SEIZURES are episodes of abnormal motor, sensory,
autonomic or psychic activity (or combination of these)
that result from sudden excessive discharge from
Mostly occur in Americans .
For example :
. 6000 people are in stadium ,in which 500 people are
suffer from epilepsy
Rate of epilepsy most occur in age of
0 to 1 or occur in age 70
What is happening with a seizure?
o Abnormal electrical activity in the
brain causing a sudden uncontrolled
o Seizures look different, depending
upon what part of the brain they
The 4 lobes of the brain
o Frontal lobes- planning and control of
o Parietal lobes- deal with sensation
o Temporal lobes- important for
learning, memory and emotions
o Occipital lobes- centers of brain that
allow us to see
A seizure in which benign at focus and
remain localized and not generalized at
rest of body.
About 60% of peoples have partial
Occur due to brain injury.
5% chances of genes.
simple partial seizure
o Not produce loss of consciousness
o People retain awareness and ability to recall
o motor or autonomic symptoms- movements of
part of the body, nausea or upset stomach
o sensory or psychic symptoms (aura)numbness, tingling, pain, smell ,etc.
o Only finger or hand may shake
o Consciousness is reduced or lost
o Occur most commonly in the temporal
and frontal lobes
o With sensory or motor symptoms
ex)lip smacking, clear throat, fiddle with clothes, laugh, staring
o Actions purposeless, look as if
Partial seizures with impairment
Diagnosis of partial seizures
Partial seizures can be difficult to
diagnose with certainty because they vary
so much from one person to another. It is
helpful for the doctor to hear a detailed
description from the person who is
experiencing the events and from people
who have seen them occur.
o Brain's electrical activity pattern is tested
with an electroencephalogram (EEG) to
see if any areas of the brain are
conducting electricity in an abnormal way.
o If the EEG is abnormal, it can confirm
suspicions that seizures are occurring.
Anti-epileptic drugs used for partial
Anti-epileptic treatment is associated with
a small risk of suicidal thoughts and
Seizure that begin over the entire surface of the
brain are called generalized seizure.
Convulsion start in generalized seizure because
of the involvement of motor system.
Types of generalized seizure:
Grand mal seizure
Petit mal seizure
Atonic mal seizure
Grand mal seizures
A grand mal seizure also known as a
tonic-clonic seizure involve loss of
consciousness and violent muscle
Convulsion involve in it
Convulsion : uncontrolled movement of
A sensation perceived by a patient that
precedes a condition affecting the brain.
An aura occurs before a seizure.
It may consist of flashing lights, a gleam
of light, blurred vision, an odor, the feeling
of a breeze, numbness, weakness, or
difficulty in speaking.
Phases of grand-mal seizures
Contraction of muscle start
Rigidity of arm
Duration 15 sec
Person loss consciousness and fall down
Saliva merge from the mouth
Arm and leg jerk rapidly
After 30 sec or few minutes jerking slow down and end
Consciousness return slowly
Show painful expressions
Than person falls, unresponsive sleep for 15 minutes
Than after awaking then sleep again for hours
Treatment of tonic and clonic seizures
Treatment of tonic and clonic seizures
There is no one treatment method for any
patient with a seizure disorder.
Each treatment plan is tailored to the individual
patient based on their diagnosis and symptoms.
Treatment options may include medical
therapy, nerve stimulation, dietary therapy,
or surgery, as appropriate. Clinical trials may
also be a valuable treatment alternative.
During grand mal seizures neural firing starts at the
focus causing aura than spread.
Firstly near areas than contralateral ----crossing
corpus callosum --- to thalamus ,hypothalamus and
Excitation increases in subcortical region and
Neurons in motor system show activity than tonic
Than diencephalon structures (the hypothalamus,
thalamus, pineal gland) start activity and send
inhibitory messages to cortex.
The inhibitory messages comes into brief
burst that cause jerking movements that
occur in clonic phase. So that muscles
relax and than contract again.
The inhibition become more and than
jerks become slow.
Than finally inhibition cause relaxation.
o An electroencephalogram (an EEG) is a recording of the
brain's electrical activity.
o About 20 small adhesive electrodes are placed on the
scalp, and the brain's activity is recorded under normal
o Then the person is exposed to various stimuli, such as
bright or flashing lights, to try to provoke a seizure.
oDuring a seizure, electrical
activity in the brain accelerates,
producing a jagged wave
oSuch recordings of brain
waves help identify a seizure
disorder. Different types of
seizures have different wave
oIt is also known as absence seizures that are type of
oPresent in children in which stop there activity and stare
off at the distance, become unresponsive for few seconds.
oIt can occur many times within day.
oDue to miss diagnosis these children are considered as
inattentive and less motivated.
Atonic mal seizure
Atonic seizures are a type of generalized
They involve a sudden loss of muscle tone, so
that the child goes limp and falls to the ground.
They are often present in children who also have
other seizure types, such as tonic.
They occur in all age groups, but are more
common in children.
Possible signs and symptoms of an atonic
Sudden loss of muscle tone
The child goes limp and falls straight to the ground
The child remains conscious or has a brief loss of
Eyelids drop, head nods
The seizure usually lasts less than 15 seconds ,
although some may last several minutes
The child quickly becomes conscious and alert
again after the seizure
Can be due to any brain injury.
Due to tumor
Drugs and infections
Alcoholic and people who take
barbiturates ,in these people after
withdraw seizures can occur.(SUDDEN
inhibitory effect stopped create excitation)
A series generalized seizures that occur without full
recovery of consciousness between attacks.
Electrical seizures (on EEG) lasting at least 30 minutes,
even without impairment of consciousness.
Considered a medical emergency.
Status Epileptics produces:
Vigorous muscular contractions impose a heavy
metabolic demand; and
Interfere with respirations.
Factors that precipitate Status
Withdrawal of antiseizure medication,
Stop the seizures as quickly as possible,
Ensure adequate cerebral oxygenation, and
Maintain the patient in a seizure-free state.
An airway and adequate oxygenation are
If the patient remains unconscious and
unresponsive, a cuffed Endotracheal tube is
Intravenous Diazepam (Valium), Lorazepam
(Ativan), or Forphenytoin (Cerebyx)