Epilepsy

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.

Latest Article: Eye Treatment

At the innermost corner of the eye, nearest the nose, are the tear ducts, or a series of tiny organs known collectively as the lacryminal apparatus.  When we have a cold, the flu, or an attack of hay fever, we are likely to think there is no way to stop this part of the eye from secreting tears but a blockage of this system does happen and it can become very painful indeed. Each of the...

Related Articles: