CSWS Epilepsy: Symptoms & Treatment
CSWS Epilepsy: Symptoms & Treatment CSWS syndrome can be a challenge for both children and their families, as it can impact various aspects of a child’s life, including sleep patterns and development. Understanding the signs and symptoms is crucial for early recognition and intervention.
Additionally, we will discuss the possible causes and triggers of CSWS epilepsy, as well as the diagnostic process involved in confirming a diagnosis. It’s essential to identify and differentiate CSWS epilepsy from other types of seizures in children to provide appropriate treatment and support.
We will explore various treatment options, both medical and non-medical, that aim to control seizures, optimize sleep patterns, and enhance developmental outcomes for children with CSWS syndrome.
Furthermore, we will discuss specific medications commonly used in the treatment of CSWS epilepsy, their mechanisms of action, and potential side effects. We will also explore non-medical interventions, such as lifestyle modifications and alternative therapies, that may complement traditional medical treatments.
Long-term management is crucial in the effective management of CSWS epilepsy. We will address the importance of regular follow-ups, ongoing seizure monitoring, and interventions to support the overall well-being and development of children diagnosed with this syndrome.
Stay with us to learn about the latest research and advancements in CSWS epilepsy, as well as the importance of seeking support for both families and caregivers. We will provide resources, advocacy groups, and support networks that can offer assistance and guidance throughout the journey of managing CSWS syndrome.
Finally, our article will present expert opinions and insights from Acibadem Healthcare Group, a trusted healthcare provider with expertise in diagnosing and treating CSWS syndrome. Their recommendations will further guide individuals seeking specialized care for this condition.
Understanding CSWS Epilepsy
CSWS epilepsy, also known as pediatric epilepsy syndrome, is a seizure disorder that primarily affects children. It is characterized by continuous spikes and waves during slow-wave sleep. In this section, we will explore the prevalence of epilepsy in children and its classification as a pediatric epilepsy syndrome. Furthermore, we will discuss the distinctive features of CSWS epilepsy compared to other types of seizure disorders in kids.
Epilepsy is a neurological condition that causes recurring seizures due to abnormal brain activity. While epilepsy can affect individuals of all ages, it is particularly prevalent in children. Pediatric epilepsy syndromes, such as CSWS epilepsy, are specific types of epilepsy that occur in childhood.
CSWS epilepsy stands for continuous spikes and waves during slow-wave sleep. It is characterized by abnormal electrical discharges in the brain during deep sleep, resulting in seizures. CSWS epilepsy is a rare condition, and its exact prevalence is not well-established. However, it is estimated that it affects a small percentage of children with epilepsy.
It is important to distinguish CSWS epilepsy from other seizure disorders in kids. While many children with epilepsy experience seizures during sleep, CSWS epilepsy is unique in its pattern of continuous spikes and waves throughout slow-wave sleep. This specific pattern differentiates CSWS epilepsy from other forms of pediatric epilepsy syndromes.
Comparison of CSWS Epilepsy and Other Pediatric Seizure Disorders
Epilepsy in Children | CSWS Epilepsy | Other Pediatric Seizure Disorders |
---|---|---|
Prevalence in children with epilepsy | Affects a small percentage of children with epilepsy | |
Main characteristic | Continuous spikes and waves during slow-wave sleep | Vary depending on the specific seizure disorder |
Distinguishing feature | Distinct pattern of abnormal electrical discharges during deep sleep | |
Treatment approach | Varies based on the individual and the specific seizure disorder |
Understanding the differences between CSWS epilepsy and other pediatric seizure disorders is crucial for accurate diagnosis and appropriate treatment. In the following sections, we will delve deeper into the signs and symptoms of CSWS epilepsy, its causes and triggers, diagnostic procedures, and various treatment options available for managing this complex pediatric epilepsy syndrome.
Signs and Symptoms of CSWS Epilepsy
CSWS syndrome, also known as CSWS epilepsy, is characterized by a range of signs and symptoms that can impact a child’s sleep patterns and overall development.
Characteristic Features
Children with CSWS syndrome may experience continuous spikes and waves during slow-wave sleep, leading to seizures during sleep and potentially affecting their daytime functioning. These spikes and waves can disrupt the normal sleep cycle, causing frequent awakenings and restless nights.
Other symptoms of CSWS epilepsy may include:
- Impaired cognitive abilities and developmental delays
- Behavioral changes, including irritability and aggression
- Difficulty with language and communication skills
- Changes in motor skills and coordination
- Attention and concentration difficulties
- Learning difficulties
Impact on Sleep
The sleep disturbances associated with CSWS epilepsy can have significant impacts on a child’s overall well-being and development. Insufficient and disrupted sleep can lead to daytime sleepiness, fatigue, and poor school performance.
It is crucial to monitor a child’s sleep patterns and observe any signs of seizures during sleep. Identifying and addressing sleep issues can help improve the quality of life for children with CSWS syndrome.
Evaluations and Monitoring
If you suspect that your child may be exhibiting symptoms of CSWS epilepsy, it is essential to seek medical evaluation. A neurologist or pediatrician specializing in epilepsy can perform diagnostic tests and monitor your child’s condition.
These evaluations may include:
- Electroencephalogram (EEG): Measures the electrical activity of the brain to detect abnormal spikes and waves
- Neuropsychological testing: Evaluates cognitive and developmental abilities
- Medical history review: Assesses any previous seizures or abnormal behaviors
Regular monitoring of seizures and sleep patterns is also crucial for managing CSWS epilepsy effectively.
Seeking Medical Care
If you notice any signs or symptoms of CSWS epilepsy in your child, it is essential to consult with a healthcare professional specializing in pediatric epilepsy. Early diagnosis and intervention can lead to better outcomes and improved quality of life for both the child and their family.
Causes and Triggers of CSWS Epilepsy
CSWS epilepsy, also known as CSWS syndrome, is a complex pediatric syndrome characterized by continuous spikes and waves during slow-wave sleep. While the exact causes of CSWS epilepsy are not yet fully understood, various factors have been identified that contribute to the development of this syndrome in children.
Genetic Factors
Research suggests that genetic factors play a significant role in the development of CSWS epilepsy. Certain gene mutations or variations have been associated with an increased risk of developing this syndrome. These genetic factors can influence the functioning of the brain and its ability to regulate electrical activity during sleep, leading to the characteristic continuous spikes and waves.
Neurological Factors
CSWS epilepsy is believed to be caused by abnormal brain activity, particularly during slow-wave sleep. This abnormal activity can be triggered by various neurological factors, such as structural abnormalities in the brain, brain injury, or inflammation. These factors disrupt the normal electrical patterns in the brain, leading to the development of CSWS syndrome.
Environmental Triggers
While CSWS epilepsy is primarily influenced by genetic and neurological factors, certain environmental triggers can exacerbate the symptoms. These triggers can include sleep deprivation, fever, stress, and certain medications. It is important to identify and manage these triggers to minimize the frequency and severity of seizures in children with CSWS syndrome.
Other Potential Factors
In addition to the above-mentioned causes and triggers, researchers are actively exploring other potential factors that may contribute to the development of CSWS epilepsy. These factors include immune system abnormalities, neurotransmitter imbalances, and hormonal changes. Further study and research are needed to fully understand the complex interplay of these factors in the onset and progression of CSWS syndrome.
Potential Causes and Triggers | Explanation |
---|---|
Genetic Factors | This includes gene mutations or variations that affect brain function and electrical activity during sleep. |
Neurological Factors | Structural abnormalities in the brain, brain injury, or inflammation contribute to abnormal brain activity during slow-wave sleep. |
Environmental Triggers | Sleep deprivation, fever, stress, and certain medications can exacerbate CSWS epilepsy symptoms. |
Other Potential Factors | Researchers are exploring immune system abnormalities, neurotransmitter imbalances, and hormonal changes as potential contributors to CSWS syndrome. |
Diagnosing CSWS Epilepsy
In order to diagnose CSWS epilepsy, healthcare professionals utilize a range of tests and evaluations. These diagnostic procedures are crucial for confirming the presence of CSWS syndrome and for differentiating it from other types of seizures in children.
One of the primary diagnostic tools used is an electroencephalogram (EEG) test, which measures the electrical activity in the brain. An EEG can help identify the distinct pattern of continuous spikes and waves during slow-wave sleep that is characteristic of CSWS syndrome.
Additionally, medical history and clinical evaluations play a significant role in the diagnostic process. Doctors will carefully assess the child’s symptoms, the frequency and duration of seizures, and any other relevant factors. This comprehensive evaluation helps to determine if CSWS epilepsy is a likely diagnosis.
It is common for healthcare professionals to request other tests, such as blood tests, to rule out other potential causes of seizures and to evaluate overall health and possible contributing factors. These tests may include genetic testing, metabolic studies, and imaging tests like magnetic resonance imaging (MRI).
Evaluating Sleep Patterns
Given the impact of CSWS epilepsy on sleep, assessing sleep patterns is an essential component of the diagnostic process. Sleep studies, also known as polysomnograms, can provide critical information about the extent and nature of sleep-related abnormalities in children with CSWS syndrome. These studies allow healthcare professionals to observe the child’s brain activity, respiratory patterns, and movements during sleep, helping to validate the presence of continuous spikes and waves during slow-wave sleep.
Collaboration and Expert Opinion
Diagnosing CSWS epilepsy often requires collaboration between multiple specialists, such as neurologists, pediatricians, sleep medicine specialists, and EEG technologists. The collective expertise of these professionals helps ensure a comprehensive evaluation and accurate diagnosis.
Furthermore, seeking second opinions from reputable medical institutions, like Acibadem Healthcare Group, can provide valuable insights and confirm the initial diagnosis. Acibadem Healthcare Group has a team of experienced experts who specialize in diagnosing and treating CSWS syndrome, providing patients with the highest level of care.
Diagnostic Procedures for CSWS Epilepsy | |
---|---|
Electroencephalogram (EEG) | Measures electrical activity in the brain to identify CSWS pattern |
Medical History and Clinical Evaluation | Evaluates symptoms, seizure frequency, and relevant factors |
Blood Tests | Rules out other potential causes and assesses overall health |
Genetic Testing | Identifies genetic factors contributing to CSWS epilepsy |
Metabolic Studies | Evaluates metabolic imbalances and dysfunction |
Imaging Tests (e.g., MRI) | Assesses brain structure and rules out structural abnormalities |
Sleep Studies (Polysomnograms) | Observes brain activity and sleep patterns during sleep |
Treatment Options for CSWS Epilepsy
When it comes to managing CSWS epilepsy, there are various treatment options available that aim to control seizures, improve sleep patterns, and optimize developmental outcomes for children with CSWS syndrome. These treatment options can be categorized into medical interventions and non-medical approaches. Let’s explore them in detail.
Medical Interventions
Medical interventions for CSWS epilepsy primarily focus on reducing the frequency and intensity of seizures. The first line of treatment often involves anti-seizure medications, such as:
- Benzodiazepines
- Valproic acid
- Lamotrigine
- Topiramate
These medications work by inhibiting abnormal electrical activity in the brain, helping to stabilize brain function and reduce seizure activity.
For some individuals who do not respond well to medication or experience severe symptoms, other medical interventions may be considered. These can include:
- Ketogenic diet: A high-fat, low-carbohydrate diet that can help control seizures in some individuals.
- Vagus nerve stimulation (VNS): A device implanted under the skin that sends electrical impulses to the brain, helping to reduce seizure activity.
- Epilepsy surgery: In select cases, surgery may be recommended to remove or modify the part of the brain causing seizures.
Non-Medical Approaches
In addition to medical interventions, non-medical approaches can also play a significant role in managing CSWS epilepsy. These approaches aim to improve overall well-being, support healthy sleep patterns, and enhance developmental outcomes. Some non-medical interventions that may be beneficial include:
- Sleep hygiene practices: Establishing a regular sleep routine, creating a comfortable sleep environment, and avoiding stimulating activities before bedtime.
- Behavioral therapies: Working with psychologists or therapists who specialize in epilepsy to address behavioral issues and develop coping strategies.
- Physical therapy: Engaging in targeted exercises and activities to promote strength, coordination, and mobility.
It is important to note that the effectiveness of these treatment options may vary for each individual with CSWS epilepsy. It is essential to consult with a healthcare professional experienced in managing this condition to develop a personalized treatment plan.
Treatment Option | Method | Key Benefits |
---|---|---|
Anti-seizure medications | Medication intake | Reduces seizure frequency and intensity |
Ketogenic diet | Dietary modification | Can control seizures in some individuals |
Vagus nerve stimulation (VNS) | Implantation of a device | Helps reduce seizure activity |
Epilepsy surgery | Surgical intervention | May remove or modify brain area causing seizures |
Sleep hygiene practices | Adopting healthy sleep habits | Improves sleep quality and patterns |
Behavioral therapies | Psychological intervention | Addresses behavioral issues and develops coping strategies |
Physical therapy | Customized exercises and activities | Promotes strength, coordination, and mobility |
Medications for CSWS Epilepsy
When it comes to managing CSWS epilepsy, medications play a crucial role. A variety of anti-seizure medications are commonly prescribed to help control the continuous spikes and waves during slow-wave sleep characteristic of CSWS syndrome. These medications aim to reduce seizure frequency, improve sleep patterns, and support overall developmental progress in children with CSWS epilepsy.
There are different types of anti-seizure medications available, each working through different mechanisms of action to suppress epileptic activity. The choice of medication depends on several factors, including the severity of the seizures, other medical conditions the child may have, and individual response to specific drugs.
Here are some of the commonly prescribed anti-seizure medications for CSWS epilepsy:
Medication | Mechanism of Action | Potential Side Effects |
---|---|---|
Valproic Acid (Depakote) | Increases the inhibitory effects of the neurotransmitter GABA, reducing abnormal electrical activity in the brain. | Fatigue, gastrointestinal disturbances, liver toxicity (rare) |
Lamotrigine (Lamictal) | Blocks sodium channels, preventing the spread of abnormal electrical signals in the brain. | Rash (most commonly benign), dizziness, headache |
Topiramate (Topamax) | Enhances the inhibitory effects of GABA and inhibits excitatory neurotransmission in the brain. | Weight loss, cognitive slowing, kidney stones (rare) |
Clobazam (Onfi) | Increases the effects of GABA, a natural calming neurotransmitter in the brain. | Sedation, drowsiness, constipation |
It is important to note that these medications may have potential side effects, and their effectiveness can vary from person to person. Close monitoring by a healthcare professional is essential to evaluate the response to treatment and make any necessary adjustments.
In addition to medication, other treatment options such as neurostimulation devices, dietary modifications, and behavioral interventions may be considered in conjunction with medical management to optimize outcomes for children with CSWS epilepsy.
Non-Medical Interventions for CSWS Epilepsy
While medical interventions play a crucial role in managing CSWS epilepsy, non-medical interventions can also be effective in supporting the overall well-being and treatment outcomes for individuals with CSWS syndrome. These interventions focus on lifestyle modifications, dietary approaches, and alternative therapies that may complement traditional medical treatments. By incorporating these non-medical interventions into a comprehensive treatment plan, individuals with CSWS epilepsy can potentially experience improved seizure control, sleep patterns, and overall quality of life.
Lifestyle Modifications
Lifestyle modifications can be beneficial for individuals with CSWS epilepsy. These may include:
- Establishing a regular sleep schedule: Maintaining a consistent sleep routine can help promote better sleep quality and minimize disruptions in sleep patterns, potentially reducing the occurrence of seizures during nighttime sleep.
- Maintaining a healthy lifestyle: Engaging in regular physical activity, maintaining a balanced diet, and managing stress levels can contribute to overall well-being and potentially improve seizure control.
- Creating a safe environment: Implementing safety measures at home, such as removing potential hazards and creating a calm and structured environment, can help prevent accidents during seizures.
Dietary Approaches
Dietary approaches may complement traditional medical treatments for CSWS epilepsy. These can include:
- Ketogenic diet: The ketogenic diet is a high-fat, low-carbohydrate diet that has shown promise in reducing seizure frequency in some individuals with epilepsy, including those with CSWS syndrome.
- Modified Atkins diet: Similar to the ketogenic diet, the modified Atkins diet is a low-carbohydrate diet that may help control seizures.
- Elimination diet: In some cases, identifying and eliminating specific food triggers, such as food allergies or sensitivities, may help reduce seizure activity.
Alternative Therapies
Alternative therapies can be explored as complementary interventions for individuals with CSWS epilepsy. These may include:
- Acupuncture: Acupuncture, an ancient Chinese practice, involves the insertion of fine needles into specific points on the body to promote balance and well-being. It may help reduce seizure frequency and improve overall health.
- Mind-body techniques: Techniques such as meditation, relaxation exercises, and biofeedback can assist in stress reduction and promote relaxation, potentially supporting better seizure control and sleep patterns.
- Herbal supplements: Some individuals may consider herbal supplements as adjunctive treatments for CSWS epilepsy. It is important to consult with a healthcare professional before starting any herbal supplement regimen.
It is crucial to note that non-medical interventions should always be discussed and integrated into a treatment plan under the guidance of healthcare professionals. The effectiveness of these interventions may vary for each individual, and it is essential to approach them as complementary strategies alongside medical treatments for CSWS epilepsy.
Treatment Approach | Description | Benefits |
---|---|---|
Lifestyle Modifications | Includes establishing a regular sleep schedule, maintaining a healthy lifestyle, and creating a safe environment. | Promotes better sleep quality, overall well-being, and minimizes seizure-triggering factors. |
Dietary Approaches | Involves implementing ketogenic diet, modified Atkins diet, or elimination diet. | Potentially reduces seizure frequency and provides additional seizure control measures. |
Alternative Therapies | Includes acupuncture, mind-body techniques, and herbal supplements. | Supports stress reduction, relaxation, and overall well-being, potentially improving seizure control and sleep patterns. |
Long-Term Management of CSWS Epilepsy
Managing CSWS syndrome requires a comprehensive long-term approach to ensure the overall well-being and development of children. Regular follow-ups with healthcare professionals play a crucial role in tracking the progress of the condition and making necessary adjustments to the treatment plan.
One of the key aspects of long-term management is ongoing seizure monitoring. This involves keeping a record of the frequency, duration, and severity of seizures to identify any patterns or triggers that may be contributing to the episodes. Seizure diaries or electronic monitoring devices can be helpful tools in this process.
In addition to medication, non-medical interventions often play a significant role in managing CSWS syndrome. These interventions can include behavior therapies, occupational therapies, and speech therapies tailored to the specific needs of each child. These therapies aim to improve the child’s cognitive, motor, and communication skills, enhancing their overall quality of life.
Supportive interventions, such as healthy sleep hygiene practices, can also contribute to the long-term management of CSWS epilepsy. Establishing a consistent sleep routine, creating a calm sleep environment, and implementing relaxation techniques before bedtime can help optimize sleep quality and reduce the occurrence of seizures during sleep.
Furthermore, it is essential for parents and caregivers to educate themselves about CSWS syndrome and its management. Understanding the condition, its triggers, and the available treatment options can empower them to make informed decisions and actively participate in their child’s care.
Overall, effective long-term management of CSWS epilepsy involves a multidisciplinary approach, including regular medical follow-ups, ongoing seizure monitoring, tailored therapies, and supportive measures. By addressing the unique needs of each child with CSWS syndrome, we can work towards improving their quality of life and optimizing their developmental outcomes.
Research and Advances in CSWS Epilepsy
In recent years, there has been significant progress in the research and understanding of CSWS epilepsy, also known as continuous spikes and waves during slow-wave sleep syndrome. Ongoing studies have shed light on the underlying mechanisms of this pediatric epilepsy syndrome and have paved the way for promising advancements in its treatment.
Researchers have been exploring various aspects of CSWS epilepsy to gain a deeper understanding of its causes, symptoms, and neurological impact. By studying patterns of continuous spikes and waves during slow-wave sleep, scientists have made strides in identifying the specific brain regions affected by this syndrome.
The emerging research in CSWS epilepsy has highlighted the importance of early detection and diagnosis. Healthcare professionals now have a better grasp of the clinical features and diagnostic criteria for this condition, enabling more accurate and timely identification.
One of the notable areas of progress is in the development of novel treatment approaches for CSWS epilepsy. Researchers are investigating the effectiveness of new anti-seizure medications, including those specifically targeted at suppressing the spikes and waves during sleep. These advancements offer hope for improved seizure control and overall management of the syndrome.
Additionally, emerging research in the field of CSWS epilepsy explores the potential benefits of non-medical interventions. Lifestyle modifications, such as optimizing sleep hygiene and implementing behavioral therapies, have shown promise in reducing seizure frequency and improving cognitive outcomes in children with CSWS syndrome.
Advancements in Neuroimaging Techniques
Advancements in neuroimaging techniques have played a pivotal role in deepening our understanding of CSWS epilepsy. Magnetic Resonance Imaging (MRI) and functional MRI (fMRI) have allowed researchers to visualize and examine the structural and functional abnormalities in the brains of individuals with CSWS syndrome.
Using these techniques, researchers have discovered correlations between the severity of spikes and waves during sleep and the associated cognitive impairments. This knowledge can help healthcare professionals tailor treatment plans and monitor the response to interventions more effectively.
Collaborative Efforts and Future Directions
The field of CSWS epilepsy is continually evolving, driven by collaborative efforts between researchers, healthcare providers, and advocacy groups. These collaborations allow for the sharing of knowledge, resources, and clinical experiences, leading to improved outcomes for individuals with CSWS syndrome.
In the years to come, it is anticipated that further research will enhance our understanding of the intricate mechanisms underlying CSWS epilepsy. This knowledge will form the foundation for the development of more targeted and personalized treatment strategies, ultimately aiming to optimize the quality of life for children living with this complex epilepsy syndrome.
Seeking Support for CSWS Epilepsy
Managing CSWS syndrome can be a challenging journey for families and caregivers of children with this condition. That’s why seeking support from the right resources and networks is essential to ensure the well-being and quality of life for both the child and the entire family.
There are various organizations and advocacy groups dedicated to supporting individuals affected by CSWS epilepsy. These organizations provide valuable information, resources, and emotional support to help families navigate the complexities of managing CSWS syndrome.
Resources for CSWS Epilepsy:
- CSWS Foundation: The CSWS Foundation is a non-profit organization that aims to raise awareness about CSWS syndrome and provide support to families and individuals affected by this condition. Their website offers information on symptoms, treatment options, and resources for managing CSWS epilepsy.
- Online Communities: Joining online communities and forums can provide a sense of community and connection for families and caregivers facing similar challenges. These platforms allow individuals to share experiences, seek advice, and offer support to one another.
- Support Groups: Local support groups can offer a safe space for families to connect with others who understand the unique struggles associated with CSWS syndrome. These groups often organize regular meetings, educational events, and guest speaker sessions to provide additional insights and support.
It is crucial to connect with healthcare professionals who have experience in managing CSWS epilepsy. They can provide personalized guidance, treatment options, and monitor the child’s progress closely. Building a strong collaborative relationship with healthcare providers is key to effectively managing CSWS syndrome and ensuring the best possible outcomes for the child.
Remember, you are not alone on this journey. Seeking support from the right resources and networks can make a significant difference in managing CSWS epilepsy and providing the necessary support for both the child and the entire family.
Expert Opinion from Acibadem Healthcare Group
As a leading healthcare institution, Acibadem Healthcare Group provides valuable insights and expert opinions on CSWS epilepsy, also known as CSWS syndrome. Our team of experienced healthcare professionals has extensive knowledge in diagnosing and treating this complex condition.
At Acibadem Healthcare Group, we understand the challenges that individuals with CSWS syndrome and their families face. Our comprehensive approach to care involves a thorough evaluation to accurately diagnose the condition and develop personalized treatment plans.
We recommend individuals seeking specialized care for CSWS epilepsy to consult with our expert team at Acibadem Healthcare Group. Our multidisciplinary team of neurologists, pediatricians, and other specialists collaborate to provide comprehensive and holistic care to meet the unique needs of each patient.
With a focus on delivering evidence-based treatments and utilizing advanced technologies, Acibadem Healthcare Group strives to improve the quality of life for individuals with CSWS syndrome. We are committed to providing compassionate care and supporting individuals and their families throughout their journey.
FAQ
What is CSWS epilepsy?
CSWS epilepsy, also known as continuous spikes and waves during slow-wave sleep, is a pediatric epilepsy syndrome characterized by continuous electrical abnormalities in the brain during sleep. These abnormalities, known as spikes and waves, can lead to various symptoms and developmental challenges in affected children.
What are the symptoms of CSWS epilepsy?
The symptoms of CSWS epilepsy can vary but often include seizures, language and cognitive impairments, behavioral changes, sleep disturbances, and developmental regression. These symptoms tend to worsen during sleep and can affect a child's overall quality of life.
What causes CSWS epilepsy?
The exact causes of CSWS epilepsy are still being studied, but it is believed to result from a combination of genetic and neurologic factors. Some cases of CSWS syndrome have been linked to specific genetic mutations, while others may be due to underlying brain abnormalities or inflammation.