All details about epilepsy and seizure
Epilepsy and seizure defination epidemiology pathophysiology investigation management treatment prevention all data with reference
"epilepsy"[MeSH Terms] AND "seizures"[MeSH Terms]
epilepsy seizure definition epidemiology pathophysiology management 2024 guidelines
| Section | Key Content |
|---|---|
| 1. Definitions | ILAE 2014 definition of epilepsy, seizure, status epilepticus |
| 2. Epidemiology | 50 million globally, incidence/prevalence data, age patterns |
| 3. Etiology | Structural, genetic, metabolic, immune, infectious, unknown |
| 4. Classification | ILAE 2017 focal vs. generalized; all seizure subtypes with descriptions |
| 5. Pathophysiology | Excitation/inhibition imbalance, PDS, channelopathies, hippocampal sclerosis, genetics |
| 6. Clinical Presentation | Auras by localization, tonic-clonic phases, postictal features |
| 7. Investigations | EEG, MRI protocol, blood tests, LP, genetic/autoimmune workup |
| 8. Management/Treatment | Acute first aid → Status epilepticus protocol → Chronic ASMs (full table) → Surgery → VNS/RNS/DBS → Ketogenic diet |
| 9. Drug-induced seizures | Metabolic causes; ineffectiveness of ASMs if underlying cause not treated |
| 10. Prevention | Primary, secondary, tertiary prevention strategies |
| 11. Special populations | Pregnancy, elderly, children |
| 12. Prognosis | 70% seizure-free; pharmacoresistance; surgical outcomes; SUDEP |
| 13. References | 15 authoritative references (textbooks + ILAE + AAN + PubMed) |
Give uper all information in ppt
ls -la /home/daytona/workspace/
mkdir -p /home/daytona/workspace/epilepsy-ppt
~/epilepsy-ppt/epilepsy.js
const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Epilepsy and Seizures - Complete Clinical Reference";
pres.author = "Orris Medical";
// ─── COLOR PALETTE ──────────────────────────────────────────────
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// ─── HELPERS ────────────────────────────────────────────────────
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// ═══════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════
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s.addText("Sources: Adams & Victor | Bradley & Daroff | Katzung | WHO 2024 | ILAE 2017", {
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// ═══════════════════════════════════════════════════════
// SLIDE 2 — CONTENTS
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["01", "Definitions"],
["02", "Epidemiology"],
["03", "Etiology"],
["04", "Classification of Seizures"],
["05", "Pathophysiology"],
["06", "Clinical Presentation"],
["07", "Investigations"],
["08", "Management & Treatment"],
["09", "Antiseizure Medications"],
["10", "Non-Pharmacological Treatment"],
["11", "Prevention & Prognosis"],
["12", "References"],
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// ═══════════════════════════════════════════════════════
// SLIDE 3 — DEFINITIONS
// ═══════════════════════════════════════════════════════
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// Seizure card
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"A transient event of signs/symptoms due to abnormal, excessive, and hypersynchronous neuronal activity in the brain. May manifest as involuntary movements, altered consciousness, sensory disturbance, autonomic phenomena, or psychic symptoms.",
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{ text: "2. One unprovoked seizure + ≥60% probability of recurrence over next 10 years\n", options: { color: C.textLight } },
{ text: "3. Diagnosis of an epilepsy syndrome", options: { color: C.textLight } },
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// Status card
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// ═══════════════════════════════════════════════════════
// SLIDE 4 — EPIDEMIOLOGY
// ═══════════════════════════════════════════════════════
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{ val: "50M", label: "People worldwide\nhave epilepsy", col: C.accentTeal },
{ val: "80%", label: "Cases in low/middle-\nincome countries", col: C.accentGold },
{ val: "70%", label: "Can be seizure-free\nif treated", col: C.green },
{ val: "3×", label: "Higher premature\ndeath risk", col: C.red },
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["Annual incidence (US)", "~44 new cases per 100,000 persons/year"],
["Lifetime prevalence (US)", "~3% lifetime risk of receiving an epilepsy diagnosis"],
["Active epilepsy prevalence", "~0.8% of the general population"],
["Age of onset peaks", "Early childhood (first year of life) and after age 60"],
["First seizure lifetime risk", "~9% of all people will have at least one seizure in their lifetime"],
["Treatment gap (low-income)", "Up to 75% of patients receive no treatment"],
["Most common cause after 60", "Cerebrovascular disease"],
];
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// ═══════════════════════════════════════════════════════
// SLIDE 5 — ETIOLOGY
// ═══════════════════════════════════════════════════════
{
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darkSlide(s);
sectionBar(s, "03 | Etiology");
const cats = [
{ title: "Structural", color: "1A5276", items: ["Hippocampal/mesial temporal sclerosis", "Cortical dysplasia & malformations", "Tumors (primary or metastatic)", "Cerebrovascular disease (leading cause >60yr)", "Traumatic brain injury", "Encephalitis / meningitis"] },
{ title: "Genetic", color: "1A4731", items: ["SCN1A mutation → Dravet syndrome", "KCNQ2/3 → Benign neonatal epilepsy", "CHRNA4 → Nocturnal frontal lobe epilepsy", "Monozygotic twin concordance: 70%", "Familial incidence: 5-10% of primary epilepsies", "Polygenic contributions common"] },
{ title: "Metabolic", color: "4A1942", items: ["Hypoglycemia, hyponatremia, hypocalcemia", "Hypomagnesemia, hypernatremia", "Renal failure (uremia)", "Hepatic encephalopathy, thyrotoxicosis", "Porphyria", "Alcohol/BZD withdrawal"] },
{ title: "Immune / Infectious", color: "4A2E0A", items: ["Anti-NMDAR, anti-LGI1, anti-CASPR2", "Autoimmune encephalitis", "Neurocysticercosis (global leading cause)", "Cerebral malaria, HIV", "Bacterial meningitis", "Viral encephalitis"] },
];
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});
});
});
}
// ═══════════════════════════════════════════════════════
// SLIDE 6 — CLASSIFICATION (ILAE 2017)
// ═══════════════════════════════════════════════════════
{
const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "04 | Classification of Seizures (ILAE 2017)");
// Focal
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accentLine(s, 0.45, 1.6, 2.65);
const focalItems = [
["Focal Aware", "Simple partial — consciousness preserved; aura, Jacksonian march"],
["Focal Impaired", "Complex partial — consciousness impaired; automatisms"],
["Focal → Bilateral", "Formerly 'secondarily generalized'; starts focal, spreads bilaterally"],
];
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// Generalized
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s.addText("(both hemispheres from onset)", { x: 3.7, y: 1.28, w: 3.85, h: 0.28, fontSize: 10, color: "7A9CC0", fontFace: "Calibri", align: "center", margin: 0 });
accentLine(s, 3.75, 1.6, 3.75);
const genItems = [
["Tonic-Clonic (Grand Mal)", "LOC → tonic stiffening → clonic jerking; <3 min; postictal confusion"],
["Absence (Petit Mal)", "4-20 sec staring; no postictal state; 3 Hz spike-wave; onset 5-7 yr"],
["Myoclonic", "Brief (<100 ms) muscle jerks; juvenile myoclonic epilepsy, Dravet"],
["Atonic (Drop Attacks)", "Sudden loss of muscle tone; Lennox-Gastaut syndrome"],
["Epileptic Spasms", "Sudden flexion/extension; West syndrome (infantile spasms)"],
];
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});
// Unknown
card(s, 7.85, 0.88, 1.9, 4.5, "1A2A1A");
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accentLine(s, 7.95, 1.35, 1.7);
s.addText("Seizure onset cannot be determined from available information.", {
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});
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s.addText("Insufficient information or unusual presentation.", { x: 7.92, y: 3.1, w: 1.76, h: 0.8, fontSize: 10, color: C.textLight, fontFace: "Calibri", margin: 0 });
s.addText("Source: ILAE 2017 Operational Classification", { x: 0.35, y: 5.25, w: 9.3, h: 0.28, fontSize: 9, color: "607080", fontFace: "Calibri", margin: 0 });
}
// ═══════════════════════════════════════════════════════
// SLIDE 7 — PATHOPHYSIOLOGY
// ═══════════════════════════════════════════════════════
{
const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "05 | Pathophysiology");
card(s, 0.25, 0.88, 9.5, 1.05, "0D2136");
s.addText("Core Mechanism:", { x: 0.42, y: 0.94, w: 2.2, h: 0.38, fontSize: 13, bold: true, color: C.accentTeal, fontFace: "Calibri", margin: 0 });
s.addText("Sudden imbalance between excitation (glutamate ↑) and inhibition (GABA ↓) in cortical neuronal networks → Excessive, abnormal, synchronous discharge", {
x: 2.65, y: 0.94, w: 7.0, h: 0.9, fontSize: 12, color: C.white, fontFace: "Calibri", margin: 0
});
const pathCards = [
{ title: "PDS — Paroxysmal Depolarization Shift", color: "152A40", text: "Large sustained neuronal depolarization with burst of action potentials, followed by hyperpolarization. In normal tissue, inhibitory surround contains the discharge. When inhibition fails → seizure spreads." },
{ title: "Ion Channel Dysfunction", color: "152A40", text: "Persistent Na+ currents (SCN1A mutation = Dravet), T-type Ca²+ channels (absence seizures via thalamocortical loops), voltage-gated K+ channel dysfunction (KCNQ2/3 = benign neonatal epilepsy)." },
{ title: "Hippocampal Sclerosis", color: "152A40", text: "Neuronal loss in CA1 sector (Sommer sector) + gliosis. Most common substrate in temporal lobe epilepsy. Detected by MRI. Surgical resection achieves 70% seizure freedom." },
{ title: "Consequences of Chronic Seizures", color: "1A1A0A", text: "Accelerated cortical thinning (neurodegeneration), hippocampal atrophy, memory/cognitive impairment, SUDEP risk (Sudden Unexpected Death in Epilepsy)." },
];
pathCards.forEach((pc, i) => {
const col = i < 2 ? 0 : 1;
const row = i < 2 ? i : i - 2;
const x = 0.25 + col * 4.88;
const y = 2.1 + row * 1.62;
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s.addText(pc.title, { x: x + 0.15, y: y + 0.1, w: 4.35, h: 0.32, fontSize: 12, bold: true, color: C.accentGold, fontFace: "Calibri", margin: 0 });
s.addText(pc.text, { x: x + 0.15, y: y + 0.45, w: 4.35, h: 0.92, fontSize: 10.5, color: C.textLight, fontFace: "Calibri", margin: 0 });
});
}
// ═══════════════════════════════════════════════════════
// SLIDE 8 — CLINICAL PRESENTATION
// ═══════════════════════════════════════════════════════
{
const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "06 | Clinical Presentation");
// Left: Phases
card(s, 0.25, 0.88, 4.7, 4.55, "0D2136");
s.addText("Tonic-Clonic Seizure Phases", { x: 0.38, y: 0.95, w: 4.44, h: 0.35, fontSize: 13, bold: true, color: C.accentTeal, fontFace: "Calibri", margin: 0 });
accentLine(s, 0.38, 1.33, 4.44);
const phases = [
{ phase: "PRODROME", desc: "Hours before: irritability, apathy, or ecstasy (not the aura itself)", col: "7A9CC0" },
{ phase: "AURA", desc: "Initial focal seizure; olfactory (mesial temporal), visual (occipital), déjà vu (temporal), fear/formed hallucinations (amygdalo-hippocampal)", col: C.accentGold },
{ phase: "TONIC PHASE", desc: "Sudden cry, loss of consciousness, tonic extension of limbs (~10-30 sec)", col: C.red },
{ phase: "CLONIC PHASE", desc: "Rhythmic jerking, tongue biting, incontinence (~1-2 min)", col: C.orange },
{ phase: "POSTICTAL", desc: "Confusion, headache, fatigue, Todd's paresis (transient focal weakness)", col: C.green },
];
phases.forEach((p, i) => {
s.addText(p.phase, { x: 0.38, y: 1.42 + i * 0.76, w: 1.5, h: 0.28, fontSize: 10, bold: true, color: p.col, fontFace: "Calibri", margin: 0 });
s.addText(p.desc, { x: 0.38, y: 1.7 + i * 0.76, w: 4.44, h: 0.42, fontSize: 10, color: C.textLight, fontFace: "Calibri", margin: 0 });
});
// Right: Aura localization table
card(s, 5.2, 0.88, 4.55, 4.55, "0D2136");
s.addText("Aura → Seizure Focus Localization", { x: 5.32, y: 0.95, w: 4.3, h: 0.35, fontSize: 13, bold: true, color: C.accentGold, fontFace: "Calibri", margin: 0 });
accentLine(s, 5.32, 1.33, 4.3);
const auras = [
["Somatosensory", "Contralateral post-rolandic"],
["Visual (unformed)", "Occipital cortex"],
["Olfactory", "Mesial temporal"],
["Gustatory", "Insula"],
["Auditory", "Heschl gyri"],
["Déjà vu / dreamy state", "Temporal lobe"],
["Fear / formed hallucination", "Amygdalo-hippocampal"],
["Vertigo", "Superior temporal"],
["Automatisms", "Temporal / frontal"],
];
auras.forEach((a, i) => {
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s.addShape(pres.shapes.RECTANGLE, { x: 5.32, y: 1.42 + i * 0.36, w: 4.3, h: 0.36, fill: { color: bg }, line: { color: bg } });
s.addText(a[0], { x: 5.38, y: 1.46 + i * 0.36, w: 2.1, h: 0.28, fontSize: 10, color: C.textLight, fontFace: "Calibri", margin: 0 });
s.addText(a[1], { x: 7.5, y: 1.46 + i * 0.36, w: 2.08, h: 0.28, fontSize: 10, color: C.accentTeal, fontFace: "Calibri", margin: 0 });
});
}
// ═══════════════════════════════════════════════════════
// SLIDE 9 — INVESTIGATIONS
// ═══════════════════════════════════════════════════════
{
const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "07 | Investigations");
const invCols = [
{
title: "EEG (Most Important)",
color: "0D2545",
accentC: C.accentTeal,
items: [
"Interictal EEG: epileptiform discharges (spikes, sharp waves)",
"3 Hz spike-wave → Childhood Absence Epilepsy",
"Hypsarrhythmia → West Syndrome (Infantile Spasms)",
"Centrotemporal spikes → BECTS",
"Video-EEG: gold standard for presurgical evaluation",
"Continuous EEG: after paralytics in ICU for non-convulsive status",
]
},
{
title: "Neuroimaging",
color: "0D2545",
accentC: C.accentGold,
items: [
"MRI brain (epilepsy protocol) — preferred",
"Detects hippocampal sclerosis, cortical dysplasia, tumors",
"Sequences: T1 volumetric, FLAIR, T2, DWI, gadolinium",
"CT brain: acute hemorrhage, trauma, MRI unavailable",
]
},
{
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"Glucose, electrolytes (Na⁺, Ca²⁺, Mg²⁺), BUN, creatinine",
"LFTs, TFTs, FBC",
"Toxicology screen (alcohol, drugs, bupropion, tramadol)",
"ASM drug levels if on treatment",
"Pregnancy test in women of childbearing age",
]
},
{
title: "Other Investigations",
color: "0D2545",
accentC: C.red,
items: [
"LP: if CNS infection suspected (NOT during active seizure)",
"Autoimmune panel: anti-NMDAR, anti-LGI1, anti-CASPR2",
"Genetic testing: whole exome for suspected genetic epilepsy",
"Neuropsychological testing: cognitive/memory lateralization",
"PET, SPECT, intracranial EEG for presurgical planning",
]
},
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}
// ═══════════════════════════════════════════════════════
// SLIDE 10 — STATUS EPILEPTICUS MANAGEMENT
// ═══════════════════════════════════════════════════════
{
const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "08 | Status Epilepticus — Emergency Management");
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{ time: "5-20 min", title: "BENZODIAZEPINES (1st Line)", color: "1A2E1A", textC: C.green, items: ["IV Lorazepam 2-4 mg (preferred; duration 12-24 h)", "IM Midazolam 10 mg (if no IV access; non-inferior)", "IV Diazepam 5-10 mg (faster onset; shorter duration)", "Goal: terminate seizure activity immediately"] },
{ time: "20-40 min", title: "2nd LINE AEDs", color: "2E2A10", textC: C.accentGold, items: ["Fosphenytoin IV 20 mg/kg (preferred over phenytoin)", "Valproate IV 20-40 mg/kg", "Levetiracetam IV 60 mg/kg (up to 4.5 g)", "Lacosamide IV 200-400 mg"] },
{ time: ">40-60 min", title: "REFRACTORY — ICU", color: "2E1010", textC: C.red, items: ["Intubation + general anesthesia", "Propofol IV infusion OR Midazolam infusion OR Pentobarbital", "Continuous EEG monitoring (mandatory post-paralytics)", "Do NOT perform LP during active status epilepticus", "CT/MRI once seizures controlled"] },
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}
// ═══════════════════════════════════════════════════════
// SLIDE 11 — ANTISEIZURE MEDICATIONS TABLE
// ═══════════════════════════════════════════════════════
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const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "09 | Antiseizure Medications (ASMs)");
// Table header
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["Valproic Acid", "Depakote", "1,000-3,000 mg/d", "6-15 h", "50-100 µg/mL", "GTC, Absence, Myoclonic — broad spectrum"],
["Phenytoin", "Dilantin", "300-400 mg/d", "12-36 h", "10-20 µg/mL", "Focal, GTC"],
["Carbamazepine", "Tegretol", "600-1,200 mg/d", "14-25 h", "4-12 µg/mL", "Focal seizures"],
["Oxcarbazepine", "Trileptal", "900-2,400 mg/d", "1-5 h", "—", "Focal seizures"],
["Lamotrigine", "Lamictal", "300-500 mg/d", "15-60 h", "2-7 µg/mL", "Focal, Absence, GTC — broad spectrum"],
["Levetiracetam", "Keppra", "500-3,000 mg/d", "6-8 h", "—", "Focal, GTC — broad spectrum"],
["Ethosuximide", "Zarontin", "750-1,500 mg/d", "20-60 h", "50-100 µg/mL", "Absence seizures ONLY"],
["Lacosamide", "Vimpat", "300-400 mg/d", "13 h", "—", "Focal seizures"],
["Topiramate", "Topamax", "400 mg/d", "20-30 h", "—", "Focal, GTC"],
["Phenobarbital", "Luminal", "90-200 mg/d", "40-120 h", "15-40 µg/mL", "GTC, Focal (older agent)"],
];
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// ═══════════════════════════════════════════════════════
// SLIDE 12 — MECHANISMS OF ACTION
// ═══════════════════════════════════════════════════════
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const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "09b | Mechanisms of Action of ASMs");
const mechs = [
{ title: "Na⁺ Channel Blockade", color: "0D2545", drugs: "Phenytoin, Carbamazepine,\nOxcarbazepine, Lamotrigine,\nLacosamide", text: "Reduces sustained high-frequency neuronal firing by blocking voltage-gated sodium channels in their inactivated state. Effective for focal and tonic-clonic seizures." },
{ title: "GABA Enhancement", color: "1A2E1A", drugs: "Benzodiazepines, Barbiturates,\nValproate, Vigabatrin,\nClobazam", text: "Potentiates GABAergic inhibition. BZDs and barbiturates act on GABA-A receptor. Valproate increases GABA synthesis/reduces catabolism. Vigabatrin irreversibly inhibits GABA-T." },
{ title: "T-type Ca²⁺ Channel Block", color: "2E2A10", drugs: "Ethosuximide, Valproate", text: "Specifically targets thalamocortical circuits underlying absence seizures. T-type calcium channels generate rhythmic 3 Hz spike-wave activity; their blockade abolishes absence seizures." },
{ title: "SV2A Modulation", color: "2E1010", drugs: "Levetiracetam, Brivaracetam", text: "Binds synaptic vesicle protein 2A — unique mechanism not shared by other ASMs. Reduces neurotransmitter release from presynaptic terminals." },
{ title: "AMPA Receptor Antagonism", color: "1A1A30", drugs: "Perampanel", text: "Non-competitive AMPA glutamate receptor antagonist. Reduces glutamate-mediated excitation. Approved for focal and generalized tonic-clonic seizures." },
{ title: "HCN Channel Modulation", color: "1A2040", drugs: "Lamotrigine, Gabapentin,\nPregabalin", text: "Gabapentin/pregabalin bind α2δ subunit of voltage-gated Ca²+ channels, reducing excitatory neurotransmitter release." },
];
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// ═══════════════════════════════════════════════════════
// SLIDE 13 — NON-PHARMACOLOGICAL TREATMENT
// ═══════════════════════════════════════════════════════
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const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "10 | Non-Pharmacological Treatment");
const nonPharm = [
{
title: "Epilepsy Surgery",
icon: "🔬",
color: "0D2545",
textC: C.accentTeal,
items: [
"For pharmacoresistant epilepsy (failed ≥2 ASMs)",
"Temporal lobectomy: 70% seizure-free",
"Extratemporal resection: lower success",
"Lesionectomy: curative for structural lesions",
"Presurgical: Video-EEG, MRI, neuropsychology, PET, SPECT",
]
},
{
title: "Neuromodulation",
icon: "⚡",
color: "1A2E1A",
textC: C.green,
items: [
"VNS (Vagus Nerve Stimulator): open-loop; refractory focal seizures + LGS",
"RNS (Responsive Neurostimulator): closed-loop intracranial device",
"DBS (Deep Brain Stimulation): bilateral anterior thalamic nuclei",
"All three devices approved for drug-refractory epilepsy",
]
},
{
title: "Ketogenic Diet",
icon: "🥑",
color: "2E2A10",
textC: C.accentGold,
items: [
"High fat, low carbohydrate, controlled protein",
"First-line for GLUT1 deficiency syndrome",
"Especially effective: myoclonic epilepsies, infantile spasms,",
"Dravet syndrome, tuberous sclerosis, LGS",
"Benefits both children and adults (Chen et al., 2023)",
]
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{
title: "Immunotherapy",
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color: "2E1010",
textC: C.red,
items: [
"For autoimmune/paraneoplastic epilepsy",
"1st line: Corticosteroids, IVIG, Plasmapheresis",
"2nd line: Rituximab, Mycophenolate, Azathioprine",
"ACTH or Vigabatrin for West syndrome",
]
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}
// ═══════════════════════════════════════════════════════
// SLIDE 14 — PREVENTION
// ═══════════════════════════════════════════════════════
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darkSlide(s);
sectionBar(s, "11 | Prevention");
const prevLevels = [
{
level: "PRIMARY PREVENTION",
subtitle: "Avoiding the first seizure",
color: "0D2545",
textC: C.accentTeal,
items: [
"Prevent/treat CNS infections promptly",
"Prevention of head trauma (helmets, seat belts)",
"Good prenatal care (prevent birth injuries, HIE)",
"Control cardiovascular risk factors → prevent stroke",
"Avoid precipitants: sleep deprivation, alcohol excess",
"Lead/heavy metal poisoning prevention (children)",
]
},
{
level: "SECONDARY PREVENTION",
subtitle: "Preventing seizure recurrence",
color: "1A2E1A",
textC: C.green,
items: [
"After 2 unprovoked seizures: ASM strongly recommended",
"After 1 seizure + high recurrence risk: start ASM",
"(structural lesion, epileptiform EEG, prior brain injury)",
"AAN 2015 guideline (reaffirmed Feb 2024)",
"Febrile seizures: prophylactic ASMs NOT routinely recommended",
"Medication adherence: most important factor for seizure control",
]
},
{
level: "TERTIARY PREVENTION",
subtitle: "Reducing the impact of chronic epilepsy",
color: "2E2A10",
textC: C.accentGold,
items: [
"Regular follow-up, medication optimization",
"SUDEP awareness: nocturnal supervision, detection devices",
"Driving restriction counseling (seizure-free period required)",
"Rescue benzodiazepines: intranasal midazolam, diastat",
"Mental health support (anxiety/depression 2-3x higher)",
"Seizure action plans for patients and caregivers",
]
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// ═══════════════════════════════════════════════════════
// SLIDE 15 — SPECIAL POPULATIONS & PROGNOSIS
// ═══════════════════════════════════════════════════════
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const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "11b | Special Populations & Prognosis");
// Special populations
const pops = [
{ title: "Pregnancy", color: "1A2545", textC: C.accentTeal, items: ["Continue ASMs — uncontrolled seizures risk fetal hypoxia", "Valproate: highest teratogenicity — avoid if alternatives exist", "Lamotrigine / Levetiracetam: relatively safer", "Folic acid supplementation mandatory pre-conception"] },
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"SUDEP risk: ~1/1,000 person-years in general epilepsy; up to 1/150 in severe drug-resistant epilepsy",
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// ═══════════════════════════════════════════════════════
// SLIDE 16 — REFERENCES
// ═══════════════════════════════════════════════════════
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const s = pres.addSlide();
darkSlide(s);
sectionBar(s, "12 | References");
const refs = [
"1. Adams and Victor's Principles of Neurology, 12th Ed. — Chapter 15: Epilepsy and Other Seizure Disorders",
"2. Bradley and Daroff's Neurology in Clinical Practice — Chapter 100: Seizures and Epilepsy Definitions",
"3. Katzung's Basic and Clinical Pharmacology, 16th Ed. — Chapter 24: Antiseizure Medications",
"4. Tintinalli's Emergency Medicine: A Comprehensive Study, 9th Ed. — Chapter 171: Treatment of Status Epilepticus",
"5. Eric Kandel's Principles of Neural Science, 6th Ed. — Seizure Focus and Surgical Treatment",
"6. Harriet Lane Handbook, 23rd Ed. — Status Epilepticus Treatment Guidelines",
"7. Fisher RS et al. ILAE Official Report: A practical clinical definition of epilepsy. Epilepsia 2014; 55(4):475-482",
"8. Scheffer IE et al. ILAE classification of the epilepsies. Epilepsia 2017; 58(4):512-521",
"9. WHO Epilepsy Fact Sheet, February 2024",
"10. AAN/AES Practice Guideline: Management of an Unprovoked First Seizure in Adults. Neurology 2015; 84(16):1705. Reaffirmed Feb 2024",
"11. Pressler RM et al. Treatment of seizures in the neonate: ILAE Task Force. Epilepsia 2023 Oct [PMID: 37655702]",
"12. Chu H et al. Antiseizure medications for idiopathic generalized epilepsies. J Neurol 2023 [PMID: 37378757]",
"13. Chen S et al. Ketogenic Diet and Multiple Health Outcomes: Umbrella Review. Nutrients 2023 [PMID: 37836444]",
"14. NAEC 2023 Guidelines for Specialized Epilepsy Centers. Neurology 2024 Feb",
"15. Hauser WA, Annegers JF. Epidemiology of epilepsy. Textbook of Epilepsy, 1992",
];
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// ═══════════════════════════════════════════════════════
// SLIDE 17 — CLOSING
// ═══════════════════════════════════════════════════════
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accentLine(s, 2, 0.95, 6);
const takeaways = [
["50 million people", "worldwide have epilepsy; 80% in low/middle-income countries"],
["ILAE 2014 definition", "requires ≥2 unprovoked seizures or 1 seizure with ≥60% recurrence risk"],
["Core mechanism", "is glutamate excess + GABA deficit → excessive synchronized neuronal discharge"],
["EEG + MRI", "are the cornerstone investigations for all seizure presentations"],
["Monotherapy first", "achieves seizure control in ~2/3 of patients; pharmacoresistance in ~30%"],
["Status epilepticus", "lorazepam → fosphenytoin/levetiracetam → anesthesia within 30 minutes"],
["Surgery, VNS, RNS/DBS", "and ketogenic diet are options for drug-refractory epilepsy"],
["Prevention", "addresses primary (avoid first seizure), secondary (prevent recurrence), tertiary (reduce impact)"],
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// ─── WRITE FILE ─────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/epilepsy-ppt/Epilepsy_and_Seizures.pptx" })
.then(() => console.log("SUCCESS: /home/daytona/workspace/epilepsy-ppt/Epilepsy_and_Seizures.pptx"))
.catch(e => { console.error("ERROR:", e); process.exit(1); });
cd /home/daytona/workspace/epilepsy-ppt && node epilepsy.js
node -e "const p = require('pptxgenjs'); const pres = new p(); console.log(Object.keys(pres.shapes).filter(k => k.includes('RECT') || k.includes('ELLIP') || k.includes('OVAL') || k.includes('ROUND')));"
~/epilepsy-ppt/epilepsy.js
Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/epilepsy-ppt/epilepsy.js'
cd /home/daytona/workspace/epilepsy-ppt && node epilepsy.js
Epilepsy and Seizures
Presentation · PPTX
| Slide | Content |
|---|---|
| 1 | Title slide |
| 2 | Contents / outline |
| 3 | Definitions (Seizure, Epilepsy ILAE 2014, Status Epilepticus) |
| 4 | Epidemiology (stat cards + full data table) |
| 5 | Etiology (4 column cards: Structural / Genetic / Metabolic / Immune-Infectious) |
| 6 | Classification of Seizures - ILAE 2017 (Focal / Generalized / Unknown) |
| 7 | Pathophysiology (PDS, ion channels, hippocampal sclerosis, chronic consequences) |
| 8 | Clinical Presentation (seizure phases + aura localization table) |
| 9 | Investigations (EEG, MRI, blood tests, other workup) |
| 10 | Status Epilepticus Emergency Protocol (4-step timeline) |
| 11 | Antiseizure Medications full table (10 drugs with doses, half-life, target levels) |
| 12 | Mechanisms of Action (6 drug classes) |
| 13 | Non-Pharmacological Treatment (Surgery, VNS/RNS/DBS, Ketogenic Diet, Immunotherapy) |
| 14 | Prevention (Primary / Secondary / Tertiary) |
| 15 | Special Populations + Prognosis |
| 16 | 15 References (textbooks + ILAE + AAN + PubMed PMIDs) |
| 17 | Key Takeaways closing slide |