2. Epilepsy (Repetitive Seizures)
• Epilepsy is derived from the greek word epilepsia
meaning ''To seize" was first used by Hippocrates . It is a
brain disorders defined by recurrent unprovoked
seizures.
• Definition :
• Epilepsy is abnormal , recurrent , sudden electrical
discharge from the brain (often in the cerebral cortex)
that result in changes in sensation , behaviour ,
movements , perception or consciousness.
• It is a neurological disorder marked by sudden
recurrent episodes of sensory disturbances, loss of
consciousness or convulsions associated with abnormal
electrical activity in the brain.
3. Seizure.
• A seizure is a symptom of an electrical of an electrical
disturbance in the brain. It can lead lead to loss of
consciousness , disturbance of movement, muscle spasms.
• It is hyperexcitation of neurons in the brain leading to
altered behaviour with or without violent motor activity.
• or
• The clinical manifestation of an abnormal and excessive
synchronization of a population of cortical neurons.
• A seizure usually lasts for 2-5 min when it stops, the person
may have a headache , confusion , fatigue, unsuala and
unpleasant sensation.The onset of epilepsy is common
during childhood and after the age of 65 but the condition
can occur at any age .
4. • Mechanism of epilepsy is beleid to be imbalance in
Neurotransmitter release i.e. abnormally increase
the level of excitatory neurotransmitter glutamate
while decrease in inhibitory neurotransmitter
GABA.Secveral types of epilepsy have now been
linked to defective genes for iron channels that
control the flow of ions and regulate neuron
signaling. During the seizure , neurons may fire 500
times faster than normal neuron.
5. Types of Epilepsy.
• Epilepsy is classified into two main types :
• Partial Seizures : Partial seizures evolving to
generalized seuzures.
• Seizures acivity originates in one part of brain.
• Simple partial Seizures
• Complex partial Seizures
•
7. • 1.Partial Seizure (Focal Seizure) :
A partial seizure does not involve in the whole brain which
begins in an area called focal seizure. It is limited to part of
one brain hemisphere .There is a site of , or a focus , in the
brain where seizure begins.
a. Simple Partial Seizure (Jacksonian Seizures) :
It lasts 20-60 seconds and shows recurrent involuntary
muscle contraction and rarely spread to other parts.
b. Complex Partial Seizures (Temoral lobe /psychromotor
seizures) : This attack lasts for 2-5 minutes . The focus is
located in temporal lobe. It is characterized by sudden
onset of impaired consciousness , purposeless movement ,
emotional changes, aimless walking etc.
8. • Partial Seizure Evolving to Generalized Seizures :
• The partial seizure occurs first and then evolve into
generalized tonic-clonic seizures with loss of
consciousness . Sustained contraction of muscle
(tonic) followed by alternative contraction and
relaxation is observed.
9. • Generalized seizure .
• It involves production of abronmal electrical activity
throughout brain and leads to immediate loss of
consciousness.
• Abscence Seizures.
• Abscence seizures , previously known as petit mal seizures,
often occur in children and are charcterized by starting into
space or subtle body movements such as eye blinking or lip
smacking . These seizures may occur in clusters and cause a
brief loss of awareness.
• Tonic seizures:
• Tonic seizures cause stiffening of your muscles. These
seizures usually affect muscles in your back , arms and legs
and may cause you to fall to the ground .
10. • Clonic Seizures :
• Clonic Seizures are associated with repeated or rhythmic ,
jerking muscle movements . These seizures usually affect
the muscles of neck , face , arms.
• Myoclonic Seizures : Myoclonic seizures usually appear as
sudden brief jerks or twitches of your arms and legs.
• Tonic-Clonic Seizures previously known as grand mal
seizures are the most dramatic type of epileptic seizure and
can cause an abrupt loss of consciousness , body stiffening
and shaking , and sometimes loss of bladder control or
biting your tongue.
• Status Epilepticus : Seizures occur repeatedly with no
recovery of consciousness between attacks.
11. Etiology.
• Tha exact cause of epilepsy may not be known , the
more common seizures are caused by the following :
• Head trauma : Head trauma as a result of a car
accident or other traumatic injury can cause epilepsy.
• Brain condition : Brain conditions that cause damage
to the brain , such as brain tumors or strokes , can
cause epilepsy . Stroke is a leading cause of epilepsy
in adults older than age 35.
12. Infectious Diseases.
• Infectious diseases , such as meningitis , AIDs and
Viral encephelatis can cause epilepsy.
• Prenatal Injury : Before birth, babies are sensitive
to brain damage that could be caused by several
factors, such as infection in the mother , poor
nutrition or oxygen deficiencies. This brain damage
can result in epilepsy or cerabral palsy.
13. Developmental Disorders.
• Epilepsy can sometimes be associated with develoment
disorders , such as autism and neurofibromatosis.
• Other possible causes or seizures may include :
• Brain Tumour.
• Cranial Surgery.
• Metabolic Disorders.
• Drug Toxicity.
• CNS Infection.
• Circulatory Disorders.
• Drug withdrawal States.
• Congenital Neurodegerative Disorders.
14. Pathophysiology.
• 1. Precipitating Factors :
• Sensory stimuli : Loud noise or bright lights.
• 2. Etiology :
• Altered integrity of neuron in the epileptogenic
focus.
• Hyperexicitability state of neur
• 3. Predisposing Factors (Family History)
15. Clinical Manifestations.
• Because Epilepsy is caused by abnormal activity in the brain ,
seizures can affect any process your brain coordinates.
• Seizures signs and symptoms may include :
• Temporary confusion
• A staring cells
• Uncontrollable jerking movements of the arms and legs.
• Loss of consciousness or awareness.
• Psychic symptoms such as fear, anxiety.
• Symptoms vary depending on the type of seizure . In most cases,
a person with epilepsy will tend to have the same type of seizure
each time, so the symptoms will be similar from episode to
episode . Doctors generally classify seizures as either focal or
generalized , based on how the abnormal brain activity begins.
16. Diagnosis.
• A Neurological Examination :
• Examination of behaviour , motor abilities, mental
function and other areas to diagnose the condition
and determine the type of epilepsy.
• Blood Tests : A blood sample to check for signs of
infections , genetic conditions or other conditions
that may be associated with seizures.
• Electroencephaogram (EEG) : This is the most
common test used to diagnose epilepsy . In this test
, doctors attach electrodes to scalp with a paste-
like substance.The electrodes record the electrical
activity of brain.
17. • High-density EEG : In a variation of an EEG test, a high
density EEG recommended , which spaces electrodes
more closely than conventional EEG about a half a
centimeter apart. High-density EEG may help to
determine which areas of the brain are affected by
seizures.
• Computerized Tomography (CT) scan :
• A CT scan X-rays to obtain cross-sectional images of the
brain . CT scans can reveal abnormalities in the brain
that might be causing your seizures , such as tumors ,
bleeding and cysts.
• Magnetic Resonance Imaging (MRI) : An MRI uses
powerful magnets and radio waves to ceate a detailed
view of brain.
18. • Position Emission Tomography (PET) :
• PET scan use a small amount of low dose
radioactive material that's injected into a vein help
visualize areas of the brain and detect
abnormalities.
• Single-photon Emission Computerized Tomgraphy
(SPECT) :
• This type of test is used primarily if you have had an
MRI and EEG that did not pinpoint the location in
your brain where the seizures are originating.
19. • Neuropsychological Tests :
• In these tests , doctors assess your thinking ,
memory and speech skills. The test results help
doctors determine which areas of your brain are
affected.
20. • Treatment :
• Non Pharmacological Treatment :
• Non pharmacological treatment management of
hypertension is possible with life style modification . The
life style modification measures mainly include :
• Physical Activty
• Dietary Sodium Restriction
• DASH (Dietary Approaches to stop hypertension )
• Weight Reduction
• Avoid Smoking
• Avoid Alcohol consumption
• Stress Management
21. • Pharmacological Treatment :
• The medications which are used to treat epilepsy
include :
• Carbamazepine
• Diazepam
• Ethosuximide
• Phenytoin
• Phenobarbital
• Valproic Acid
• Primidone
