Epilepsy is a chronic neurological disorder characterized by recurrent seizures. It affects people of all ages and is caused by abnormal electrical activity in the brain. There are many types of seizures which can vary depending on which part of the brain is involved. Epilepsy is diagnosed if a person has two or more unprovoked seizures. It can be treated but not cured, with medication and other therapies aiming to control seizures. The causes of epilepsy are diverse and include genetic factors, brain injury, infections, and tumors.
Most people have difficulty differentiating between seizure and convulsion. This presentation also highlights the differences between hysterical fit and grand mal seizure.
How to manage the client is briefly discussed.
Most people have difficulty differentiating between seizure and convulsion. This presentation also highlights the differences between hysterical fit and grand mal seizure.
How to manage the client is briefly discussed.
Encephalitis is a rare yet serious disease that can be life-threatening.
Encephalitis is an inflammation of the brain tissue.
The most common cause is viral infections.
In rare cases it can be caused by bacteria or even fungi.
Encephalitis is an inflammation of the brain tissue.
Primary encephalitis- It occurs when a virus directly infects the brain and spinal cord.
Secondary encephalitis- It occurs when an infection starts elsewhere in the body and then travels to your brain.
Older adults
Children under the age of 1 year
People with weak immune systems
Primary (infectious) encephalitis
Common viruses, including HSV (herpes simplex virus) and EBV (Epstein-Barr virus)
Childhood viruses, including measles and mumps
Arboviruses (spread by mosquitoes, ticks, and other insects), including Japanese encephalitis, West Nile encephalitis, and tick-borne encephalitis
Secondary encephalitis: could be caused by a complication of a viral infection.
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
Encephalitis is a rare yet serious disease that can be life-threatening.
Encephalitis is an inflammation of the brain tissue.
The most common cause is viral infections.
In rare cases it can be caused by bacteria or even fungi.
Encephalitis is an inflammation of the brain tissue.
Primary encephalitis- It occurs when a virus directly infects the brain and spinal cord.
Secondary encephalitis- It occurs when an infection starts elsewhere in the body and then travels to your brain.
Older adults
Children under the age of 1 year
People with weak immune systems
Primary (infectious) encephalitis
Common viruses, including HSV (herpes simplex virus) and EBV (Epstein-Barr virus)
Childhood viruses, including measles and mumps
Arboviruses (spread by mosquitoes, ticks, and other insects), including Japanese encephalitis, West Nile encephalitis, and tick-borne encephalitis
Secondary encephalitis: could be caused by a complication of a viral infection.
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
Definition
Epidemiology
Etiology
Pathophysiology
Classification
Diagnosis
Treatment
Anti Seizure Drugs Prices in Jordan
Two Medical cases
New drug approvals
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Effective treatment for epilepsy in Mindheal Homeopathy clinic ,Chembur, Mumb...Shewta shetty
"epilepsy-it is a brain disorder in which the person has repeated convulsions over a period of time. Epilepsy occurs when permanent changes in the brain tissue cause it to be excitable or jumpy. The brain sends out abnormal signals. Mindheal homeopathy is more effective in the treatment of epilepsy then conventional medicine."/>
Effective treatment for epilepsy in Mindheal Homeopathy clinic ,Chembur, Mumb...Shewta shetty
"epilepsy-it is a brain disorder in which the person has repeated convulsions over a period of time. Epilepsy occurs when permanent changes in the brain tissue cause it to be excitable or jumpy. The brain sends out abnormal signals. Mindheal homeopathy is more effective in the treatment of epilepsy then conventional medicine."/>
2. What is Epilepsy?
• Etymology: From the greek word Epilepsia. Epi meaning upon and
Lepsis meaning seizure. In ancient times epilepsy was known as the
sacred disease.
• Definition:
• Epilepsy is a disorder of the brain characterized by an enduring
predisposition to epileptic seizures [Fisher et al, 2005]
• WHO: Two or more unprovoked seizures. A chronic
noncommunicable disorder of the brain that affects people of all
ages.
• Epilepsy is a medical condition that produces seizures affecting a
variety of mental and physical functions. It is also called a seizure
disorder. When a person has two or more unprovoked seizures, they
are considered to have epilepsy (Epilepsy Foundation)
3. What is a seizure?
• Etymology: Seiz + ure meaning sudden attack of illness
• Definition
• An epileptic seizure is the transient occurrence of signs or
symptoms due to abnormal electrical activity in the brain [Fisher
et al, 2005]. This manifests itself as a disturbance of
consciousness, behaviour, emotion, motor function, or sensation.
• Seizures happen when clusters of nerve cells in the brain signal
abnormally, which may briefly alter a person's consciousness,
movements or actions.
4. Epilepsy Epidemiology
• 30 million people worldwide are epilepsy sufferers (WHO)
• Prevalence: 4-6 people per 1000; 0.5%
• Epilepsy has been estimated to affect between 260,000 and
416,000 people in England and Wales.
• Incidence: 40-70 new cases per 100000 annually; 0.05% .
Twice as high in developing countries.
• 80% of the world’s epilepsy is found in the developing
countries
• Why?
5. Who is at risk of Epilepsy?
• Neonatal Period
• hypoxic ischemic encephalopathy
• central nervous system (CNS)
infections
• trauma
• congenital CNS abnormalities
• Metabolic diseases
• Late infancy and Early childhood
• febrile seizures (fairly common),
caused by CNS infections and
trauma.
• Childhood
• well-defined epilepsy syndromes
• Adolescence and adulthood
• CNS lesion
• Idiopathic epilepsy (less
comon)stress, trauma, CNS
infections, brain tumors, illicit
drug use and alcohol withdrawal.
• Older adult
• cerebrovascular disease (very
common cause).
• CNS tumors
• head trauma,
• degenerative diseases e.g.
dementia.[15]
6. Epilepsy Classification
• Epilepsy is a symptom – not a diagnosis
• Epilepsies are classified in five ways:
• By their first cause (or etiology).
• By the observable manifestations of the seizures, known as semiology.
• By the location in the brain where the seizures originate.
• As a part of discrete, identifiable medical syndromes.
• By the event that triggers the seizures, such as reading or music
• Or more simply
• Symptomatic – definite lesion as the cause
• Idiopathic – what it says on the tin
• Cryptogenic – not idiopathic but no definite origin, high prevalence
of associated learning disabilities
7. Seizure Types - Definitions
• Simple – no impairment of consciousness
• Complex – impairment of consciousness
• Generalised (primary and secondary): abnormal electrical
activity is over the entire cortex immediately (primary) or
spreads over the entire cortex from a single point (secondary).
• Focal/Partial – Abnormal electrical activity is restricted to a
region of the brain
8. Seizure Types (cont.)
• Absence – seizures characterised by an abrupt, transient loss
or impairment of consciousness (which is not subsequently
remembered)
• Tonic-clonic – type of generalised seizure that involves a tonic
– stiffening phase and a clonic – jerking phase
• Atonic -seizures characterised by abrupt brief loss of muscle
tone. AKA drop seizures
• Jacksonian March – type of simple partial seizure,
characterised by jerking. Spreads from arm > face > leg
(ipsilaterally)
• Tonic seizures characterised by a stiffening of all the muscles
• Febrile seizures characterised by convulsions brought on by a
significant rise in body temperature.
11. Epilepsy Syndromes
• Epilepsy syndromes are a list of diseases that cause epilepsy
• Epilepsy syndrome as a term – means a syndrome where
recurrent seizures are the predominant feature
• 29 Epilepsy syndromes (ILAE)
12. InternationalClassificationof Epilepsiesand
EpilepticSyndromes
• 1. Localization-related (focal, local, partial) epilepsies
and syndromes
• 1.1. Idiopathic with age-related onset
• A. Benign childhood epilepsy with centrotemporal spikes
• B. Childhood epilepsy with occipital paroxysms
• 1.2. Symptomatic
• A. Chronic progressive epilepsia partialis continua of
childhood
• B. Syndromes characterized by seizures with specific
modes of precipitation
• C. Temporal lobe epilepsies
• D. Frontal lobe epilepsies
• E. Parietal lobe epilepsies
• F. Occipital lobe epilepsies
• 1.3 Crytopgenic
13. InternationalClassificationof Epilepsiesand
EpilepticSyndromes
• 2. Generalized epilepsies and syndromes
• 2.1. Idiopathic, with age-related onset
(listed in order of age)
• A. Benign neonatal familial convulsions
• B. Benign neonatal convulsions
• C. Benign myoclonic epilepsy in infancy
• D. Childhood absence epilepsy
(pyknolepsy)
• E. Juvenile absence epilepsy
• F. Juvenile myoclonic epilepsy (impulsive
petit mal)
• G. Epilepsy with grand mal seizures on
awakening
• H. Other generalized idiopathic epilepsies
not defined above
• I. Epilepsies with seizures precipitated by
specific modes of activation2.2.
Idiopathic and/or symptomatic (listed in
order of age)
• A. West syndrome (infantile spasms)
• B. Lennox-Gastaut syndrome
• C. Epilepsy with myoclonic-astatic
seizures
• D. Epilepsy with myoclonic absences
• 2.3. Symptomatic
• A. Nonspecific etiology
• a. Early myoclonic encephalopathy
• b. Early infantile epileptic encephalopathy
with suppression burst
• c. Other symptomatic generalized
epilepsies not defined above
• B. Specific etiology
• a. Epileptic seizures may complicate many
disease states
14. InternationalClassificationof Epilepsiesand
EpilepticSyndromes
• 3. Epilepsies and syndromes undetermined as to whether they are
focal or generalized
• 3.1. With both generalized and focal seizures
• A. Neonatal seizures
• B. Severe myoclonic epilepsy in infancy
• C. Epilepsy with continuous spike waves during slow-wave sleep
• D. Acquired epileptic aphasia (Landau-Kleffner syndrome)
• E. Other undetermined epilepsies not defined above
• 3.2. Without unequivocal generalized or focal features
• 4. Special syndromes
• 4.1. Situation-related seizures
• A. Febrile convulsions
• B. Isolated, apparently unprovoked epileptic events
• C. Seizures related to other identifiable situations such as stress,
hormonal changes, drugs, alcohol, or sleep deprivation
15. Reflex epilepsy
• Epilepsy always triggered by a specific stimulus
• Music
• Photosensitive epilepsy
• Reading
16. Precipitating factors
• Emotional stress
• Sleep deprivation
• Sleep itself
• Heat stress
• Alcohol
• Febrile illness
• Menstrual Cycle.
• Catamenial epilepsy is the term denoting seizures linked to the
menstrual cycle
17. What happens during the Ictal
phase?
• Dependent on the seizure
• Faecal/urinary incontinence
• Tongue biting – lateral vs anterior
• Observer – collateral history – jerking
• Loss of consciousness
18. What happens post-ictally?
• Confusion
• Extreme fatigue
• Memory Loss
• Drowsiness
• Nausea
• Headache/migraine
• psychosis
• Poor attention and concentration
• Depression
• Todd’s paresis
• Post ictal bliss
21. Psychogenic Seizures
• More common in women
• More common in people with personality disorders
• Commonly a history of physical or sexual abuse as a child
• Can also suffer epileptic attacks as well as psychogenic non-
epileptic psychogenic attacks
22. Pathophysiology of Epilepsy
• PET Scanning has shown that areas of the brain that induce
seixures are less active than other areas of the brain between
seizures (is the brain suppressing the overactive region?)
• PET scanning also revealed abnormal receptor functioning in
these regions with reduced GABAa density.
23. Complications of Epilepsy
• The risk of premature death in people with epilepsy is two to
three times higher than it is for the general population.
• Driving Restrictions – must have had no awake seizures for 6
months or only had sleep seizures for the previous three years
to retain licence in a first seizure scenario. Recurrent sseizure
profile revoke licence – 12 months seizure free
25. Taking a History of a seizure
• What you want to know?
• Are these really epileptic seizures?
• How you are going to find out?
• Ask the right questions
• Did anything bring on the attack?
• Before the attack was there any lightheadedness or blurring/fogging of vision?
• Did anyone else comment that you had become pale?
• Did this happen during or following exercise?
• Did you make an abnormal noise at the start of the attack?
• How did you fall? Stiff vs Floppy
• Did you hurt yourself when you fell?
• Tongue Biting – Lateral vs Anterior
• Faecal incontinence
• How long was the attack?
• Were you able to recognise where you were, who you were with after the attack?
If so how long did this take to resolve?
• Were you lethargic for hours after the attack?
28. Treatment of epilepsy
• Carbamazepine – focal
• Valproate – generalised
• Cepra – both
• Lamotrigine
• Carbamazepine metabolism slowed by clarithromycin
29. Treatments
• Surgery
• Vagal stimulation
• Deep brain stimulation
• Transcranial magnetic stimulation
• Ketogenic diet
• Surgery to disconnect rather than remove brain areas
30. Is Epilepsy Curable?
• Controllable but not curable. Sometimes surgery can be a
curable treatment.
• 20-40% of patients have AED resistant epilepsy
Editor's Notes
– 1st year of life
Very old – stroke related, tumour related, diabetes related, dementia