A chronic neurologic disorder

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2. CONTENTS
 What is Epilepsy
 Epidemiology
 Pathophysiology
 Causes
 Signs and symptoms
 Types of epilepsy
 Diagnosis
 Treatment
 Future perspective
 Summary
 References
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3. What is Epilepsy?
 A chronic neurologic disorder which result from paroxysmal
uncontrolled discharges of neurons within the central nervous
system. It is characterized by repeated epileptic seizures (fits or
attacks)
 It affects people of all ages.
 It can vary in frequency
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4. EPIDEMIOLOGY
Epilepsy knows no geographical, racial or social boundries
Accordindg to WHO:
 50 million people-worldwide have epilepsy
 2.4 million people-globally diagnosed with epilepsy each year
 In 2013- 116,ooo deaths reported
 Overall prevalence of epilepsy in Pakistan is estimated to be 9.99
per 1000 population
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5. Pathophysiology
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 Each electrical signal that
passes through is just ion
flowing in and out of neuron
through protein channels
 This ion flow is controlled by
neurotransmitters and receptors
 Neurotranmitters bind to the
receptors and basically tell the
cell to either open up the ion
channel

6. Pathophysiology
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7. CAUSES OF EPILEPSY
 Idiopathic epilepsy- 65-70% cases
 Symptomatic epilepsy
i. Brain damage
ii. A severe head injury
iii. Brain trauma
iv. Congenital abnormalities
v. A stroke
vi. An infection of brain
vii. Permanent change of brain tissues
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8. SIGNS AND SYMPTOMS
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 Signs and symptoms depend upon where in the brain it first
start
 Outward signs are
• Jerking
• Moving
• Losing consciousness
• Recurring episodes of seizures
 Only experienced by patient
• Fears
• Strange smells

9. TYPES OF SEIZURES
GENERALIZED
SEIZURES
 Type of seizures impairs
consciousness and distort
the electrical activity of the
whole brain
 It last for several seconds to
minutes
PARTIAL SEIZURES
 The abnormal electrical
discharge starts in the
localized area of the brain
 It may spread to other parts of
the brain to form generalized
seizures.
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10. TYPES OF SEIZURES
 GENERALIZED SEIZURES
i. Generalized tonic-clonic seizures
ii. Tonic seizures
iii. Clonic seizures
iv. Absence seizures
v. Myoclonic seizures
vi. Atonic seizures
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11. Generalized tonic-clonic seizures
 The patient loss consciousness
 Tonic phase: develops generalized stiffness
 Clonic phase: muscles alternately contract and relax
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12. TONIC AND CLONIC SEIZURES
 Tonic seizures
 Sudden sustained muscle contraction
 Immediate loss of consciousness
 Deviation of eyes and head towards one side
 Clonic seizures
 Repetitive clonic jerks
 Neck, face and arms are commonly affected
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13. MYOCLONIC & ABSENCE SEIZURES
 Myoclonic seizures
• Sudden, brief, shock like muscle
contractions
• Occurring either in one limb or
spread bilaterally
 Absence seizures
• Very short period of loss of
consciousness
• Occurs with slight turn of head or
eye blinking 13

14. ATONIC SEIZURES
• Atonic seizures
• Drop attack
• Sudden loss of muscle activity occurs
• Lasts for only seconds but may occurs several times a day
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15. TYPES OF SEIZURES
 PARTIAL SEIZURES
i. Simple partial seizures
ii. Complex partial seizures
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16. Simple partial seizures
 Patient does not loose consciousness
 Include sensory, psychic, autonomic, and motor phenomena
 Accompanied by three features
i. Jacksonian march-seconds to minutes
ii. Todd’s paralysis –minutes to hours
iii. Epilepsia partials continua- hours to days
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17. Complex partial seizures
 Impaired consciousness or losing consciousness completely
 Don’t remember exactly what happened during the seizures
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18. DIAGNOSIS
 Through history making
 Physical examination
 Blood test, EEG, MRI of brain, CT scan of brain, Skull X-ray
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19. TREATMENT
 Medication
 Surgery
 Diet
 Vagus nerve stimulation(VNS)
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20. TREATMENT
 Medication
 Anti-epileptic drugs (AEDs)
 70% of children and adults can be treated
 Surgery
 Surgical therapy might be beneficial to patients who respond
poorly to drug treatments
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21. TREATMENT
 Diet
i. Ketogenic diet
• High in fat and low in carbohydrate contents
• Prescribed when drugs proven in effective
• Mechanism not well understood
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22. TREATMENT
ii. Vagus nerve stimulation
 In 1997, FDA approved VNS
 Consider only when no chance for surgery
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23. FUTURE PERESPECTIVE
 Radiosurgery –in future might be an alternate treatment of surgery
 It might be an effective or safe techniques.
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24. SUMMARY
 Epilepsy is neurologic disorder resulting from abnormal discharge
of neurons from brain.
 Causes include head injury, brain trauma, stoke, brain infections.
 Two types: generalized and partial epilepsy
 Diagnosis is made through history making, physical examination,
and laboratory examination
 Medication, surgery, and non-pharmacologic treatments are used
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25. REFERENCES
 https://en.wikipedia.org/wiki/Epilepsy
 http://www.webmd.com/epilepsy/
 http://www.who.int/mediacentre/factsheets/fs999/en/
 www.who.int/mental_health/media/en/639.pd
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1867089/
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26. THANK YOU
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