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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