Non-epileptic paroxysmal disorders can mimic seizures. Careful history and examination is often sufficient to differentiate them from epilepsy, though sometimes EEG or other testing is needed. They can be classified by age of presentation and symptoms. Conditions discussed include breath holding spells, prolonged QT syndrome, hyperekplexia, alternating hemiplegia of childhood, motor tics, episodic ataxias, spasmus nutans, opsoclonus-myoclonus syndrome, sleep related disorders like benign sleep myoclonus, sleep transition disorder, and narcolepsy-cataplexy. Differentiation from epilepsy is important to avoid unnecessary treatment while ensuring appropriate management of the underlying
It contains description and salient points to diagnose various epileptic encephalopathies seen during infancy such as early myoclonic encephalopathies, Otahara syndrome, Dravet syndrome, West syndrome.
Definition
Epidemiology
Etiology
Pathophysiology
Classification
Diagnosis
Treatment
Anti Seizure Drugs Prices in Jordan
Two Medical cases
New drug approvals
the causes, pathophysiology, clinical manifestations, diagnosis and treatment of epilepsy has been discussed in detail with the perspective of a subject called pathophysiology in both medical sciences as well as the pharmaceutical sciences
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
It contains description and salient points to diagnose various epileptic encephalopathies seen during infancy such as early myoclonic encephalopathies, Otahara syndrome, Dravet syndrome, West syndrome.
Definition
Epidemiology
Etiology
Pathophysiology
Classification
Diagnosis
Treatment
Anti Seizure Drugs Prices in Jordan
Two Medical cases
New drug approvals
the causes, pathophysiology, clinical manifestations, diagnosis and treatment of epilepsy has been discussed in detail with the perspective of a subject called pathophysiology in both medical sciences as well as the pharmaceutical sciences
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
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effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
3. • The misdiagnosis of epilepsy is estimated as high as 5 to 40 %
• Often all that is needed to differentiate non-epilectic paroxysmal
disorders from epilepsy is careful and detailed history in addition
to a thorough clinical examination, but sometimes an
electroencephalogram (EEG) or more advanced testing may be
necessary
4. Non-epileptic paroxysmal disorders can be classified according to
the age at presentation and the clinical manifestations
1. Syncope and other generalized paroxysms
2. Movement disorders and other paroxysmal movements and
postures
3. Oculomotor and visual abnormalities and visual hallucinations
4. Sleep related disorders
5. SYNCOPE AND OTHER GENERALIZED
PAROXYSMS
• Apnea, apneic episodes (cessation of breathing > 20 sec) in
neonates and apnea due to brainstem compression are usually
associated with bradycardia, while in seizures is usually
accompanied by tachycardia exceptions are there
• Sleep apnea can either be central (most commonly in premature
neonates) or obstructive.
• Apnea, can also be secondary to cerebral herniation and
brainstem compression due to increased ICP.
6. • Breath holding spell
• A breath-holding spell can be a frightening experience for parents because the infant
becomes lifeless and unresponsive .
• There are two major types of breath-holding spells: the more common cyanotic
form and t he pallid form.
• Cyanotic Spells: The episode is heralded by a brief, shrill cry followed by forced
expiration and apnea.
• There is a rapid onset of generalized cyanosis and a loss of consciousness that may
be associated with repeated generalized clonic jerks, opisthotonus, and bradycardia.
• Normal EEG.
• Rare before 6 months of age.
• They peak at about 2 yr of age, and they abate by 5 yr of age.
• The management is support and reassurance of the parents.
7. Pallid Spells:
• Less common than breath-holding spells.
• Initiated by a painful experience such as falling and striking the head, the child
stops breathing, rapidly loses consciousness, becomes pale and hypotonic.
• Bradycardia may occur.
• Management by conservative measures and atropine sulfate in some cases.
• Prolonged QT Syndrome:
• It is characterized by sudden loss of consciousness during exercise or an emotional
and stressful experience.
• During the period of syncope, various cardiac arrhythmias are evident.
• The child may recover within minutes or die during the event.
• Prolonged QT more than 0.46 msec support the diagnosis.
• B-Adrenergic- antagonist drugs are usually effective and may be lifesaving.
8. Psychological disorders (Pseudoseizures)
• Occur typically between 10 and 18 yr of age and are more frequent among
girls.
• Occur with patients with a past history of epilepsy.
• There are several distinguishing features of pseudoseizure, including lack of
cyanosis, normal reaction of the pupil to light, no loss of sphincter control,
normal plantar responses, and absence of tongue biting.
• The most reliable method of differentiation epilepsy from suspected
pseudoseizures is to record an attack.
• The EEG shows an excess of muscle artifact during the pseudoseizure.
• After a true epileptic seizure, there is a significant increase in serum
prolactin whereas pseudoseizure not.
9. Movement disorder and other paroxysmal
movements and postures
• Neonatal Jitteriness and clonus: Jitteriness consists of recurrent tremors.
Equal backward and forward movements of the limbs, spontaneous, or
triggered by touch or loud sounds.
• Movements suppression by stimulus removal or by relaxing the affected
limbs, the lack of autonomic symptoms and the clear difference from the two
faced (fast contraction, slow relaxation) clonic activity and the very quick
myoclonic jerks, point to a nonepileptic event
• Hypocalcemia, hypoglycemia, drug withdrawal, and hypoxic-ischecmic
encephalopathy or possible etiologies.
10. • Hyperekplexia (stiff baby syndrome) and pathologic startles
• Rare, sporadic or dominantly inherited disorder with neonatal
onset of life threatening episodes of tonic stiffening leads to apnea
and convulsive hypoxic seizure, characterized by a triad of
generalized stiffness, nocturnal myoclonus and startle reflex
• Stiffness in the neonatal form improves by one year of age and
may disappear during sleep
• Specific diagnostic sign can be elicited by tapping the nose, which
produces a nonfatigable startle reflex with head retraction.
• Treatment of choice clonazepam
11. • Alternating hemiplegia of childhood
• This is a rare, often severe, disorder that consists of flaccid
hemiplegia affecting one or both sides lasting minutes to days,
starting in the first 18 months of life.
• Earlier manifestations include paroxysmal nystagmus, which is
monocular and ipsilateral to the hemiplegia or dystonia
• Most effected children also have ataxia and developmental delay,
choreoathetosis and behavioral problems
• Flunarizine 2.5-20 mg/day reduces the frequency and severity of
the attacks
12. • Motor tics
• Movements that are under partial control and are associated with
an urge to do them and with subsequent relief.
• Simple tics, occur at some time in about one in five children,
involve in one or two muscle groups
• Complex tics, involve multiple tics or muscle groups
• Tourette syndrome, consists of multiple motor tics and vocal tics
for more than a year, there is often a family history of tics and/or
obsessive-compulsive disorder or personality trait
13. • Episodic ataxias
• Form a clinically and genetically heterogeneous group of diseases that
manifest with recurrent truncal ataxia and incoordination of the eight
syndromes described so far, only two (types 1 and 2 ) have been reported in a
large number of families from different ethnic groups.
• Type 1, caused by mutations in the voltage-gated potassium channel. It
consists of brief episodes (sec to min) of cerebellar ataxia and partial seizures
• Type 2, characterized by longer attacks (min-hours) and interictal cerebellar
signs. Its caused by mutation in the voltage gated calcium channel gene. This
type is more responsive than type-1 to acetazolamide; the drug can reduce
frequency and severity of attacks
14. • Psychological disorders; many psychological disorders can be
mistaken for epileptic seizures
• Stereotypies repetitive movements that are more complex then
tics and do not changed and wax and wane as do tics (head-
banging, head-rolling, body rocking and hand flapping) usually
occur in neurological impaired children
• Hyperventilation spells; can be precipitated by anxiety and are
associated with dizziness, tingling, and, at times, carpopedal
spasm
• Transient global amnesia; consists of isolated short term memory
loss for minutes to hours have been reported in children
•
15. Oculomotor And Visual Abnormalities
• Spasmus Nutans ; triade of nystagmus head tilt and head nodding. Brain
MRI should be performed because the triade has been associated with masses
in the optic chiasm and third ventricle.
• In the absence of these associations remission occurs before 5 years of age.
• Opsoclonus-myoclonus syndrome; dancing eyes with continuous, random,
irregular, and conjugate eye movements that may fluctuate intensity
• Neuroblastoma (more commonly ), encephalitis and post infectious etiology
are possible causes and treated with clonazepam, corticosteroids, rituximab.
16. • Day dreaming and behavioral staring
• It is because of fatigue and inattention a differentiating point
from absence seizures, this is common in children with
attention deficit disorder
• Hyperventilation in the office precipitates absence seizure and
is useful clinical test
17. Sleep Related Disorders
• Paroxysmal nonepileptic sleep events are more common in
epileptic patients than in general population which makes there
diagnosis more difficult.
• Benign sleep myoclonus and neonatal sleep myoclonus
• Consists of repetitive, usually bilateral, rhythmic jerks involving
the upper and lower limbs during non rapid eye movement sleep,
sometimes mimicking clonic seizure.
• Remission is spontaneous usually at 2 to 3 months of age
18. • Sleep transition disorder
• Nocturnal head banging ( jactatio capitis nocturnal ), rolling, repetitive
limb movements, or body rocking occur in infants and toddlers as they
are trying to fall asleep and can be mistaken for seizure or spasms. They
usually remit spontaneously by 5 years of age, no specific therapy is
needed
• Narcolepsy-cataplexy
• Narcolepsy is characterized by excessive day time sleepiness, cataplexy,
sleep paralysis, hypnogogic hallucinations and disturb night time sleep
• Therapy relies on scheduled naps; medications such as amphetamines,
tricyclic antidepressants and counseling about precautions in work and
driving.