This document summarizes information about seizures and epilepsy. It defines a seizure as abnormal excessive neuronal discharge and epilepsy as a chronic seizure disorder. Seizures are classified as partial or generalized. Common causes of epilepsy include family history, head injuries, infections, and tumors. Diagnosis involves EEG and brain imaging. Treatment depends on seizure type but may include carbamazepine, lamotrigine, valproic acid, and other anticonvulsants. The majority of people with epilepsy live normal lives, as epilepsy is not contagious or a mental illness.
2. A seizure is a paroxysmal event characterized by abnormal,
excessive, hypersynchronous discharge of cortical neuron
activity.
Epilepsy can be defined as a chronic seizure disorder or group
of disorders characterized by seizures that usually recur
unpredictably in the absence of a consistent provoking factor.
Seizure ?? Epilepsy??
3. Epilepsy is not contagious
it is not a mental illness
or a cognitive disability.
The neurological dysfunction seen in epilepsy can :
begin at birth
childhood
adolescence or
even in adulthood
4. CLASSIFICATION
I. Partial seizures
A. Simple seizures
(without impairment of consciousness)
1. With motor symptoms
2. With special sensory or somatosensory symptoms
3. With psychic symptoms
B. Complex seizures
(with impairment of consciousness)
1. Simple partial onset followed by impairment of
consciousness
2.Impaired consciousness at onset
C. Secondarily generalized
(partial onset evolving to generalized tonic-clonic seizures)
5. II. Generalized seizures
A. Absence
B. Myoclonic
C. Clonic
D. Tonic
E. Tonic-clonic
F. Atonic
G. Infantile spasms
III. Unclassified seizures
IV. Status epilepticus
6. PARTIAL SEIZURES:
Common, 80% patients
simple partial seizures:
do not cause loss of consciousness
Signs &symptoms:
motor – convulsive jerking, chewing
motions, lip smacking
Sensory & somatosensory – paresthesias,
auras
Automatic – sweating, flushing, pupil
dilation
Behavioural – hallucinations, dysphasia,
impaired consciousness (rare).
7. complex partial seizures:
impairment of consciousness
purposeless behaviour is common
affected person may wander about aimlessly
aggressive behaviour (violence)
automatism (eg: picking at clothes)
visual, auditory, or olfactory hallucinations
8. GENERALIZED SEIZURES:
Affecting both hemispheres
Diffuse
3 types:
1) Idiopathic epilepsies
• Age related
• Genetic origin
2) Symptomatic epilepsies
• A consequence of a known/suspected underlying
disorder of CNS
3) Cryptogenic epilepsies
• Disorder of a hidden course
• Age related
9. ABSENCE SEIZURES (petit mal)
Alterations of conciousness (absence) lasting 10-30sec
Staring (with occ. eye blinking) & loss in postural tone
100 or more daily
Onset occurs from 3-16yrs, disappear by 40yrs.
MYOCLONIC:
sudden, Involuntary jerking of facial, limb or trunk
muscles, in rhythmic manner
CLONIC:
Sustained muscle contractions alternating with relaxations
TONIC:
Sustained muscle stiffening
10. TONIC-CLONIC (grand mal) :
Sudden loss of consciousness
Tonic phase:
Pt become rigid & falls to the ground
Respiration are interrupted
Back arches
Lasts about 1min
Clonic phase:
Rapid muscle jerking
Muscle flaccidity
Incontence, tongue biting,
tachy cardia, heavy salvation
11. During postictal phase:
Head ache, confusion, nausea, drowsiness, disorientation
May last for hours
ATONIC (drop attacks):
Sudden loss of postural tone, pt falls to the ground
Occur primarily in children
13. High fever, especially in infants
Drug use, alcohol withdrawal
Near-drowning or lack of oxygen from another cause
Metabolic disturbances
Head trauma
Brain tumor, infection, stroke
Complication of diabetes or pregnancy
CAUSES
14. Causes of epilepsy
Stroke
Brain tumor
Brain infection
Past head injury
Drug use, alcohol
withdrawal
Epilepsy may occur with:
Metabolic problems
Other neurological conditions
High fever, especially in infants
Genetic factors
Developmental disabilities
Autism
Cognitive impairments
… but the majority
of people who have
epilepsy do not have
other impairments
and live very normal
lives.
15. Paroxysmal discharges in cortical neurons
A seizure orignates from grey matter of any cortical or subcortical area
Abnormal firing of neurons
Breakdown of normal membrane conductance & inhibitory synaptic
currents
Locally widely
Focal seizure Generalized seizure
PATHOPHYSIOLOGY
16. •Abnormality of Potassium conductance
•Defect in voltage sensitive ion channels
•Deficiency in membrane ATPase
seizures
Neurone membrane instability
promotes
Deficiency of inhibitory neurotransmitters
Increase in excitatory neurotransmitters
Abnormal neuronal acitvity
Seizure