Episodes of abnormal sudden, excessive, uncontrolled electrical discharge of neurons within the...

Episodes of abnormal sudden, excessive, uncontrolled electrical discharge of neurons within the brain

May result in alteration in consciousness, motor or sensory ability and/or behavior

Birth trauma/Asphyxia during birth Head injuries/ brain tumors Infectious disease Toxicity (carbon monoxide and lead poisoning) Fever Drug/alcohol intoxication Metabolic disturbances Inherited Idiopathic (unknown cause)

History MRI/ CT scan EEG SPECT (single photon emission

computed tomography) – helps identify zone giving rise to seizures, can then be removed surgically

Blood chemistry test

Chronic disorder Recurrent unprovoked seizure activity

CAUSE OF EPILEPSY abnormal electrical neuronal activity Imbalance of neurotransmitters:

Gamma aminobutyric acid (GABA)

Two or more consecutive seizures that occur without full recovery of consciousness between attacks

Also includes continuous electrical seizures lasting at least 30 minutes

Generalized seizures-involves both cerebral hemispheres

Partial seizures (focal or local)› Begins in a part of one cerebral

hemisphere› Complex- may cause loss of consciousness› Simple-remains conscious

Unclassified seizures

Video from faculty animation only chapter 44 partial seizure

TONIC-CLONIC SEIZURE› Lasts up to a min.› Starts with tonic movements: stiffening or

rigidity of the muscles of arms and legs› Loss of consciousness› Incontinent bladder/bowel› Clonic movements follow: rhythmic jerking of

all extremities› May bite tongue› Followed by a postictal phase

POST-ICTAL STATE: after seizure Pt is confused and hard to arouse, may sleep for hours

Tonic seizures: › Abrupt increase in muscle tone› Loss of consciousness› Loss of autonomic signs for 30 sec to several

minutes Clonic seizure:

› Lasts several minutes› Muscle contraction and relaxation

Absence seizure› Common in children ( familial)› Brief (seconds) loss of consciousness› Blank starring, returning to normal› May occur frequently throughout day

Myoclonic seizure:› Brief jerking/stiffening extremities› Singly or in groups› Lasts few seconds

Atonic(akinetic)seizure› Sudden loss of muscle tone for a few

seconds, may fall› Followed by POSTICTAL(after seizure)

confusion

Partial- only involves one side of the brain

Simple: person remains conscious

Complex: impaired consciousness bizarre behavior

amnesia