ABSTRACT

Idiopathic generalised epilepsies (IGEs) constitute one-third of all epilepsies and the majority start during childhood or adolescence in otherwise healthy individuals. IGEs are genetically determined. Three main types of seizures in IGEs are typical absences, generalised tonic-clonic seizures and myoclonic seizures. The predominance of those seizure subtypes and age at onset of epilepsy are major factors in the recognition of different clinical sub-groups of IGEs. The EEG is the most informative test in IGEs. The EEG reveals ictal, or, interictal generalized discharges of spike-waves or multiple spike-waves on a normal background activity in patients with IGEs. Paroxysmal discharges in the EEG are mostly precipitated by hyperventilation and intermittent photic stimulation (IPS) as also, following sleep deprivation. Molecular genetic studies in recent years point to candidate genes and loci in IGEs. Genetic mutations in subunits of GABAA receptors are demonstrated as strong implications in the role of GABAA receptors in IGEs. Valproic acid, lamotrigine, ethosuximide and levetiracetam are major anti- epileptic drugs (AED) used in the treatment of IGEs depending on the type of the IGE sub-group. AEDs used for focal epilepsies can be detrimental in IGEs.