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Epilepsy
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- 2. CONTENTS What isEpilepsy Epidemiology Pathophysiology Causes Signs and symptoms Types of epilepsy Diagnosis Treatment Future perspective Summary References 2
- 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 3
- 4. EPIDEMIOLOGY Epilepsy knows nogeographical, 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 4
- 5. Pathophysiology 5 Each electricalsignal 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
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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 7
- 8. SIGNS AND SYMPTOMS 8 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. 9
- 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 10
- 11. Generalized tonic-clonic seizures The patient loss consciousness Tonic phase: develops generalized stiffness Clonic phase: muscles alternately contract and relax 11
- 12. TONIC AND CLONICSEIZURES 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 12
- 13. MYOCLONIC & ABSENCESEIZURES 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 • Atonicseizures • Drop attack • Sudden loss of muscle activity occurs • Lasts for only seconds but may occurs several times a day 14
- 15. TYPES OF SEIZURES PARTIAL SEIZURES i. Simple partial seizures ii. Complex partial seizures 15
- 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 16
- 17. Complex partial seizures Impaired consciousness or losing consciousness completely Don’t remember exactly what happened during the seizures 17
- 18. DIAGNOSIS Through historymaking Physical examination Blood test, EEG, MRI of brain, CT scan of brain, Skull X-ray 18
- 19. TREATMENT Medication Surgery Diet Vagus nerve stimulation(VNS) 19
- 20. TREATMENT Medication Anti-epilepticdrugs (AEDs) 70% of children and adults can be treated Surgery Surgical therapy might be beneficial to patients who respond poorly to drug treatments 20
- 21. TREATMENT Diet i. Ketogenicdiet • High in fat and low in carbohydrate contents • Prescribed when drugs proven in effective • Mechanism not well understood 21
- 22. TREATMENT ii. Vagus nervestimulation In 1997, FDA approved VNS Consider only when no chance for surgery 22
- 23. FUTURE PERESPECTIVE Radiosurgery–in future might be an alternate treatment of surgery It might be an effective or safe techniques. 23
- 24. SUMMARY Epilepsy isneurologic 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 24
- 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/ 25
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Editor's Notes
- #5 In low and middle income countries, this figure can be upto two times higher, this is likely due to increase risk of endemic conditions such as malaria and neurocysticerosis, increased risk of road traffic injuries,birth related injuries, and variation in medical infrastructure
- #8 Brain damage
- #9 Its signs n sym vary depending upon where in the brain it first start and how far it spread, depending on this epilepsy classified into two types general n partial which will discussed later
- #12 DURING TONIC PHASE THE BREATHING STOPS AS ALL THE MUSCLES OF THE TRUNK ARE IN SPASMA
- #17 Focus on primary motor cortex, primary sensory cortex, foci in the temporal lobe of the brain, consist of changes in the mood, memory or thought. There may be distorted perception or problem with language
- #18 A strange feeling in the stomach rises upto the throat and head, or sensation of light, smell, sound or taste. Automatism-psychomotor symptoms like chewing movements, smacking of lips, the patient is completely unaware of their actions
- #19 EEG, Imaging scan to confrm the diagnosis of epilepsy
- #22 Shifting of ph towards the metabolic acidosis and alteration of brain metabolism may be involved.
- #23 Device is implanted to control seizures by delivering electrical stimulation to the vagus nerve in the neck, which relays impulses to widespread areas of the brain
- #24 Radiosurgery focus raditions on targed volume area with in the brain which have been identified by MRI, this treatment being evaluated as alternate treatment to surgery, it may be an effective or safe technique