Epilepsy: One of Paroxysmal disorders. Patients affected with this disorder are susceptible to recurrent seizures. Paroxysmal events associated with abnormal electrical discharges of neurons in the brain. These discharges may be focal or diffuse, and the site of discharges determine the symptoms that occur during the attack. Seizures are among the most commonly observed neurologic dysfuntions in children and can occur with widely varying Central Nervous System (CNS) conditions.
There are several types of seizures (see symptoms below)
The cause of about half the cases of epilepsy are idiopathic (occurring
without unknown cause). However, idiopathic epilepsy may indicate
that genetic factors have in some way altered the seizure threshold to
influence neuronal discharge. Seizures may occur as part of congenital
defects and some genetic disorders. Studies have shown that certain
seizure disorders appears to run in the families, and researchers have
detected hereditary EEG abnormalities in some families.
Seizure disorders has been a result from and not limited to: head
injury, brain tumors, anoxia, meningitis, or other infectious disease,
ingestion's of toxins and or chemicals, birth trauma such as; inadequate
oxygen supply to the brain, perinatal infection, CVA, and metabolic disorders,
such as, hypoglycemia.
Symptoms:
Recurring seizures may be classified as partial or generalized,
some patients may be affected by more than one type os seizures.
Partial seizures: Seizures
in this class arise from a localized area of the brain and cause specific
symptoms. In some patients, partial seizure activity may spread to
the entire brain, causing a generalized seizure. Partial seizures
include jacksonian and complex partial seizures - psychomotor
or temporal lobe.
Jacksonian seizure -begins as
a localized motor seizure characterized by the spread of abnormal activity
to adjacent areas of the brain. Symptoms includes: Stiffening or jerking in one extremity, accompanied by a tingling sensation in the same area. Patients usually does not lose consciousness. A jacksonian seizure may progress to a generalized tonic-clonic seizure (see below)
Complex partial seizures - varies,
but usually include purposeless behavior. This seizure may begin
with an aura, a sensation the patient feels beginning of abnormal
electrical discharges within a focal area of the brain and may include
a pungent smell, a rising or sinking feeling in the stomach,
feeling of nausea or other GI distress, patient may have an unusual
taste, a dreamy feeling, and or a visual disturbance.
Patient may have a glassy stare, he may be picking at his clothes,
aimless wandering,lip smacking or chewing motions, and unintelligible
speech. * Mental confusion may last several minutes
after the seizure.
Generalized seizures:
These seizures cause a generalized electrical abnormality within the brain.
Generalized seizures include absence, myoclonic, generalized tonic-clonic,
and akinetic.
Absence seizure: also known as Petit
mal seizure - usually begins with a brief change in level of consciousness,
patient may start out with, blinking or rolling of the eyes,
a blank stare, and slight mouth movements. The patient
retains his posture and continues pressure activity without difficulty.
Seizures usually last 1 to 10 seconds. If seizure is not treated, seizures
can recur as often as 100 times a day. Petit mal seizures may
progress to generalized tonic-clonic seizures.
Myoclonic seizure: also called
bilateral massive epileptic myoclonus, it is characterized by brief,
involuntary muscular jerks of the body or extremities, which may occur
in a rhythmic fashion.
Generalized tonic-clonic seizure:
also called Grand mal seizure, it usually begins with a loud
cry precipitated by air rushing from the lungs through the vocal cords. The patient then
falls to the ground, losing consciousness. The body stiffens (tonic phase), then alternates between episodes
of muscle spasm and relaxation (clonic phase). The
patient may bite his tongue, have labored breathing, or absent of
breathing (apnea), and may subsequently be cyanotic.
Incontinence may occur. The seizure usually stops in 2 to 5 minutes,
when abnormal electrical conduction of the neurons is completed.
The patient then regains consciousness but is somewhat confused and may
have difficulty talking. If patient can talk, he may complain of
drowsiness, fatigue, muscle soreness, headache, and arm or leg weakness.
Patient may fall into a deep sleep after a grand mal seizure.
Akinetic seizure: also called
drop attack because it causes the patient to fall. This
seizure type is characterized by a general loss of postural tone and a
temporary loss of consciousness. It occurs in young children.
Status epilepticus: a continuous
seizure state, (which can occur in all seizure types). In the most
life threatening form, generalized tonic-clonic status epilepticus,
the patient experiences a continuous generalized tonic-clonic seizure without
intervening return of consciousness. Accompanied by respiratory distress,
status epilepticus can result from abrupt withdrawal of antiepileptic medications,
hypoxic encephalopathy, acute head trauma, metabolic encephalopathy or
septicemia secondary to encephalitis or meningitis
Treatment:
Treatment consist of drug therapy. The most commonly prescribed
medication include phenobarbital, carbamazepine, and phenytoin. administered
individually for generalized tonic-clonic seizures and complex partial
seizures.
For petit mal seizure - Valproic acid, clonazepam, and ethosuximide
are most common prescribed meds.
If drug therapy fails, treatment may include surgical removal of a demonstrated
focal lesion to attempt to bring an end to seizures.
Emergency treatment for status epilepticus usually consists of diazepam,
phenytoin, or Phenobarbital.
Note: there are social agencies in your community that can help epileptic patients.
You may also contact: Epilepsy Foundation of America for more information.
