\
sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}}\picscalex100 \picscaley100 \
piccropl0 \piccropr0 \piccropt0 \piccropb0 \picwgoal3360 \pichgoal3885 \jpegblip
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2439545e408a1a4040f040f222dc3e046c07a8f7329dbfb95397c4d0222e8bcb3d8cf73fb8380fac1a8
7e373e901db280d9d5ce7941a9a786e7da57b7c07827b9807bf17a27d27da68fb3a682c73a29a8da5db
733c5a3bba80db5edf28407d2c5a37564762fc36c8cb0242f812e374d6681b8033556db7fe72e1144b0
c52000743adc20f0936092b10105bb565e25aa2d952b32456d8c0a0f54ca654a951254af14dca611a3e
c5a802b3aa9999648abce23f8876851c306da3d80390806b5ee1de05ed2bb7b451306a8d169576d2827
b4885975dc3ea3d726ed571690bc6bc47a5acf7fe11b093f539c42e8ad6538607928ed05ed1b76edf19
83330b9999998cb61343ec3b955e6a6168e102d018cc4ec552efa2a239c52c6c70116e9b2869c0838b6
3b8630a56eb6eb9aa2ad121757b2df1789b4b8b185f172e5fa97afc2e5cb8370cc5b6cd187c02708f6a
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64f64a773d93d929dffdefffd9}}\plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \
f28 \i \fs36 \cf16 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 Seizure types are organized firstly according
to whether the source of the seizure within the brain is localized \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 (partial or focal onset
seizures)\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 or
distributed (generalized seizures). Partial seizures are further divided on the
extent to which \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 consciousness is affected. If it
is unaffected, then it is a \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf13 \lang1033 simple partial\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf7 \lang1033 seizure; otherwise it is a\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf13 \lang1033 complex partial\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 (psychomotor) seizure. A partial seizure may spread
within the brain - a process known as \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 secondary generalization. \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
Generalized seizures are divided according to the effect on the body but all
involve loss of consciousness. These include absence (petit mal), myoclonic, \plain
\rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 colic\plain \rtlch \fcs1
\afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 , tonic, tonic-\plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 colic\plain \rtlch \fcs1 \afs30 \ltrch
\fcs0 \f17 \fs30 \cf7 \lang1033 (grand \par \pard \brdrt \brdrnone \brdrw10 \brsp0
\brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 mal),
and atonic seizures. Children may exhibit behaviors that are easily mistaken for
epileptic seizures but are not caused by epilepsy. These include: \par \pard \brdrt
\brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 \u9642 ? Inattentive staring\par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \
u9642 ? Benign shudders (among children younger than age 2, usually when they are
tired or excited) \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \u9642 ? Self-gratification
behaviors (nodding, rocking, head banging) \u9642 ? Conversion disorder (flailing
and jerking of the head, often in response to severe personal stress such as
physical abuse) Conversion disorder can be distinguished from epilepsy because the
episodes never occur during sleep and do not involve incontinence or self-injury. \
plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i
\fs32 {\*\shppict {\pict {\*\picprop {\sp {\sn shapeType}{\sv 0}}{\sp {\sn fFlipV}
{\sv 0}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fLockRotation}{\sv 0}}{\sp {\sn
fLockAspectRatio}{\sv 1}}{\sp {\sn fLockAgainstSelect}{\sv 0}}{\sp {\sn
fLockCropping}{\sv 0}}{\sp {\sn fLockVerticies}{\sv 0}}{\sp {\sn fLockText}{\sv 0}}
{\sp {\sn fLockAdjustHandles}{\sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}}\
picscalex100 \picscaley100 \piccropl0 \piccropr0 \piccropt0 \piccropb0 \
picwgoal4005 \pichgoal4275 \jpegblip
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cc69af06622ad637306cb6889049d8bd4ada6aebee236322c8afe6f3bf86bc3630007e0c51eb08b54c3
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d12e2b5869e3d4bc03da8c1335505a85b889977f2cae18edf88af31dacaeb09f5c02203851d008370d4
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216895b7f0778b1eac5a00e847a334861d69e140af95f640f5ff00c27fffd9}}\plain \cs28 \rtlch
\fcs1 \ai \afs26 \ltrch \fcs0 \f28 \i \fs26 \lang16393 \par \pard \brdrt \brdrnone
\brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
Just as there are many types of seizures, there are many types of epilepsy
syndromes. Epilepsy classification includes more information about the person and
the episodes than seizure type alone, such as clinical features (e.g., behavior
during the seizure) and expected causes. Each type of epilepsy presents with its
own unique combination of seizure \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 type, typical age
of onset, EEG findings, treatment, and \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
prognosis. The most widespread classification of the epilepsies \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 divides epilepsy syndromes by location or distribution of seizures (as
revealed by the appearance of the seizures and by EEG) and by cause. Syndromes are
divided into \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 localization-related epilepsies,
generalized epilepsies, or epilepsies of unknown localization .\plain \cs28 \
rtlch \fcs1 \ai \afs26
\ltrch \fcs0 \f28 \i \fs26 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 Localization-related
epilepsies, sometimes termed partial or focal epilepsies, arise from an epileptic
focus, a small portion of the brain that serves as the irritant driving the
epileptic \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 response. Generalized epilepsies, in
contrast, arise from many independent foci (multifocal epilepsies) or from
epileptic \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
circuits that involve the whole brain. Epilepsies of unknown \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 localization remain unclear as to whether they arise from a \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
portion of the brain or from more widespread circuits. Epilepsy syndromes are
further divided by presumptive cause: idiopathic, symptomatic, and cryptogenic. In
general, idiopathic epilepsies are thought to arise from \plain \rtlch \fcs1 \afs30
\ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 genetic abnormalities that lead to
alteration of basic neuronal regulation. Symptomatic epilepsies arise from the
effects of an epileptic lesion, whether that lesion is focal, such as a tumor, or a
defect in metabolism causing widespread injury to the brain. Cryptogenic epilepsies
involve a presumptive lesion that is otherwise difficult or impossible to uncover
during evaluation. The genetic component to epilepsy is receiving particular
interest from the scientific community. Conditions such as \plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 ring chromosome 20\plain \rtlch \fcs1
\afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 syndromes are gaining
acknowledgment, and \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \ul \cf13 \
lang1033 although only 60 cases have been reported in the literature since 1976,\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 "more widespread
cytogenetic chromosomal karyotyping in nonetiological cases of epilepsy" is likely.
Some epileptic syndromes are difficult to fit within this classification scheme and
fall in the unknown localization/etiology category. People with seizures that occur
only after specific precipitants \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 ("provoked seizures"), have "epilepsies" that fall into this \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 category. \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 Febrile are\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 an example of seizures bound to a particular precipitant.\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 Landau-Kleffner
syndrome\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 is
epilepsy that, because of its variety of EEG distributions, falls uneasily \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 in clear categories. What can be even more confusing
is that certain syndromes, such as West syndrome, featuring seizures such as
infantile spasms, can be \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 classified as idiopathic, syndromic, or \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 cryptogenic \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 depending on cause and can arise from both
focal and generalized epileptic lesions \plain \rtlch \fcs1 \afs36 \ltrch \fcs0 \
f17 \fs36 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \
ltrch \fcs0 \f10 \i \fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \
cf11 \lang16393 MANAGEMENT \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \
i \fs60 \cf11 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10
\brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 Epilepsy is usually treated with \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 medication\plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 prescribed by a \plain \
rtlch \fcs1 \ab \afs30 \ltrch \fcs0 \f17 \b \fs30 \cf13 \lang1033 physician;
primary caregivers, neurologists, and neurosurgeons all frequently care for people
with epilepsy.\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
However, it has been stressed that accurate differentiation between generalized and
partial seizures is especially important in determining the appropriate treatment.
In some cases the implantation of a stimulator of the \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 vague\plain \rtlch \fcs1 \afs30 \ltrch \fcs0
\f17 \fs30 \cf13 \lang1033 nerve\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 , or a special diet can be helpful. Neurosurgical operations for
epilepsy can be \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
palliative\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 ,
reducing the frequency or severity of seizures; or, in some patients, an operation
can be curative. The proper initial response to a generalized \plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
tonic-\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 colic\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 epileptic\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 seizure is to
roll the person on the side \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf13 \lang1033 (recovery position)\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 to prevent ingestion of fluids into the lungs, which can
result in choking and death. Should the person \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf13 \lang1033 regurgitate\plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 , this should be allowed to drip out the side of the
person's mouth. The person should be prevented from self-injury by moving them away
from sharp edges, and placing something soft beneath the head. If a seizure lasts
longer than 5 minutes, or if more than one seizure occurs without regaining
consciousness \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
emergency medical services\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 should be contacted.\plain \cs28 \rtlch \fcs1 \ai \afs30 \ltrch \fcs0 \
f17 \i \fs30 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f28 \i \fs36 \
cf16 \lang16393 MEDICATIONS \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \
f28 \i \fs36 \cf16 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 The mainstay of treatment of
epilepsy is anticonvulsant medications. Often, anticonvulsant medication treatment
will \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 be life long and can have major effects on quality
of life. The choice among anticonvulsants and their effectiveness differs by
epilepsy syndrome. Mechanisms, effectiveness for particular epilepsy syndromes, and
side-effects differ among the individual anticonvulsant medications. Some general
findings \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 about the use of anticonvulsants are outlined
below. \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0
\brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf15 \highlight7 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf15 \
highlight7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf15 \highlight7 \lang1033 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf15 \highlight7 \lang1033 Effectivenes\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17
\fs30 \cf7 \highlight7 \lang1033 s\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 - The definition of "effective" varies. FDA \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30
\cf7 \lang1033 approval usually requires that 50% of the patient treatment group
had at least a 50% improvement in the rate of epileptic seizures. About 20% of
patients with epilepsy continue to have breakthrough epileptic seizures despite
best anticonvulsant treatment. \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf15 \highlight7 \lang1033 Safety and
Side Effects\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 -
88% of patients with epilepsy, in a European survey, reported at least one
anticonvulsant related side-effect. Most side effects are mild and "dose-related"
and can often be avoided or minimized by the use of the smallest effective amount.
Some examples include mood changes, sleepiness, or unsteadiness in gait. Some
anticonvulsant medications have "idiosyncratic" side effects that can not be
predicted by dose. Some examples include drug rashes, liver toxicity (hepatitis),
or aplastic anemia. Safety includes the consideration of teratogenicity (the
effects of medications on fetal development) when women with epilepsy become
pregnant. \plain \rtlch \fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7 \lang1033 \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs34 \ltrch \
fcs0 \f17 \fs34 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f28 \i \fs36 \cf16 \lang16393 SURGERY\plain \
cs28 \rtlch \fcs1 \ai \afs40 \ltrch \fcs0 \f17 \i \fs40 \par \pard \brdrt \brdrnone
\brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f28 \i \fs36 \
cf16 \lang16393 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
Epilepsy surgery is an option for people with focal seizures that remain resistant
to treatment. The goal for these procedures is total control of epileptic seizures,
although anticonvulsant medications may still be required. Certain lesions
require \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 Long-
term video-EEG \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
monitoring with the use of intracranial electrodes if noninvasive testing was
inadequate \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 to identify the epileptic focus or
distinguish the surgical \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 target from normal brain
tissue and function. \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \
lang1033 Brain mapping\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 by the technique of cortical electrical stimulation are other \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \
ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 procedures used in the process of invasive testing
in some \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 patients. The most common surgeries are the
resection of \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 lesions like \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 tumors or arteriovenous malformations,\plain
\rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 which, in the process
of treating the underlying lesion, often result in \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
control of epileptic seizures caused by these lesions. Other lesions are more
subtle and feature epilepsy as the main or sole symptom. The most common form of
intractable epilepsy in these disorders in adults is \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 temporal lobe epilepsy \plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 with \plain \rtlch \fcs1 \afs30 \ltrch
\fcs0 \f17 \fs30 \cf13 \lang1033 hippocampal sclerosis\plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 , and the most common type of epilepsy
surgery is the \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
anterior temporal lobectomy\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf7 \lang1033 , or the removal of the front portion of the temporal lobe including
the \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \ul \cf13 \lang1033 amygdala
and hippocampus\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 .
Some neurosurgeons recommend selective surgery because of possible benefits in
postoperative memory or language function. Surgery for temporal lobe epilepsy is
effective, durable, and results in decreased health care costs. Despite the
efficacy of epilepsy surgery, some patients decide not to undergo surgery owing to
fear or the uncertainty of having a brain operation. \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 Palliative surgery \plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 for epilepsy is intended to reduce the
frequency or severity of seizures. Examples are \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf13 \lang1033 callosotomy or commissurotomy\plain \rtlch \fcs1 \
afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 to prevent seizures from generalizing
(spreading to involve the entire brain), which results in a loss of consciousness.
This procedure can therefore prevent injury due to the person falling to the ground
after losing consciousness. It is performed only when the seizures cannot be
controlled by other means. \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13
\lang1033 Multiple subpial transections \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 can also be used to decrease the spread of seizures across
the cortex especially when the epileptic focus is located near important functional
areas of the cortex. Resective surgery can be considered palliative if it is \plain
\rtlch \fcs1 \afs28 \ltrch \fcs0 \f17 \fs28 \cf7 \lang1033 undertaken with the
expectation that it will reduce but not \plain \rtlch \fcs1 \afs28 \ltrch \fcs0 \
f17 \fs28 \cf7 \lang1033 eliminate seizures \plain \rtlch \fcs1 \afs30 \ltrch \fcs0
\f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i
\fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone
\brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \
fcs0 \f10 \i \fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \lang16393
DEATH \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \par \
pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 Beyond symptoms of the underlying diseases that can
be a part of certain epilepsies, people with epilepsy are at risk for death from
four main problems: \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \
lang1033 status epilepticus\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf7 \lang1033 (most often \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf7 \lang1033 associated with\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf7 \lang1033 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
anticonvulsant\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
noncompliance), \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
suicide\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
associated with \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
depression\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 ,
trauma from seizures, and \plain \rtlch \fcs1 \ab \afs30 \ltrch \fcs0 \f17 \b \fs30
\ul \cf13 \lang1033 Sudden Unexpected Death In Epilepsy (SUDEP)\plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 . Those at highest risk for
epilepsy-related deaths usually have underlying neurological impairment or poorly
controlled seizures; those with more benign epilepsy syndromes have little risk for
epilepsy-related death. The \plain \rtlch \fcs1 \ab \afs30 \ltrch \fcs0 \f17 \b \
fs30 \cf13 \lang1033 NICE National Sentinel Audit of Epilepsy-Related Deaths\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 , led by "Epilepsy
Bereaved" drew attention to this important \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 problem. The Audit revealed; "1,000 deaths occur
every year in the UK as a result of epilepsy" and most of them are associated with
seizures and 42% of deaths were potentially avoidable". Certain diseases also seem
to occur in higher than expected rates in people with epilepsy, and the risk of
these "comorbidities" often varies with the epilepsy syndrome. These diseases
include depression and anxiety disorders, migraine and other headaches, infertility
and low sexual libido.\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \
lang1033 Attention deficit/hyperactivity disorder (ADHD)\plain \rtlch \fcs1 \afs30
\ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 affects three to five times more children
with epilepsy than children in the general population. ADHD and epilepsy have
significant consequences on a child's behavioral, learning, and social development.
Epilepsy is prevalent in \plain
\rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 autism\plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 . \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i
\fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone
\brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \
fcs0 \f10 \i \fs60 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \lang16393
HISTORY \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 In the past, epilepsy was associated with \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 religious\plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 experiences and even\plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 demonic possession\
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 . In ancient
times, epilepsy was known as the "Sacred Disease" (as described in a 5th century BC
treatise by Hippocrates) because people thought that epileptic seizures were a form
of attack by \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
demons\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 , or that
the visions experienced by persons with epilepsy \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 were sent by the gods. Among \plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 A\plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 nimist Hmong\plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 families, for example, epilepsy was
understood as an attack by an evil spirit, but the affected person could become
revered as a \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033
shaman\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 through
these otherworldly experiences. A chapter from a Babylonian textbook of medicine,
dating from about 2000BC and consisting of 40 tablets, records many of the
different seizure types we recognize today, and it emphasizes the supernatural
nature of epilepsy, while the Ayurvedic text of Charaka Samhita (about 400BC),
describes epilepsy as "apasmara", i.e., "loss of consciousness". In most cultures,
persons with epilepsy have been stigmatized, shunned, or even imprisoned; in the \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 Salp\u234 ?tri\
u232 ?re\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 , the
birthplace of modern neurology,\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf13 \lang1033 Jean-Martin Charcot\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 found people with epilepsy side-by-side with the mentally
retarded, those with chronic \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \
cf13 \lang1033 syphilis\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 , and the criminally insane. In \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf13 \lang1033 Tanzania\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 to this day, as with other parts of Africa, epilepsy is
associated with possession by evil spirits, witchcraft, or poisoning and is
believed by many to be contagious. In ancient Rome, epilepsy was known as the
Morbus \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 Comitial
is\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 ('disease of
the assembly hall') and was seen as a curse from the gods. Stigma continues to this
day, in both the public and private spheres, but polls suggest it is generally
decreasing with time, at least in the developed \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 world; \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf13 \lang1033 Hippocrates\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 remarked that epilepsy would cease to be considered divine the
day\plain \rtlch \fcs1 \afs28 \ltrch \fcs0 \f17 \fs28 \cf7 \lang1033 it was \plain
\rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 understood. \plain \
rtlch \fcs1 \afs36 \ltrch \fcs0 \f17 \fs36 \cf7 \lang1033 \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i
\fs32 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs32 \ltrch \fcs0 \f28 \i \fs32 \cf11 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \
lang16393 SOCIETY AND CULTURE\plain \cs28 \rtlch \fcs1 \ai \afs24 \ltrch \fcs0 \f28
\i \fs24 \cf11 \lang16393 \plain \cs28 \rtlch \fcs1 \ai \afs24 \ltrch \fcs0 \f28 \
i \fs24 \cf11 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10
\brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs24 \ltrch \fcs0 \f28 \i \fs24 \cf11 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs34 \ltrch \fcs0 \f28 \i \fs34 \cf16 \
lang16393 LOGICAL IMPLICATION\plain \cs28 \rtlch \fcs1 \ai \afs34 \ltrch \fcs0 \f28
\i \fs34 \lang16393 \plain \cs28 \rtlch \fcs1 \ai \afs34 \ltrch \fcs0 \f28 \i \
fs34 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 Many jurisdictions forbid certain activities to
persons suffering from epilepsy. The most commonly prohibited activities involve
operation of vehicles or machinery, or other activities in which continuous
vigilance is required. However, there are usually exceptions for those who can
prove that they have stabilized their condition. Those few whose seizures do not
cause impairment of consciousness, have a lengthy aura preceding impairment of
consciousness, or whose seizures only arise from sleep, may be exempt from such
restrictions, depending on local laws. There is an ongoing debate in \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf13 \lang1033 bioethics\plain \rtlch \
fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 over who should bear the burden
of ensuring that an epilepsy patient does not drive a car or fly an airplane. \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \
fcs0 \f28 \i \fs36 \par \pard \brdrt \brdrnone \brdrw10
\brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f16 \i \fs36 \cf16 \
lang16393 AUTOMOBILES \plain \cs28 \rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f28 \i \
fs36 \cf16 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 In the U.S., people with epilepsy can drive
if their seizures are controlled with treatment and they meet the licensing
requirements in their state. The amount of time someone needs to be free of \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 seizures varies in
different states, but is \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 most likely to be between three months and a year. The majority of the 50
states place the burden on patients to report their condition to appropriate
licensing authorities so that their privileges can be revoked where appropriate. A
minority of states place the burden of reporting on the patient's physician. After
reporting is carried out, it is usually the driver's licensing agency that decides
to revoke or restrict a driver's license \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs36 \ltrch \fcs0 \f17 \i \fs36 \cf16 \par \pard \brdrt \brdrnone
\brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs30 \ltrch \fcs0 \f16 \i \fs30 \
cf16 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs30 \ltrch \fcs0 \f16 \i \fs30 \cf16 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs30 \ltrch \
fcs0 \f16 \i \fs30 \cf16 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs30 \ltrch \fcs0 \f16 \i \fs30 \cf16 \lang16393 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs30 \
ltrch \fcs0 \f16 \i \fs30 \cf16 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs30 \ltrch \fcs0 \f16 \i \fs30 \cf16 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs30 \ltrch \fcs0 \f16 \i \fs30 \cf16 \lang16393 NOTABLE CASES \plain \cs28 \rtlch
\fcs1 \ai \afs30 \ltrch \fcs0 \f28 \i \fs30 \cf16 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033
Many notable people, past and present, have carried the diagnosis of epilepsy. In
many cases, their epilepsy is a footnote to their accomplishments; for some, it
played an integral role in their fame. Historical diagnoses of epilepsy are not
always certain; there is controversy about what is considered an acceptable amount
of evidence in support of such a diagnosis .\plain \rtlch \fcs1 \afs30 \ltrch \fcs0
\f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs32 \ltrch \fcs0 \f28 \i \fs32 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \
ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \
cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \
fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \
ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb
\brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \
ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \
cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \
fcs0 \f10 \i \fs52 \cf11 \lang16393 CASE STUDY \plain \cs28 \rtlch \fcs1 \ai \afs52
\ltrch \fcs0 \f10 \i \fs52 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \ai \ab \afs30 \ltrch \fcs0 \f17 \i \b \fs30 \ul \cf7 \lang1033 A
longitudinal study of epilepsy in Kolkata\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 ,\plain \rtlch \fcs1 \ai \ab \afs30 \ltrch \fcs0 \f17 \i \
b \fs30 \ul \cf7 \lang1033 India.\plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \
fs30 \cf7 \lang1033 \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \
lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 PURPOSE: This study aimed to determine the
prevalence, incidence, and mortality rates of \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 epilepsy in the city of Kolkata, India. This is the
first such longitudinal study in a heterogeneous urban Indian population.\par \pard
\brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \ltrch \
fcs0 \f17 \fs30 \cf7 \lang1033 METHODS: A two-stage door-to-door survey of a
stratified random sample was undertaken within the municipal limits of Kolkata.
Trained field workers detected and interviewed the cases using a simple screening
questionnaire, and the detailed follow-up was done by neurologists. The survey was
conducted annually for five consecutive years from March 2003 through February
2008. \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 RESULTS: A total of 52,377 (52.74% men)
individuals were screened. There were 309 prevalent and 66 incident cases of active
epilepsy. The prevalence and average annual incidence rate (AAIR) with 95%
confidence interval (CIage-standardized to World Standard Population, were 572.8
(509.79-641.54) per 100,000 and 27.27 (21.03-34.80) per 100,000 per year,
respectively. The age-specific incidence rates of epilepsy showed bimodal
distribution. During the 5-year period, 20 cases of active epilepsy died. The
average annual mortality rate (AAMR) was \plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \
f17 \fs30 \cf7 \lang1033 7.63 (95% CI 4.45-11.26) per 100,000 population per year.
Compared to the general population of Kolkata, the all-cause standardized mortality
ratio (SMR) for persons with epilepsy was 2.58 overall (men 3.67; women \plain \
rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 1.77). There was no
significant difference between slum and non slum dwellers in epidemiologic
parameters.\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs30 \
ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \rtlch \fcs1 \afs30 \ltrch \fcs0 \f17 \fs30 \cf7 \lang1033 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
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\cf7 \lang1033 The AAIR of epilepsy is comparable to that observed in developed
countries, but AAMR is higher. The all-cause SMR for epilepsy relative to the
general population is, however, similar to that of developed nations. Wiley
Periodicals, Inc. \u169 ? 2010 International League Against Epilepsy\plain \rtlch \
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2cbe3390e5b410b85be18c2c43f56a55d443e9020820890412ba69f7d03a01041b7b1c15fb58688a6e8
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bae92c1b96b57184fe22c51ad2c89acb34c5da40636457aa208563c4be95676b923566a88ad8ea24c08
29ef599c0af0422a14cdf31d037734886af310e7d9777845437fbf351a0f97562119bee808932448219
5d34fb820820e823bf480a3f2c600f20fdd1ab4683fb7ed0380befca5408563c931dd5f64d4bb67b887
2558d95765c724ef1cf78f10ad78b7a7cf10aa1db5492c5c1285483c07386010c19b72cc1eda0aff009
9b11a944ee8e1e2181a236a0b4a4b76acf686be041e1215311d02bf04a5fdc82f1e65aab883e7e6018e
25d87c77820800af1ffd9550d7880c4a62a664441b96c64e8082082574fe6821820e8129c7fd8c5f912
e46c16bb73147ad7d309db87c72b8a4aed2c6afb5f314280c9384f7119924a101f514692888c4f3bcb8
488c870fa89898993654781078b6ff007972e8416d8c7a857a16ab0d78ee623ac028ea04d597815ee61
61e4d7a7782c0c71d08b498f63d5374f963a558c7678804994e2ca7c4c4a9b65ffc45b2ddb796ef3188
8e4d6d34767b984910136d68fe9001041d75f9860821e815ad0be80c7c7ef2a2b907240c074dadac943
4f34ea005aedcb01d20c630878022c17f8447616c4bcf0cd7409c8bc136e201fd9ea5690be92bbf47f5
03d84d300f3c420a5a0a72f73dcbf542957c4565301daa25306b45c1135857c918bd2728d70afdc6d42
ab0c069c3a80d3d97fca30a076584429170d87d470872150c5652590d7919f9ed08698e6c2f30a76aae
bbcbbd66b21884c897d010c10c32ba0b21820e90966a93b7b4ae522fe17312b8ccad7d9f40c91e10dd0
967ef1a49a5977e2cbe02af3794f536a8290c48e3a1c2fed2cdfb2cf881f48f899d46a691afea25ca27
470adfc3c40c5bce06fda7364a8558aea35823861f52ef81c9a7cc43947a5811915056d6a57a8dd962c
dd78861b3ea0795326009b100cb5dcef09529b1c7c40a992a3d561d14635e2041e1ae842297bddbc439
f3041d230752082182084451861644aaf51c087b371bab165f799fc1c66df4445410d80f06a2b558b85
3dae05b29e1ccab4d729ccb6076ab6be88aad10a55caf71051565309ee11b87a1687c9118c560d87892
4c95182f1b83f94529531d107248fde21b86cae1804c1eb8ebbd41cc18ba95adca690a5c23b17fe152d
8ac90aabce371c1e4b3ff00172a2691be9186082574370c10c10e61c455a9e0e370c478a95a121a350a
c5e748e491a58b1ff66493d52da847aa18651a3acfef1088397625a820bbc9ff0022c1309756c5594bd
d9b5e25f95c5e7e61b15ba068e5c76854502b79f98b3cd91fd86643bb1c0f8972e0c3a3cd31265c724c
29042c6b518c349a9d898fe13d210c3986574da0821821d41319a009f71e4ca3e3b233837fb4e6023f9
edf370d5e6d958c25e185fb43a4fe886d9c853db07f8b886d46dbd50ff252d4cd07686eea6e9a1e12a4
cdc591e7d4b08d61b3fec4df3231c9af889d9731dcbad7e8b8a3cc419402e310566148cc72fe2739711
d5e56e4960d6c13b9910c30e6195d3f820e93a83a4c7509ce372751b88cfd91bcd583b3a44f85761bef
df2f1f6db60f30c002343508f7d81b03b1fcc628cabbb727f7817b5ab1bb87407979ec8b542097b535e
e67a19bf2dc4bad02d3328cee471fa6ba1e6512ba8d4895d91996521be3cc128bab16ce5a99a84c30f7
d2a0c430f4d74fe2e830c30c30c60d12e9de040b050710a41ca04d48b0c23de1846a06fccb6660a11ae
34d3169c0d1ccc776055e7297fb8675056add94454ae44bb598b322d6fe7dcd71306c41634d82793513
9b0c53979972fa73d388626f2a66b8da41e74524bd31c1c902c79d86ff0078fee1ba72fb7982a1ab086
187aff1c30c30430c3307dcc220a0788a8d96fa4c8d9f31ba6c703b269950e4a1727aed03f8928d6201
96ec82e3e67c4679598950b0a34e041ca684cdacc76e6e307a1d0eada3d43f4876403be2941bb597b9a
741861861ebb7d754c30c30c331eea279829bbd1d20cb1573f0cb031650c2764e6345739338a8db61ca
db1a09707b4c31780fc0fe921086ba11660a0b8b3673da31deaec5c2502764ab842058a1de187139fe8
75d37fa861fd14c3d39a40cb17231eb23052cda6cbcc076b05fb8853ef129ed17bb859d8719aece8890
958e8420c184086e5d212eaf504d67ea27e714fb47c2172a2ad9ddc30c1b82187aeff504306bae7a759
599be95f3e267c730d24c99ce12cc553df98ee1a454022fbced427bedfdc0db67710e81788874210810
86e0f45c7e1c554c2a65672a027d9cb055f787f4730f5dbebafc7a0e3adac3714ae06000365ce516238
e3523eac1803183486eac512b1c5c7f73f7866194336b849f1984081084371508d90b8697cc038c507e
95e9fa7dbebf5e3bcd6095af732ef6f3322c4751ee4049dda1c6534c091a21e1e7f78a184c0b02ba85f
6984c3a3508aa105548fa407b2d34f3cf57666937fd17fb7afc7f43de6bd3921158ec033eebad258f11
1a6e8a948f012f9d275ba5e257a217d1832458d4f04a7518bca4f52e2b5cff00e46c52a79bbce1d7e53
97e9d50f68004d3d2f51f5f79ac2308dac217825d27140a4f3894eed678fb90e06af38a8aa394692e2e
30cb11e5c83cc0c42e5cd903b49538c6fdbea2542bf5390746831e8be4f78fea2e9e5fa17bfab3efd90
3c067094fd1de22c4426d651e25506eb12f69b44cc7aebb3fde669c0265bc91f19872f6b812d1f10e19
3530e230ea5659342bbb480855ed6100cab77c4619bfcffe4da9ff009ea527c8bff8898ad18060238e7
f4dd610a80f302fa797f505a3f4a57afb92bff440f5f7a55fe994ff00a651fef874cb490f9188123b50
7ed8aedbdb37b94ec4c2c63626122a42b6ae60728c89b3ea780fa9476e8234b00d0fca2fb5f6a791f73
c8fb8a58df0a001a0d188fd142db7fdc7f73f3097ff00be7e472dff006cbbfd52cff745ff00d914dfd8
8a5695f3ff00cfffd9}}\plain \rtlch \fcs1 \ltrch \fcs0 \f16 \fs18 \cf7 \lang1033 \par
\pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \
ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393
\par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \
ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \
brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \
brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \
brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \
shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \
lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \
brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \
brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \
fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \
afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \
brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \
brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \
brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \
ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \
cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \
brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \
brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \
ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \
brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \
brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \
brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \
sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \
fcs0 \f10 \i \fs52 \cf11 \lang16393 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \qc \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \cs28 \rtlch \fcs1 \ai \afs52 \ltrch \fcs0 \f10 \i \fs52 \cf11 \lang16393
BILOGRAPHY\plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \
lang16393 \plain \cs28 \rtlch \fcs1 \ai \afs60 \ltrch \fcs0 \f10 \i \fs60 \cf11 \
par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \
brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone
\brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs34 \ltrch \
fcs0 \f17 \fs34 \cf7 \lang1033 \u10146 ? http://en.wikipedia.org/wiki/Epilepsy \par
\pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs34 \ltrch \
fcs0 \f17 \fs34 \cf7 \lang1033 \u10146 ?http://answers.yahoo.com/question/index?
qid=20080712 105034AAiTvq8 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \
rtlch \fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7 \lang1033 \u10146
?http://search.yahoo.com/search?p=Epilepsy=csc_answe rs_us \par \pard \brdrt \
brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10
\brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar
\brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \
slmult1 \ltrpar \shading0 \plain \rtlch \fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7 \
lang1033 \u10146 ? {\field \fldedit {\*\fldinst HYPERLINK
"http://en.wikipedia.org/wiki/Epilepsy_in_animals"}{\fldrslt \plain \cs45 \rtlch \
fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \ulnone \cf7 \lang1033
http://en.wikipedia.org/wiki/Epilepsy_in_animals}}\plain \rtlch \fcs1 \afs34 \ltrch
\fcs0 \f17 \fs34 \cf7 \lang1033 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \
brdrb \brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \
brdrw10 \brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \
brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \
plain \rtlch \fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7 \lang1033 \u10146 ?
http://www.google.co.in/#hl=en=8_id=3=t& q=Epilepsy=p=psy-ab==
hp=1=Epilepsy=0=g4=_sm=& gs_upl==on.2,or.r_gc.r_pw.,cf.osb=ecb049eb56d1
82c6=1024=677\plain \rtlch \fcs1 \afs34 \ltrch \fcs0 \f17 \fs34 \cf7 \lang1033 \par
\pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \brdrnone \brdrw10 \brsp0 \brdrl \
brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10 \brsp0 \brdrbtw \brdrnone \
brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \lin0 \ri0 \rin0 \fi0 \ql \
sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \rtlch \fcs1 \ai \afs34 \
ltrch \fcs0 \f17 \i \fs34 \par \pard \brdrt \brdrnone \brdrw10 \brsp0 \brdrb \
brdrnone \brdrw10 \brsp0 \brdrl \brdrnone \brdrw10 \brsp0 \brdrr \brdrnone \brdrw10
\brsp0 \brdrbtw \brdrnone \brdrw10 \brsp0 \brdrbar \brdrnone \brdrw10 \brsp0 \li0 \
lin0 \ri0 \rin0 \fi0 \ql \sb0 \sa0 \sl240 \slmult1 \ltrpar \shading0 \plain \cs28 \
rtlch \fcs1 \ai \afs34 \ltrch \fcs0 \f17 \i \fs34 \par }