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Dr shabeel pn <ul><li>Clinical cases </li></ul>
EPILEPSY <ul><li>It is a condition in which a person has recurrent seizures </li></ul><ul><li>Seizure – Paroxysmal event d...
Partial Seizure <ul><li>Simple partial </li></ul><ul><li>Complex partial </li></ul><ul><li>Partial seizure with secondary ...
PRIMARILY GENERALISED <ul><li>Absence ( Petit Mal) </li></ul><ul><li>Tonic- clonic ( Grand Mal ) </li></ul><ul><li>Tonic <...
PATHOPHYSIOLOGY OF PARTIAL SEIZURE <ul><li>Paroxysmal discharge in a focal area </li></ul><ul><li>Secondary generalization...
PATHOPHYSIOLOGY OF GENERALIZED SEIZURE <ul><li>Discharge spreads simultaneously in both hemispheres </li></ul>
SIMPLE PARTIAL SEIZURE <ul><li>Consciousness is fully preserved </li></ul><ul><li>Motor, sensory, autonomic or psychic sym...
COMPLEX PARTIAL SEIZURE <ul><li>Consciousness is impaired in the form of transient impairment in the patients ability to m...
PARTIAL SEIZURE WITH SECONDARY GENERALIZATION <ul><li>Starts with partial seizure & then becomes generalized </li></ul>
ABSENCE SEIZURE ( PETIT MAL) <ul><li>Sudden brief lapse of consciousness without loss of postural control </li></ul><ul><l...
GENERALIZED TONIC-CLONIC ( GRAND MAL) <ul><li>No aura </li></ul><ul><li>Tonic contractions of the muscles of the body </li...
GENERALIZED TONIC-CLONIC ( Contd) <ul><li>Cyanosis </li></ul><ul><li>Biting of the tongue </li></ul><ul><li>HR/BP increase...
ATONIC <ul><li>Sudden loss of postural muscle tone lasting for 1-2 sec ( Head drop) </li></ul><ul><li>Consciousness is imp...
MYOCLONIC <ul><li>Sudden clonic movement of the limbs </li></ul><ul><li>Objects fall from the hand as if it is thrown away...
CAUSES OF GEN. SEIZURE <ul><li>Cerebral anoxia </li></ul><ul><li>Alcohol & withdrawal </li></ul><ul><li>Metabolic </li></u...
CAUSES ( Contd) <ul><li>Drugs </li></ul><ul><ul><ul><li>Penicillin </li></ul></ul></ul><ul><ul><ul><li>Lignocaine </li></u...
CAUSES ( Contd) <ul><li>Infective </li></ul><ul><ul><ul><li>Meningitis  </li></ul></ul></ul><ul><ul><ul><li>Encephalitis <...
CAUSES OF PARTIAL SEIZURE <ul><li>Cerebral embolism </li></ul><ul><li>AV malformation </li></ul><ul><li>Tumor </li></ul><u...
INVESTIGATIONS <ul><li>EEG </li></ul><ul><li>CT </li></ul><ul><li>MRI </li></ul><ul><li>Electrolytes </li></ul><ul><li>Sug...
FACTORS TRIGGER SEIZURE <ul><li>Sleep deprivation </li></ul><ul><li>Alcohol / withdrawal </li></ul><ul><li>Physical / ment...
MANAGEMENT- IMMEDIATE <ul><li>Air way </li></ul><ul><li>Breathing </li></ul><ul><li>Carry the person away from danger </li...
PARTIAL SEIZURE MANAGEMENT - LONG TERM <ul><li>Carbamazepine </li></ul><ul><li>Valproate </li></ul><ul><li>Phenytoin </li>...
MANAGEMENT – GTCS - Long term <ul><li>Valproate </li></ul><ul><li>Carbamazepine </li></ul><ul><li>Phenytoin </li></ul>
STATUS EPILEPTICUS <ul><li>Continuous seizure or repetitive seizures with impaired consciousness in the inter ictal period...
THANK YOU
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Epilepsy

  1. 1. Dr shabeel pn <ul><li>Clinical cases </li></ul>
  2. 2. EPILEPSY <ul><li>It is a condition in which a person has recurrent seizures </li></ul><ul><li>Seizure – Paroxysmal event due to abnormal,excessive,hyper synchronous discharge from CNS neurons </li></ul><ul><li>Classification – </li></ul><ul><ul><ul><li>Partial seizure </li></ul></ul></ul><ul><ul><ul><li>Primary generalized </li></ul></ul></ul>
  3. 3. Partial Seizure <ul><li>Simple partial </li></ul><ul><li>Complex partial </li></ul><ul><li>Partial seizure with secondary generalization </li></ul>
  4. 4. PRIMARILY GENERALISED <ul><li>Absence ( Petit Mal) </li></ul><ul><li>Tonic- clonic ( Grand Mal ) </li></ul><ul><li>Tonic </li></ul><ul><li>Atonic </li></ul><ul><li>Myoclonic </li></ul>
  5. 5. PATHOPHYSIOLOGY OF PARTIAL SEIZURE <ul><li>Paroxysmal discharge in a focal area </li></ul><ul><li>Secondary generalization- spread to both hemispheres simultaneously </li></ul>
  6. 6. PATHOPHYSIOLOGY OF GENERALIZED SEIZURE <ul><li>Discharge spreads simultaneously in both hemispheres </li></ul>
  7. 7. SIMPLE PARTIAL SEIZURE <ul><li>Consciousness is fully preserved </li></ul><ul><li>Motor, sensory, autonomic or psychic symptoms </li></ul><ul><li>Jacksonian march </li></ul><ul><li>Todd’s paralysis- lasts for minutes to hours </li></ul><ul><li>Epilepsia partialis continua </li></ul>
  8. 8. COMPLEX PARTIAL SEIZURE <ul><li>Consciousness is impaired in the form of transient impairment in the patients ability to maintain normal contact with the environment </li></ul><ul><li>Aura ( simple partial seizure) </li></ul><ul><li>Automatisms- lip smacking, chewing, swallowing , picking movements of the hand </li></ul><ul><li>Confused following seizure </li></ul>
  9. 9. PARTIAL SEIZURE WITH SECONDARY GENERALIZATION <ul><li>Starts with partial seizure & then becomes generalized </li></ul>
  10. 10. ABSENCE SEIZURE ( PETIT MAL) <ul><li>Sudden brief lapse of consciousness without loss of postural control </li></ul><ul><li>Lasts for few seconds only </li></ul><ul><li>No post ictal confusion </li></ul><ul><li>Begin in child hood </li></ul><ul><li>Occur hundreds of times per day </li></ul><ul><li>EEG – spike & wave discharge </li></ul>
  11. 11. GENERALIZED TONIC-CLONIC ( GRAND MAL) <ul><li>No aura </li></ul><ul><li>Tonic contractions of the muscles of the body </li></ul><ul><li>Often starts with a cry – laryngeal muscle contraction </li></ul><ul><li>Impaired respiration </li></ul><ul><li>Pooling of secretions </li></ul>
  12. 12. GENERALIZED TONIC-CLONIC ( Contd) <ul><li>Cyanosis </li></ul><ul><li>Biting of the tongue </li></ul><ul><li>HR/BP increased </li></ul><ul><li>After 10-20 sec tonic phase is evolved into a clonic phase </li></ul><ul><li>Bladder / Bowel incontinence </li></ul><ul><li>Post ictal confusion / coma / myalgia/fatigue </li></ul>
  13. 13. ATONIC <ul><li>Sudden loss of postural muscle tone lasting for 1-2 sec ( Head drop) </li></ul><ul><li>Consciousness is impaired </li></ul><ul><li>No post ictal confusion </li></ul>
  14. 14. MYOCLONIC <ul><li>Sudden clonic movement of the limbs </li></ul><ul><li>Objects fall from the hand as if it is thrown away </li></ul>
  15. 15. CAUSES OF GEN. SEIZURE <ul><li>Cerebral anoxia </li></ul><ul><li>Alcohol & withdrawal </li></ul><ul><li>Metabolic </li></ul><ul><ul><ul><li>Hyponatraemia </li></ul></ul></ul><ul><ul><ul><li>Hypoglycemia </li></ul></ul></ul><ul><ul><ul><li>Hypocalcaemia </li></ul></ul></ul>
  16. 16. CAUSES ( Contd) <ul><li>Drugs </li></ul><ul><ul><ul><li>Penicillin </li></ul></ul></ul><ul><ul><ul><li>Lignocaine </li></ul></ul></ul><ul><ul><ul><li>Metronidazole </li></ul></ul></ul><ul><ul><ul><li>Chloroquin </li></ul></ul></ul>
  17. 17. CAUSES ( Contd) <ul><li>Infective </li></ul><ul><ul><ul><li>Meningitis </li></ul></ul></ul><ul><ul><ul><li>Encephalitis </li></ul></ul></ul>
  18. 18. CAUSES OF PARTIAL SEIZURE <ul><li>Cerebral embolism </li></ul><ul><li>AV malformation </li></ul><ul><li>Tumor </li></ul><ul><li>Cerebral abscess </li></ul><ul><li>Tuberculoma </li></ul>
  19. 19. INVESTIGATIONS <ul><li>EEG </li></ul><ul><li>CT </li></ul><ul><li>MRI </li></ul><ul><li>Electrolytes </li></ul><ul><li>Sugar </li></ul><ul><li>Calcium </li></ul>
  20. 20. FACTORS TRIGGER SEIZURE <ul><li>Sleep deprivation </li></ul><ul><li>Alcohol / withdrawal </li></ul><ul><li>Physical / mental strain </li></ul><ul><li>Flashing / flickering lights </li></ul><ul><li>Infection </li></ul><ul><li>Loud noise </li></ul><ul><li>Hot water </li></ul>
  21. 21. MANAGEMENT- IMMEDIATE <ul><li>Air way </li></ul><ul><li>Breathing </li></ul><ul><li>Carry the person away from danger </li></ul><ul><li>Diazepam – IV/ PR </li></ul>
  22. 22. PARTIAL SEIZURE MANAGEMENT - LONG TERM <ul><li>Carbamazepine </li></ul><ul><li>Valproate </li></ul><ul><li>Phenytoin </li></ul>
  23. 23. MANAGEMENT – GTCS - Long term <ul><li>Valproate </li></ul><ul><li>Carbamazepine </li></ul><ul><li>Phenytoin </li></ul>
  24. 24. STATUS EPILEPTICUS <ul><li>Continuous seizure or repetitive seizures with impaired consciousness in the inter ictal period </li></ul>
  25. 25. THANK YOU
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