Idiopathic Generalized Epilepsies of Adolescence

Abstract

Summary: The prevalence of idiopathic generalized epilepsies (IGEs) has been assessed as being 15–20% of all epilepsies. The seizure types in IGEs are typical absences, myoclonic jerks, and generalized tonic–clonic seizures (TCS), alone or in varying combinations and with variable severity. The seizures tend to be more frequent on awakening and with sleep deprivation. This group of clinical conditions includes among others, age‐related epilepsy syndromes of adolescence such as juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), and IGE with generalized TCS or epilepsy with grand mal on awakening (EGMA). The classification of IGEs follows two schools of thought; one maintains that IGEs are a group of different and separate syndromes while the other suggests that IGEs are one biological continuum. Patients with IGEs may have mild impairment of cognitive functions, especially verbal memory and other frontal lobe functions, despite a normal IQ, and some seem to have characteristic personality traits, although further studies are needed to support this theory. They appear to lack a degree of self‐control, to neglect their physical needs, and are poorly compliant with therapy. Some patients become obstinate and are impressionable. The cognitive and behavioral aspects of these patients suggest an involvement of frontal lobes.

Concept analysis of impressionability among adolescents and young adults

“…Flexibility, susceptibility, openness, malleability, adaptability, plasticity, and vulnerability to attitude and behaviour change (Alwin et al, 1992; Beghi et al, 2006; Glantz & Mandel, 2005; Kinder & Sears, 1985; Krosnick & Alwin, 1989; Miller, 2005; Tyler & Schuller, 1991);…”

“…Being easily influenced and distracted by an external environment (Beghi et al, 2006; Fenush Jr & Hupcey, 2008; Fenwick et al, 2012; May et al, 2004; Walsh, 2011);…”

Impaired language function in generalized epilepsy: Inadequate suppression of the default mode network

“…Generalized epilepsy (GE) comprises a heterogeneous group of epilepsies of genetic origin with a widespread rather than focal atypical cortical activity [10,11]. Previous findings suggest subtle frontal executive impairments in GE patients having normal IQ [12].…”

Clinical Reasoning: A teenage girl with excessive daytime sleepiness, “fainting spells,” and dream mentations

“…Common IGEs in adolescents include juvenile absence epilepsy (JAE), JME, and IGE with generalized tonic-clonic seizures on awakening (GTCSA). 5 IGE with phantom absences is a newly described IGE, which is not as yet accepted as a separate entity by the International League Against Epilepsy. It is characterized by phantom absences, infrequent GTCS, and absence status epilepticus.…”