Idiopathic generalized epilepsy

Idiopathic Generalized Epilepsy (IGE) is a group of epileptic syndromes that are characterized by seizures with no identifiable cause. These syndromes are primarily genetic or presumed genetic in origin. IGE typically manifests during childhood or adolescence, but onset can occur at any age. The term "idiopathic" is used when the epilepsy is not secondary to another condition, and "generalized" refers to seizures that involve both hemispheres of the brain from the onset.

Classification

IGE is classified into several syndromes based on the type of seizures and age of onset. These include:

• Childhood Absence Epilepsy (CAE)
• Juvenile Absence Epilepsy (JAE)
• Juvenile Myoclonic Epilepsy (JME)
• Generalized Tonic-Clonic Seizures alone
• Other less common syndromes

Symptoms

Symptoms vary depending on the specific syndrome but generally include different types of generalized seizures such as absence seizures, myoclonic seizures, and generalized tonic-clonic seizures. Absence seizures often manifest as brief lapses in awareness, while myoclonic seizures involve sudden jerks of the body. Generalized tonic-clonic seizures are characterized by stiffening of the body followed by jerking movements.

Diagnosis

Diagnosis of IGE is based on the clinical history, seizure types, and findings on electroencephalogram (EEG). An EEG in individuals with IGE often shows specific patterns, such as generalized spike-and-wave or polyspike-and-wave discharges. Genetic testing may also be helpful in some cases to identify specific genetic mutations associated with IGE.

Treatment

Treatment of IGE typically involves antiepileptic drugs (AEDs) that are effective against generalized seizures. The choice of medication depends on the specific syndrome and the patient's response to treatment. Commonly used AEDs include valproate, lamotrigine, and levetiracetam. Lifestyle modifications and avoidance of seizure triggers are also important aspects of management.

Prognosis

The prognosis for individuals with IGE varies. Some syndromes, such as CAE, often resolve by adulthood, while others, such as JME, may require lifelong treatment. The response to treatment and long-term outcome can also vary widely among individuals.

Epidemiology

IGE accounts for a significant proportion of all epilepsies, with estimates ranging from 15% to 20%. It affects both males and females equally and has a worldwide distribution.