This document provides an overview of the ILAE classification of seizures. It begins with definitions of key terms like seizure, epilepsy, aura, etc. It describes the purpose of the ILAE classification system and how it categorizes seizures as either partial or generalized based on clinical manifestations and EEG findings. The classifications include simple and complex partial seizures as well as generalized seizure types like absence seizures, myoclonic seizures, and tonic-clonic seizures. Electrographic characteristics are also discussed for different seizure types. The document concludes with references for further information.
Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy caused by an autoimmune attack against the peripheral nervous system, often triggered by a preceding infection. It is characterized by rapidly progressive muscle weakness that can lead to paralysis. The syndrome was first described in 1916 by Guillain, Barré, and Strohl. It has several subtypes classified by whether the immune attack affects the myelin sheath or axon. The most common subtype in Western countries damages the myelin sheath. Prodromal diarrhea or respiratory infection often precedes the onset of numbness and weakness, which starts in the legs and ascends symmetrically. Areflexia is
Epilepsy is characterized by recurrent seizures that result from abnormal neuronal activity in the brain. Seizures can be generalized, originating simultaneously across both hemispheres of the brain, or partial, originating in a localized region of the brain. Generalized seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. Partial seizures can be simple, with motor, sensory or other symptoms but no change in consciousness, or complex, with impaired consciousness. Seizures can have various causes including genetic factors, head injuries, infections, or other acquired brain abnormalities. Evaluation and treatment involve diagnostic testing, medication, and management of any underlying conditions.
Absence seizures typically have two peaks in age of onset, between 5-8 years and near 12 years. Childhood absence epilepsy (CAE) accounts for 10-17% of childhood epilepsy cases and is characterized by brief seizures without aura or postictal period. Typical absence seizures involve eye blinking or movements lasting a few seconds accompanied by generalized spike-and-wave discharges on EEG. Treatment typically begins with ethosuximide, though valproate or lamotrigine may be used if generalized tonic-clonic seizures are also present. While often labeled benign, CAE has variable outcomes, with some studies finding generalized tonic-clonic seizures develop later in 40% of cases.
This document discusses psychiatric presentations in epilepsy. It begins by noting the increased prevalence of psychiatric disorders in patients with epilepsy compared to the general population. It then categorizes psychiatric disorders seen in epilepsy into several groups: disorders related to the underlying brain pathology causing epilepsy, disorders related to the seizure occurrence itself (pre-ictal, ictal, post-ictal), and interictal psychiatric disorders not clearly related to seizures. Specific syndromes and disorders are discussed within each category. Ictal phenomena include epileptic auras, automatisms, and non-convulsive status epilepticus, which can resemble psychiatric symptoms but are distinguished by their brief and stereotyped nature.
This document provides information about epilepsy, including its definition, types of seizures, causes, symptoms, diagnosis, treatment and classification of antiepileptic drugs. Some key points:
- Epilepsy is a chronic neurological condition characterized by recurrent seizures. Seizures have focal or generalized onset in the brain.
- Common causes include genetic factors, brain injury, infections, tumors and metabolic imbalances. Symptoms vary depending on the seizure type and location in the brain.
- Diagnosis involves patient history, physical exam, EEG, imaging and lab tests. Treatment involves antiepileptic drugs to reduce seizures, with drug choices based on seizure type.
- Major antiepileptic drug classes work
EPILEPSY AND SEIZURE DISORDERS
The document discusses epilepsy and seizure disorders. It defines seizures as paroxysmal events due to abnormal neuronal activity in the brain. It classifies seizures as either focal or generalized based on their origin. Focal seizures originate in one hemisphere while generalized seizures rapidly engage both hemispheres. Common types of seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. The document also discusses the etiology, diagnosis, treatment and management of epilepsy through use of anti-epileptic drugs, surgery, or other methods.
Epilepsy syndromes can be categorized based on age of onset from neonates to childhood. Syndromes include self-limited, developmental and epileptic encephalopathies, and genetic generalized epilepsies. Syndromes are defined by seizure type, EEG findings, development, and treatment response/prognosis. Examples provided include benign familial neonatal epilepsy, Dravet syndrome, childhood absence epilepsy, Lennox-Gastaut syndrome, and Landau-Kleffner syndrome.
Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy caused by an autoimmune attack against the peripheral nervous system, often triggered by a preceding infection. It is characterized by rapidly progressive muscle weakness that can lead to paralysis. The syndrome was first described in 1916 by Guillain, Barré, and Strohl. It has several subtypes classified by whether the immune attack affects the myelin sheath or axon. The most common subtype in Western countries damages the myelin sheath. Prodromal diarrhea or respiratory infection often precedes the onset of numbness and weakness, which starts in the legs and ascends symmetrically. Areflexia is
Epilepsy is characterized by recurrent seizures that result from abnormal neuronal activity in the brain. Seizures can be generalized, originating simultaneously across both hemispheres of the brain, or partial, originating in a localized region of the brain. Generalized seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. Partial seizures can be simple, with motor, sensory or other symptoms but no change in consciousness, or complex, with impaired consciousness. Seizures can have various causes including genetic factors, head injuries, infections, or other acquired brain abnormalities. Evaluation and treatment involve diagnostic testing, medication, and management of any underlying conditions.
Absence seizures typically have two peaks in age of onset, between 5-8 years and near 12 years. Childhood absence epilepsy (CAE) accounts for 10-17% of childhood epilepsy cases and is characterized by brief seizures without aura or postictal period. Typical absence seizures involve eye blinking or movements lasting a few seconds accompanied by generalized spike-and-wave discharges on EEG. Treatment typically begins with ethosuximide, though valproate or lamotrigine may be used if generalized tonic-clonic seizures are also present. While often labeled benign, CAE has variable outcomes, with some studies finding generalized tonic-clonic seizures develop later in 40% of cases.
This document discusses psychiatric presentations in epilepsy. It begins by noting the increased prevalence of psychiatric disorders in patients with epilepsy compared to the general population. It then categorizes psychiatric disorders seen in epilepsy into several groups: disorders related to the underlying brain pathology causing epilepsy, disorders related to the seizure occurrence itself (pre-ictal, ictal, post-ictal), and interictal psychiatric disorders not clearly related to seizures. Specific syndromes and disorders are discussed within each category. Ictal phenomena include epileptic auras, automatisms, and non-convulsive status epilepticus, which can resemble psychiatric symptoms but are distinguished by their brief and stereotyped nature.
This document provides information about epilepsy, including its definition, types of seizures, causes, symptoms, diagnosis, treatment and classification of antiepileptic drugs. Some key points:
- Epilepsy is a chronic neurological condition characterized by recurrent seizures. Seizures have focal or generalized onset in the brain.
- Common causes include genetic factors, brain injury, infections, tumors and metabolic imbalances. Symptoms vary depending on the seizure type and location in the brain.
- Diagnosis involves patient history, physical exam, EEG, imaging and lab tests. Treatment involves antiepileptic drugs to reduce seizures, with drug choices based on seizure type.
- Major antiepileptic drug classes work
EPILEPSY AND SEIZURE DISORDERS
The document discusses epilepsy and seizure disorders. It defines seizures as paroxysmal events due to abnormal neuronal activity in the brain. It classifies seizures as either focal or generalized based on their origin. Focal seizures originate in one hemisphere while generalized seizures rapidly engage both hemispheres. Common types of seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. The document also discusses the etiology, diagnosis, treatment and management of epilepsy through use of anti-epileptic drugs, surgery, or other methods.
Epilepsy syndromes can be categorized based on age of onset from neonates to childhood. Syndromes include self-limited, developmental and epileptic encephalopathies, and genetic generalized epilepsies. Syndromes are defined by seizure type, EEG findings, development, and treatment response/prognosis. Examples provided include benign familial neonatal epilepsy, Dravet syndrome, childhood absence epilepsy, Lennox-Gastaut syndrome, and Landau-Kleffner syndrome.
Epilepsy is a disease of the brain defined by recurrent seizures that are not caused by an immediate brain insult. A seizure involves abnormal neuronal activity in the brain, while epilepsy describes the underlying brain condition causing recurrent seizures. Epilepsy is generally diagnosed after a person experiences at least two unprovoked seizures more than 24 hours apart or one unprovoked seizure and at least a 60% risk of having another within ten years. Epilepsy can be caused by genetic and structural/metabolic factors and in some cases the cause is unknown. Seizures are classified as generalized or partial based on where they originate in the brain. Diagnosing epilepsy involves taking a detailed history, physical exam, EEG, and brain imaging.
Status epilepticus is defined as continuous seizure activity lasting more than 5 minutes or multiple seizures without recovery between seizures. It can become refractory or super-refractory if seizures continue despite treatment. The pathophysiology involves failure of endogenous mechanisms to terminate seizures, leading to a self-sustaining state through receptor trafficking and gene expression changes. Prolonged seizures cause neuronal injury and death. Poor prognosis factors include older age, longer duration of status epilepticus, lack of prior seizures, lower Glasgow Coma Scale, and acute symptomatic etiology.
1. Stroke is defined as a nontraumatic brain injury caused by occlusion or rupture of cerebral blood vessels that results in sudden neurological deficits.
2. The most common types of stroke are ischemic (85%) and hemorrhagic (15%). Ischemic strokes are further classified as thrombotic, embolic, or lacunar.
3. Major risk factors for stroke include hypertension, heart disease, diabetes, smoking, and older age. Location of brain injury determines the specific neurological symptoms, such as deficits on one side of the body for middle cerebral artery strokes.
Myasthenia gravis (MG) is a long-term neuromuscular disease that leads to varying degrees of skeletal muscle weakness. The most commonly affected muscles are those of the eyes, face, and swallowing. It can result in double vision, drooping eyelids, trouble talking, and trouble walking.
Epilepsy is a disorder caused by abnormal electrical activity in the brain that causes seizures. Seizures occur when groups of nerve cells, or neurons, in the brain send out abnormal burst of electrical activity. The main types of seizures are generalized seizures, which involve the whole brain, and partial seizures, which originate in one area of the brain. Epilepsy has many potential causes including genetic factors, brain injury, infections, tumors, and metabolic imbalances. Treatment involves medications to control seizures and lifestyle modifications to prevent injury during seizures.
This document discusses the key changes in the 2017 classification of epilepsies by the International League Against Epilepsy (ILAE). It presents the 3-level classification system:
1) Seizure type - Based on where seizures begin in the brain, level of awareness, and other features.
2) Epilepsy type - Focal, generalized, combined, or unknown.
3) Epilepsy syndrome - Specific diagnoses incorporating etiology, seizure types, EEG and imaging features.
The document outlines the changes from prior classifications, new terminology, seizure and epilepsy definitions, etiology categories, and provides examples to illustrate the classification framework.
This document provides definitions and information about seizures and epilepsy. It defines a seizure as a sudden wave of synchronous electrical activity in the brain that affects how a person feels or acts for a short time. Epilepsy is defined as a condition that affects the central nervous system and requires a person to have had at least two seizures not caused by a known medical condition or extremely low blood sugar. The document discusses different types of seizures including partial and generalized seizures, as well as diagnostic testing and treatment options for epilepsy.
This document discusses acute confusional state (delirium). It defines delirium as an acute mental status change characterized by abnormal and fluctuating attention. There are three subtypes of delirium - hyperactive, hypoactive, and mixed. Delirium is very common in hospitalized patients, especially in the ICU. It has a multifactorial etiology, with common causes including metabolic disturbances, toxins, infections, neurological issues, and the perioperative period. Diagnosis involves assessing for features of acute onset and fluctuating course, inattention, disorganized thinking, and altered consciousness. Treatment focuses on treating underlying causes, preventing delirium through non-pharmacological measures, and potentially using low-dose antipsychotics
This document discusses sensory ataxia, including its causes, clinical presentation, and differential diagnosis. Sensory ataxia results from disorders of the cerebellum, vestibular system, or sensory pathways. It is characterized by incoordination without significant weakness. Key findings include impaired proprioception, positive Romberg's sign, pseudoathetosis, and loss of vibration or joint position sense. Causes include peripheral neuropathies, paraneoplastic disorders, infections like HIV, autoimmune conditions like Sjogren's syndrome, and medications like chemotherapy. Dorsal root ganglionopathies commonly underlie sensory ataxia and can be assessed through nerve conduction studies and lumbar puncture. Distinguishing sensory
This document provides information about acute disseminated encephalomyelitis (ADEM). It defines ADEM as a demyelinating disease of the central nervous system that typically presents as a monophasic disorder with encephalopathy and multifocal neurological symptoms. The document discusses the pathogenesis, clinical features, diagnosis, differential diagnosis and treatment of ADEM. It states that ADEM is usually treated initially with high-dose intravenous corticosteroids over 3-5 days.
This document classifies and defines different types of seizures. It discusses the importance of determining the seizure type to identify the cause, select appropriate treatment, and provide a prognosis. Seizures are classified as either focal or generalized. Focal seizures originate in one area of the brain, while generalized seizures involve both hemispheres. Different generalized seizures include tonic-clonic, absence, myoclonic, atonic, and others. Focal seizures can be simple, complex, or start focally and spread. The document provides detailed descriptions and diagrams of the clinical presentations and brain mechanisms of several common seizure types.
The document discusses different types of seizures, including primary generalized seizures which involve both sides of the brain at once and partial seizures which begin in a limited area of the brain. It provides details on different types of primary generalized seizures such as absence seizures, atypical absence seizures, myoclonic seizures, atonic seizures, and tonic seizures; describing their characteristics, symptoms, typical age of onset, and other clinical features. The document also mentions that electroencephalograms can help identify seizure disorders by recording abnormal electrical brain wave patterns during seizures.
This document discusses different types of seizures, including partial seizures (simple and complex), generalized seizures (absence, myoclonic, infantile spasms, clonic, tonic, tonic-clonic, atonic), and provides details on each type. It also covers topics like epilepsy, seizure classification, recognizing seizures, and complex partial seizures transitioning to generalized seizures.
semiological classification of seizure, localisation and lateralisation Vinayak Rodge
This document discusses seizure semiology and classification. It begins with an overview of seizure types including motor, aura, dialeptic, autonomic, and special seizures. Motor seizures are further divided into simple and complex seizures. Aura symptoms are described and their localizing value discussed. Dialeptic seizures include absence and complex partial seizures. Autonomic seizures must have objective evidence of autonomic changes. Special seizures include atonic, astatic, negative myoclonic, akinetic, aphasic, and hypomotor seizures. Lateralizing signs and their localizing value are then reviewed. Finally, generalized and focal epilepsies are contrasted, and features of frontal lobe seizures are outlined.
ATAXIA IN CHILDREN -CAUSES, MANAGEMENT, INVESTIGATIONS, TYPES, COMMONEST ATAXIA IN CHILDREN IN DETAIL, HOW WILL YOU FIND OUT THE CAUSE FOR ATAXIA IN CHILDREN FLOWCHART, DEFINITION, TREATMENT
Guillain-Barré syndrome is an acute polyneuropathy that affects the peripheral nervous system, causing demyelination of nerve fibers which results in loss of neurotransmission to the periphery. It is an acute and potentially fatal disorder that more commonly affects males. Common causes include bacterial or viral infections. Symptoms include ascending paralysis, bulbar weakness, paresthesia, hypotonia, and areflexia. Treatment focuses on corticosteroids, immunoglobulins, antibiotics, and supportive care like plasmapheresis or mechanical ventilation.
This document provides information about transverse myelitis (TM), including its definition, etiology, presentation, diagnosis, treatment, and prognosis. Some key points:
- TM is defined as acute spinal cord inflammation and injury that causes neurological deficits. It can be post-infectious, post-vaccination, or associated with MS.
- Presentation involves varying degrees of motor weakness, sensory alterations, and autonomic dysfunction below a certain spinal level. Up to half of idiopathic cases follow a respiratory or gastrointestinal illness.
- Diagnosis involves ruling out other causes through MRI, CSF analysis showing inflammation, and clinical features meeting criteria. Treatment begins with high-dose steroids to reduce inflammation,
Multiple sclerosis is an autoimmune disease of the central nervous system characterized by demyelination of nerve fibers. It most commonly presents in young adults between 20-40 years of age and is more prevalent in women. Symptoms vary depending on the location of lesions but commonly include weakness, numbness, vision issues, and balance problems. Diagnosis involves MRI of the brain showing characteristic white matter lesions. Treatment focuses on reducing relapses through disease-modifying drugs for relapsing-remitting MS, and managing symptoms like spasticity, pain, and bladder problems.
This document discusses different types of tremors, including essential tremor, parkinsonian tremor, enhanced physiologic tremor, drug-induced tremor, cerebellar tremor, psychogenic tremor, dystonic tremor, and Wilson's disease tremor. It provides details on symptoms, causes, diagnostic criteria and approach for each type. The most common tremors are essential tremor, parkinsonian tremor, and enhanced physiologic tremor. A thorough history, physical exam, and categorization of tremor characteristics are important for diagnosis.
This presentation provides information on Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). It discusses their etiology, clinical presentation, diagnosis, and physiotherapy management. Both GBS and CIDP result from an autoimmune attack on peripheral nerves causing demyelination. While GBS is acute, CIDP is chronic with progressive symptoms over time. Clinical features include weakness, numbness, and sensory loss. Physiotherapy focuses on maintaining function, mobility, and recovery through various exercises depending on the patient's stage of illness. Prognosis is generally good, with around 65% of GBS patients achieving near complete recovery within a year.
Classification of Seizures (ILAE) By Syed Irshad MurtazaMurtaza Syed
The document provides an overview of the International League Against Epilepsy's (ILAE) classification of seizures. It defines key terms like seizure, epilepsy, aura, ictus, and status epilepticus. It outlines the ILAE's definitions and categories of partial and generalized seizures like simple partial, complex partial, absence, myoclonic, clonic, tonic, and tonic-clonic seizures. Example EEG findings and videos of different seizure types are also provided. The classification aims to standardize seizure terminology and aid in electroclinical diagnosis through categorizing seizures based on clinical manifestations and EEG findings.
This document provides information on seizure and epilepsy, including definitions, classifications, and pathophysiology. It begins with learning objectives and definitions of key terms like seizure, epilepsy, and seizure types. It then covers classifications of seizures and epilepsies based on ictal phenomenology, seizure type, epileptic syndrome, and etiology. Pathophysiology, risk factors, investigations, and treatments are also discussed. Classification systems aim to accurately identify etiology, treatment, and prognosis.
Epilepsy is a disease of the brain defined by recurrent seizures that are not caused by an immediate brain insult. A seizure involves abnormal neuronal activity in the brain, while epilepsy describes the underlying brain condition causing recurrent seizures. Epilepsy is generally diagnosed after a person experiences at least two unprovoked seizures more than 24 hours apart or one unprovoked seizure and at least a 60% risk of having another within ten years. Epilepsy can be caused by genetic and structural/metabolic factors and in some cases the cause is unknown. Seizures are classified as generalized or partial based on where they originate in the brain. Diagnosing epilepsy involves taking a detailed history, physical exam, EEG, and brain imaging.
Status epilepticus is defined as continuous seizure activity lasting more than 5 minutes or multiple seizures without recovery between seizures. It can become refractory or super-refractory if seizures continue despite treatment. The pathophysiology involves failure of endogenous mechanisms to terminate seizures, leading to a self-sustaining state through receptor trafficking and gene expression changes. Prolonged seizures cause neuronal injury and death. Poor prognosis factors include older age, longer duration of status epilepticus, lack of prior seizures, lower Glasgow Coma Scale, and acute symptomatic etiology.
1. Stroke is defined as a nontraumatic brain injury caused by occlusion or rupture of cerebral blood vessels that results in sudden neurological deficits.
2. The most common types of stroke are ischemic (85%) and hemorrhagic (15%). Ischemic strokes are further classified as thrombotic, embolic, or lacunar.
3. Major risk factors for stroke include hypertension, heart disease, diabetes, smoking, and older age. Location of brain injury determines the specific neurological symptoms, such as deficits on one side of the body for middle cerebral artery strokes.
Myasthenia gravis (MG) is a long-term neuromuscular disease that leads to varying degrees of skeletal muscle weakness. The most commonly affected muscles are those of the eyes, face, and swallowing. It can result in double vision, drooping eyelids, trouble talking, and trouble walking.
Epilepsy is a disorder caused by abnormal electrical activity in the brain that causes seizures. Seizures occur when groups of nerve cells, or neurons, in the brain send out abnormal burst of electrical activity. The main types of seizures are generalized seizures, which involve the whole brain, and partial seizures, which originate in one area of the brain. Epilepsy has many potential causes including genetic factors, brain injury, infections, tumors, and metabolic imbalances. Treatment involves medications to control seizures and lifestyle modifications to prevent injury during seizures.
This document discusses the key changes in the 2017 classification of epilepsies by the International League Against Epilepsy (ILAE). It presents the 3-level classification system:
1) Seizure type - Based on where seizures begin in the brain, level of awareness, and other features.
2) Epilepsy type - Focal, generalized, combined, or unknown.
3) Epilepsy syndrome - Specific diagnoses incorporating etiology, seizure types, EEG and imaging features.
The document outlines the changes from prior classifications, new terminology, seizure and epilepsy definitions, etiology categories, and provides examples to illustrate the classification framework.
This document provides definitions and information about seizures and epilepsy. It defines a seizure as a sudden wave of synchronous electrical activity in the brain that affects how a person feels or acts for a short time. Epilepsy is defined as a condition that affects the central nervous system and requires a person to have had at least two seizures not caused by a known medical condition or extremely low blood sugar. The document discusses different types of seizures including partial and generalized seizures, as well as diagnostic testing and treatment options for epilepsy.
This document discusses acute confusional state (delirium). It defines delirium as an acute mental status change characterized by abnormal and fluctuating attention. There are three subtypes of delirium - hyperactive, hypoactive, and mixed. Delirium is very common in hospitalized patients, especially in the ICU. It has a multifactorial etiology, with common causes including metabolic disturbances, toxins, infections, neurological issues, and the perioperative period. Diagnosis involves assessing for features of acute onset and fluctuating course, inattention, disorganized thinking, and altered consciousness. Treatment focuses on treating underlying causes, preventing delirium through non-pharmacological measures, and potentially using low-dose antipsychotics
This document discusses sensory ataxia, including its causes, clinical presentation, and differential diagnosis. Sensory ataxia results from disorders of the cerebellum, vestibular system, or sensory pathways. It is characterized by incoordination without significant weakness. Key findings include impaired proprioception, positive Romberg's sign, pseudoathetosis, and loss of vibration or joint position sense. Causes include peripheral neuropathies, paraneoplastic disorders, infections like HIV, autoimmune conditions like Sjogren's syndrome, and medications like chemotherapy. Dorsal root ganglionopathies commonly underlie sensory ataxia and can be assessed through nerve conduction studies and lumbar puncture. Distinguishing sensory
This document provides information about acute disseminated encephalomyelitis (ADEM). It defines ADEM as a demyelinating disease of the central nervous system that typically presents as a monophasic disorder with encephalopathy and multifocal neurological symptoms. The document discusses the pathogenesis, clinical features, diagnosis, differential diagnosis and treatment of ADEM. It states that ADEM is usually treated initially with high-dose intravenous corticosteroids over 3-5 days.
This document classifies and defines different types of seizures. It discusses the importance of determining the seizure type to identify the cause, select appropriate treatment, and provide a prognosis. Seizures are classified as either focal or generalized. Focal seizures originate in one area of the brain, while generalized seizures involve both hemispheres. Different generalized seizures include tonic-clonic, absence, myoclonic, atonic, and others. Focal seizures can be simple, complex, or start focally and spread. The document provides detailed descriptions and diagrams of the clinical presentations and brain mechanisms of several common seizure types.
The document discusses different types of seizures, including primary generalized seizures which involve both sides of the brain at once and partial seizures which begin in a limited area of the brain. It provides details on different types of primary generalized seizures such as absence seizures, atypical absence seizures, myoclonic seizures, atonic seizures, and tonic seizures; describing their characteristics, symptoms, typical age of onset, and other clinical features. The document also mentions that electroencephalograms can help identify seizure disorders by recording abnormal electrical brain wave patterns during seizures.
This document discusses different types of seizures, including partial seizures (simple and complex), generalized seizures (absence, myoclonic, infantile spasms, clonic, tonic, tonic-clonic, atonic), and provides details on each type. It also covers topics like epilepsy, seizure classification, recognizing seizures, and complex partial seizures transitioning to generalized seizures.
semiological classification of seizure, localisation and lateralisation Vinayak Rodge
This document discusses seizure semiology and classification. It begins with an overview of seizure types including motor, aura, dialeptic, autonomic, and special seizures. Motor seizures are further divided into simple and complex seizures. Aura symptoms are described and their localizing value discussed. Dialeptic seizures include absence and complex partial seizures. Autonomic seizures must have objective evidence of autonomic changes. Special seizures include atonic, astatic, negative myoclonic, akinetic, aphasic, and hypomotor seizures. Lateralizing signs and their localizing value are then reviewed. Finally, generalized and focal epilepsies are contrasted, and features of frontal lobe seizures are outlined.
ATAXIA IN CHILDREN -CAUSES, MANAGEMENT, INVESTIGATIONS, TYPES, COMMONEST ATAXIA IN CHILDREN IN DETAIL, HOW WILL YOU FIND OUT THE CAUSE FOR ATAXIA IN CHILDREN FLOWCHART, DEFINITION, TREATMENT
Guillain-Barré syndrome is an acute polyneuropathy that affects the peripheral nervous system, causing demyelination of nerve fibers which results in loss of neurotransmission to the periphery. It is an acute and potentially fatal disorder that more commonly affects males. Common causes include bacterial or viral infections. Symptoms include ascending paralysis, bulbar weakness, paresthesia, hypotonia, and areflexia. Treatment focuses on corticosteroids, immunoglobulins, antibiotics, and supportive care like plasmapheresis or mechanical ventilation.
This document provides information about transverse myelitis (TM), including its definition, etiology, presentation, diagnosis, treatment, and prognosis. Some key points:
- TM is defined as acute spinal cord inflammation and injury that causes neurological deficits. It can be post-infectious, post-vaccination, or associated with MS.
- Presentation involves varying degrees of motor weakness, sensory alterations, and autonomic dysfunction below a certain spinal level. Up to half of idiopathic cases follow a respiratory or gastrointestinal illness.
- Diagnosis involves ruling out other causes through MRI, CSF analysis showing inflammation, and clinical features meeting criteria. Treatment begins with high-dose steroids to reduce inflammation,
Multiple sclerosis is an autoimmune disease of the central nervous system characterized by demyelination of nerve fibers. It most commonly presents in young adults between 20-40 years of age and is more prevalent in women. Symptoms vary depending on the location of lesions but commonly include weakness, numbness, vision issues, and balance problems. Diagnosis involves MRI of the brain showing characteristic white matter lesions. Treatment focuses on reducing relapses through disease-modifying drugs for relapsing-remitting MS, and managing symptoms like spasticity, pain, and bladder problems.
This document discusses different types of tremors, including essential tremor, parkinsonian tremor, enhanced physiologic tremor, drug-induced tremor, cerebellar tremor, psychogenic tremor, dystonic tremor, and Wilson's disease tremor. It provides details on symptoms, causes, diagnostic criteria and approach for each type. The most common tremors are essential tremor, parkinsonian tremor, and enhanced physiologic tremor. A thorough history, physical exam, and categorization of tremor characteristics are important for diagnosis.
This presentation provides information on Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). It discusses their etiology, clinical presentation, diagnosis, and physiotherapy management. Both GBS and CIDP result from an autoimmune attack on peripheral nerves causing demyelination. While GBS is acute, CIDP is chronic with progressive symptoms over time. Clinical features include weakness, numbness, and sensory loss. Physiotherapy focuses on maintaining function, mobility, and recovery through various exercises depending on the patient's stage of illness. Prognosis is generally good, with around 65% of GBS patients achieving near complete recovery within a year.
Classification of Seizures (ILAE) By Syed Irshad MurtazaMurtaza Syed
The document provides an overview of the International League Against Epilepsy's (ILAE) classification of seizures. It defines key terms like seizure, epilepsy, aura, ictus, and status epilepticus. It outlines the ILAE's definitions and categories of partial and generalized seizures like simple partial, complex partial, absence, myoclonic, clonic, tonic, and tonic-clonic seizures. Example EEG findings and videos of different seizure types are also provided. The classification aims to standardize seizure terminology and aid in electroclinical diagnosis through categorizing seizures based on clinical manifestations and EEG findings.
This document provides information on seizure and epilepsy, including definitions, classifications, and pathophysiology. It begins with learning objectives and definitions of key terms like seizure, epilepsy, and seizure types. It then covers classifications of seizures and epilepsies based on ictal phenomenology, seizure type, epileptic syndrome, and etiology. Pathophysiology, risk factors, investigations, and treatments are also discussed. Classification systems aim to accurately identify etiology, treatment, and prognosis.
Epilepsy is defined as recurrent seizures caused by excessive electrical discharges in the brain. It affects people of all ages worldwide. The causes of epilepsy can include genetic factors, structural abnormalities, metabolic disorders, infections, or unknown causes. Seizures occur due to an imbalance between excitatory and inhibitory signals in the brain. Epilepsy is diagnosed based on having two or more unprovoked seizures or one seizure with a high risk of future seizures. Seizures can vary in their clinical presentation depending on the area of brain involved.
This document provides an overview of seizure disorders, including:
- Seizures are caused by abnormal electrical activity in the brain and can cause changes in sensation, movement, or consciousness. Epilepsy is defined as recurrent seizures.
- Seizures are classified as partial or generalized, with partial seizures originating in one area of the brain and generalized seizures involving both hemispheres.
- Seizures have various clinical manifestations depending on their type, including motor, sensory, autonomic, or psychic symptoms. Generalized seizures typically involve loss of consciousness.
This document provides an overview of seizure disorders, including:
- Seizure disorders result from abnormal electrical activity in the brain that causes temporary dysfunction. They can be focal or generalized.
- Common causes include strokes, brain injuries, tumors, and genetic factors. During a seizure, increased brain activity can cause hypoxia and cell damage if prolonged.
- Seizures are classified based on symptoms like impaired consciousness, motor movements, or sensory changes. Management involves identifying and treating underlying causes, preventing injuries, and using anticonvulsant medications to control seizures.
This CME presentation on epilepsy provided an overview of the disorder, including definitions, epidemiology, pathophysiology, classification, diagnosis, and management. Some key points included:
- Epilepsy is one of the most common neurological disorders worldwide, affecting over 50 million people.
- It is characterized by recurrent seizures that can be focal or generalized.
- Evaluation involves a detailed history, physical exam, EEG, and neuroimaging to determine the underlying cause and guide treatment.
- Management consists of pharmacotherapy with antiepileptic drugs as first-line treatment. For refractory cases, surgical options like resection or vagus nerve stimulation may be considered.
This document provides an overview of epilepsy, including definitions, types of seizures, causes, diagnosis, and treatment. Some key points:
- Epilepsy is defined as recurrent seizures due to an underlying neurological condition. A seizure is a brief episode caused by abnormal neuronal activity in the brain.
- Seizures are classified as either generalized or partial/focal, depending on where in the brain the abnormal activity originates. Common types include generalized tonic-clonic, absence, myoclonic, atonic, and complex partial seizures.
- Epilepsy has various causes including genetic factors, brain injury, infection, tumors, and metabolic imbalances. Diagnosis involves a neurological exam, medical history
This document discusses antiepileptic drugs. It begins by defining epilepsy as a group of chronic CNS disorders characterized by recurrent seizures. It then discusses the underlying mechanisms of epileptic seizures and various types of seizures. The rest of the document discusses the mechanisms of action, classes, and examples of antiepileptic drugs, which work to inhibit abnormal neuronal discharge rather than cure the underlying cause. It also discusses strategies for drug treatment and classifications of antiepileptic drugs.
This document discusses seizures and epilepsy. It defines an epileptic seizure and classifies seizures as either provoked/symptomatic or unprovoked. It discusses various types of seizures including focal seizures which originate in one hemisphere, generalized seizures which engage networks in both hemispheres, and combined seizures. The document outlines the 2017 revised classification system for seizures which is based on where seizures begin, level of awareness, and other features. It provides details on various types of seizures like absence seizures, myoclonic seizures, and how seizures can be localized based on their clinical features.
This document provides information about epilepsy and different types of seizures. It begins with defining the key differences between seizures and epilepsy, noting that epilepsy refers to a tendency for recurrent seizures. Several types of seizures are then described in detail, including generalized seizures (such as absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures) and partial seizures (simple, complex, and those with secondary generalization). Causes of epilepsy are discussed. The document provides an overview of epilepsy and classifications of seizure types.
The document discusses the importance of education in developing critical thinking skills. It states that education should aim to teach students how to think, not what to think, by exposing them to diverse ideas and viewpoints. Developing critical thinking in students is crucial for creating open and democratic societies.
This document summarizes information about epilepsy and seizures. It defines epilepsy as recurrent seizures and describes different types of seizures including focal-onset, generalized-onset, tonic-clonic, absence, myoclonic, atonic, and tonic seizures. Causes, pathophysiology, diagnosis and treatment options are discussed. Treatment involves antiepileptic medications as first-line treatment, with surgery, neurostimulation or dietary therapies as options for refractory cases. Potential risks and complications of treatments are also summarized.
This document provides information on seizures and epilepsy, including:
- Definitions of seizure types such as generalized, focal, absence, myoclonic, tonic-clonic, and others.
- Classification systems for seizures and epilepsies.
- Common precipitants and comorbidities of epilepsy.
- Diagnostic tests for epilepsy including EEG, MRI, and bloodwork.
- Syndromes associated with different seizure types such as Lennox-Gastaut syndrome.
- Features of post-ictal states, epilepsy diagnosis, and co-morbid conditions.
This document provides information on epilepsy, including definitions of key terms, classification of seizure types, pathophysiology, diagnosis, treatment, and management. It defines epilepsy as a chronic disorder involving recurrent seizures from abnormal neuronal discharge in the brain. Seizures are classified based on origin point and symptoms. Treatment involves identifying and treating underlying causes, avoiding triggers, suppressing seizures with antiepileptic drugs or surgery, and managing related physiological and social issues. Commonly used AEDs are discussed as well as protocols for managing status epilepticus, an emergency condition.
This document discusses seizures and epilepsy. It defines a seizure as abnormal excessive neuronal activity in the brain and epilepsy as a predisposition to recurrent seizures. Seizures are classified as acute symptomatic, occurring within a week of an injury or illness, or unprovoked. Epilepsy is diagnosed if there are two unprovoked seizures or one seizure and high risk of recurrence. Causes include genetic, structural, metabolic, immune and infectious factors. Seizures are also classified as focal or generalized. Treatment involves controlling seizures with antiseizure medication while minimizing side effects and maintaining quality of life. Goals are seizure freedom, monitoring for side effects, and considering medication withdrawal after being seizure-free for two years.
Neuropsychiatric aspects of epilepsy osmanaliOSMAN ALI MD
This document provides an overview of neuropsychiatric aspects of epilepsy. It discusses the epidemiology of epilepsy and describes different types of seizures. It covers psychiatric manifestations like ictal, perictal, and interictal features. It also addresses behavioral disturbances variably related to seizures, like mood disorders. The document outlines management implications and describes evaluating epilepsy versus non-epileptic seizures through tools like EEG, imaging, and response to medication.
This document provides guidelines for performing and interpreting somatosensory evoked potentials (SSEPs), which assess sensory nerve conduction in the upper and lower extremities. It describes stimulation and recording procedures, including electrode placement and montages. For upper extremity SSEPs following median nerve stimulation, it identifies the key components N9, N13, P14, N18, and N20 and provides criteria for abnormal findings such as absent waves or prolonged interpeak latencies. For lower extremity SSEPs following posterior tibial nerve stimulation, it identifies the components LP, P31, N34, and P37 and also provides criteria for abnormal findings.
Anomalous Innervations in (EMG/NCS) by MurtazaMurtaza Syed
Anomalous Innervation.
These are the sort of normal variants which can be found in any normal subject or can concomitantly be found or superimposed in pathological cases. Identifying these anomalies helps out interpreting and making correct diagnosis and to avoid any misinterpretation.
Neuron & its structural & functional type by Murtaza SyedMurtaza Syed
This document discusses neurons and their structural and functional types. It begins by defining neurons as the functional units of the nervous system, consisting of a cell body, axon, and dendrites. It then describes the three main types of neurons based on their structures - unipolar, bipolar, and multipolar. The document also covers the functional classifications of neurons into sensory, motor and interneurons. It provides details on the structural components of neurons including axons, nerve fibers, and synapses. Finally, it explains the phases and propagation of action potentials in neurons.
Anatomy of Ear and BERA with its technical aspects. by Murtaza. March 2015.Murtaza Syed
BAEPs (Brainstem Auditory Evoked Potentials) assess the function of the auditory pathways by measuring the brain and brainstem's response to acoustic nerve stimulation. The responses originate from multiple sources along the auditory nerve, brainstem, and possibly higher structures. Wave V is considered the most reliable peak for interpretation as it has the lowest threshold, highest amplitude, and represents activity in the entire peripheral to central pathway. BAEPs are used to evaluate conditions affecting the auditory system like acoustic neuromas and multiple sclerosis.
The document summarizes testing of the autonomic nervous system, including the sympathetic and parasympathetic divisions. It describes several tests used to evaluate autonomic function clinically, including heart rate variability tests like deep breathing and Valsalva maneuver, as well as sympathetic skin response testing. Preparation of patients and protocols for each test are provided. The tests can help diagnose autonomic dysfunction and define its severity and distribution.
Autonomic Nervous System (SSR) TestingMurtaza Syed
The document summarizes testing of the autonomic nervous system. It discusses the two main components of the autonomic nervous system - the sympathetic and parasympathetic nervous systems. It then describes several specific tests used to evaluate autonomic function, including heart rate response to deep breathing, Valsalva ratio, and sympathetic skin response. The document provides details on the protocols, normal responses, and clinical significance of these autonomic function tests.
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)Murtaza Syed
The brachial plexus is a network of nerves in the neck, axilla, and arm that originates from the cervical and thoracic spinal nerve roots. It provides motor and sensory innervation to the upper limb. Specifically, the brachial plexus forms from the ventral rami of cervical nerve roots C5-C8 and thoracic nerve root T1. These rami come together to form the roots, trunks, divisions, cords, and peripheral branches that make up the brachial plexus and allow it to innervate the muscles and skin of the arm.
Anatomy of lumbosacral plexus (by Murtaza Syed)Murtaza Syed
This document provides an overview of the anatomy of the lumbosacral plexus, which is formed from the combination of the lumbar and sacral plexuses. It describes the roots, branches, divisions, and terminal branches that form the various nerves. These include the femoral, obturator, superior gluteal, inferior gluteal, and sciatic nerves. It also outlines the motor and sensory distributions of the nerves of the lumbosacral plexus to the lower limbs and related structures.
This document provides guidance on taking a thorough medical history for patients presenting with seizures. It outlines the key components of a seizure history, including onset, duration, symptoms, triggers, and descriptions of the aura, ictal, and post-ictal phases. Detailed questions are provided related to seizure type, frequency, consciousness level, and associated behaviors. The importance of also obtaining family, birth, medical, and medication histories is emphasized. Guidelines are given for properly preparing to take a history, defining medical terms, and describing events to patients.
Multiple sleep latency Test (MSLT) and Maintenance of Wakefulness Test (MWT) ...Murtaza Syed
The document provides information about the Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT). It describes how MSLT is used to test for excessive daytime sleepiness by measuring how quickly a person falls asleep during nap opportunities. Abnormally short sleep latencies or two or more sleep onset REM periods indicate narcolepsy. MWT measures ability to stay awake and is used to assess treatment effectiveness. Both tests involve daytime nap recordings preceded by an overnight sleep study and use similar protocols and equipment to objectively measure sleepiness and wakefulness.
This document discusses encephalopathy and summarizes key points about its causes, features on EEG, and types. Encephalopathy is defined as altered brain function resulting in impaired consciousness. It can be caused by metabolic, toxic, infectious, hepatic or other issues. On EEG, encephalopathy typically shows generalized slowing and reduced reactivity. Specific patterns like triphasic waves indicate metabolic encephalopathy. The document outlines different types of encephalopathy and their associated EEG findings to help evaluate severity and guide treatment.
EEG Variants with patterns by Murtaza SyedMurtaza Syed
This document provides information on normal variant EEG patterns. It discusses four main types of EEG variants: rhythmic patterns, epileptiform patterns, lambda and lambdoids, and age-related variants. Six main rhythmic variant patterns are described including alpha variants, mu rhythm, rhythmic mid-temporal theta of drowsiness, subclinical rhythmic electrographic discharges in adults, midline theta rhythm, and frontal arousal rhythm. Four epileptiform variant patterns are also outlined. The document provides detailed descriptions of each variant pattern.
This document provides information about brainstem auditory evoked potentials (BAEPs). It discusses the anatomy and physiology of the peripheral and central auditory systems, including the pathways from the inner ear to the brainstem and cortex. It describes the generators of BAEP waveforms and standards for BAEP testing according to the American Clinical Neurophysiology Society, including stimulus parameters, recording settings, and analysis time. The document is intended to inform readers about BAEP testing and interpretation.
This document provides information about late responses in nerve conduction studies, including F-waves, H-reflexes, and axon reflexes. It discusses the mechanisms, characteristics, and clinical applications of each response. The F-wave results from antidromic stimulation of motor neurons and evaluates more proximal nerve segments. The H-reflex is a monosynaptic stretch reflex that is reliably measured in the lower limbs. Axon reflexes occur due to terminal nerve branching and suggest reinnervation. Late responses provide valuable information about radiculopathies and plexopathies that cannot be observed with distal nerve studies alone.
This document provides information about repetitive nerve stimulation (RNS) testing, including:
1) RNS is used to evaluate neuromuscular junction disorders like myasthenia gravis by assessing changes in the compound muscle action potential with repetitive nerve stimulation.
2) In myasthenia gravis, the safety factor is reduced due to fewer acetylcholine receptors, so some endplate potentials may not reach threshold, causing a decremental response on RNS.
3) The protocol for RNS involves stimulating multiple nerves at rest and after exercise to look for an abnormal decremental or incremental response that indicates impaired neuromuscular transmission.
Anatomy of posterior tibial nerve by imMurtaza Syed
The document provides detailed information on the anatomy and function of the posterior tibial nerve. It describes the nerve's origin, branches, innervation areas, and testing techniques. Key points include:
- The posterior tibial nerve originates from lumbar and sacral nerve roots and provides motor and sensory innervation to muscles and skin in the leg and foot.
- It gives off branches that innervate important calf and foot muscles like the gastrocnemius, soleus, flexor hallucis longus.
- The nerve can become entrapped in the tarsal tunnel, causing tarsal tunnel syndrome.
- Electromyography techniques are used to study the nerve by stimulating and recording from sites along its path
EEG variants, are always to be recognized while interpreting the EEG one must be aware of these. Major and most common EEG is variants are discussed in the stated presentation.
Syed Irshad Murtaza.
Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy characterized by acute onset of peripheral and cranial nerve dysfunction and progressive muscle weakness. It is caused by an autoimmune reaction directed against peripheral nerves, often preceded by a viral infection. Clinically, GBS presents with rapidly progressive symmetric weakness, loss of tendon reflexes, and sensory symptoms like paresthesia. Electrodiagnostic studies are diagnostic in most cases and show features of demyelination like prolonged latencies and conduction block. Treatment involves supportive care and immunotherapy.
The document discusses the blink reflex, which evaluates the trigeminal and facial cranial nerves. Stimulation of the trigeminal nerve leads to contraction of the orbicularis oculi muscle mediated by the facial nerve. This produces two responses - an early R1 response localized to the stimulated side, and a later R2 response seen bilaterally. Analysis of blink reflex latencies can identify lesions along the afferent trigeminal or efferent facial nerve pathways or in the brainstem. The blink reflex is useful for evaluating various neurological conditions that may affect these cranial nerves or central pathways.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. Study Outlines:-
Definitions
Purpose of the International Classification
of Seizures and Epilepsies
Recommended terminology for etiology
Recognition of seizures
Classification of Seizures pictorial division
Descriptive details of seizures
References
13-10-2014
Classification of Seizures By IM
2
3. Definitions:-
Seizure:-
1- An event of sudden abnormal excessive discharges of
electrical activity within the brain, which leads to a
change in movement, sensation or consciousness.
2- Its is an uncontrolled, synchronized paroxysmal
excitation of cortical neurons in the brain that results in
motor (body movements,) sensory (unusual sensation) &
autonomic (altered perception, hallucination etc)
manifestations.
3- A seizure is the manifestation of an abnormal,
hypersynchronous discharge of a population of cortical
neurons. This discharge may produce subjective
symptoms or objective signs, in which case it is a
clinical seizure, or it may be apparent only on an
electroencephalogram (EEG), in which case it is an
electrographic (or Classification subclinical) of Seizures By: IM
seizure.
3
4. Definitions cont’d . . .
Convulsions:-
Convulsions are violent
involuntary contractions of body
musculature.
In neurology, this term is limited to
contractions produced by cerebral seizure
activity.
Epilepsy:-
Epilepsy is defined as two or more
recurrent seizures unprovoked by systemic
or acute neurologic insults.
Classification of Seizures By: IM
4
5. • Aura:- Definitions cont’d . . .
It’s the initial event, signaling the beginning
of seizure and it is part of the seizure.
• Epileptic prodrome:-
Its change in mode or behavior before
the seizure and could be in hours or days before
the seizure event.
Ictus or ictal phase:-
It’s a synonym word for seizure event.
Post-Ictus or Postictal Phase:-
Its Time after a Seizure; may experience
sensory, motor, or autonomic manifestations
and it usually lasts longer than the seizure itself.
Classification of Seizures By: IM
5
6. Definitions cont’d . . .
• Interictal period:-
It’s the time period between two
successive seizure events.
• Status Epilepticus:-
1.It is described as the recurrence of seizures by
intervals too short to allow recovery of the
condition that existed before the onset of the
seizures.
2. *An episode of more than 05 minutes of
continuous seizure activity, or
3.*Two or more sequential seizures spanning
this period without full recovery between
seizures.
*American Epilepsy Society “Epilepsia USA”
Classification of Seizures By: IM
6
7. Definitions cont’d . . .
• Epilepsia Partialis Continua:-
It is continuous and rather stereotype
repetition of one, fairly constant type of epileptic
activity, usually rhythmical jerking of a limb or of
part of a limb, or lower face etc may be with
mildly reduced alertness. It may be lasted for
weeks, months or years.
• It may be interrupted by discrete partial or
generalized seizures or may become less violent or
more restricted and even disappear intermittently.
Classification of Seizures By: IM
7
8. Purpose of the International Classification of Seizures
and Epilepsies
• The seizers classification being most widely used is
proposed by the Commission on classification
and Terminology of the International League
Against Epilepsy(ILAE).
• Classification is necessary for;
New terms & concepts with internationally
accepted terminology
Standardization of the seizures types description
New concepts regarding Focal and generalized
seizures
Better adaptation of etiological terms
Electro-clinical diagnosis for seizures etc
Classification of Seizures By: IM
8
9. Cont’d. . .
How ILAE Defines/Categorized seizures?
ILAE defines Seizures types only in terms of
clinical manifestations & EEG findings,
▫ It differs from previous classifications
because it is based on the study of
videotape recordings of simultaneously
recorded EEG & clinical epileptic seizures.
Classification of Seizures By: IM
9
11. SEIZURE RECOGNITION:-
• HOW TO RECOGNIZE SEIZURES:-
• Anatomical
(patient history help us to locate the
origin of discharge )
• Pathological
(infections or lesions help us to
reorganization of Sz)
• Clinical
(by self observation during seizure)
• Electro diagnostically
(by the help of EEG+VEEG recording)
Classification of Seizures By: IM
11
12. 12
Origin of symptoms and signs in focal seizures - Visual display over the
dominant hemispheres Classification of Seizures By: IM
15. • Partial Seizures:-
• Involve only part
of one cerebral
region or
hemisphere and
produce symptoms
in corresponding
parts of body or
some related
mental functions.
11-06-2012
15
Classification of Seizures
By: IM
Seizures
Partial Generalized
Simple Partial
Complex Partial
Secondarily
Generalized
16. Localization of Partial Seizure Focus
11-06-2012
2200%%
Classification of Seizures By: IM
16
7700%% 1100%%
16
17. Simple partial Seizures:-
• With somatosensory
or special sensory
symptoms
• Convulsion confine to
single limb ,
• Autonomic
manifestations
• Psychic or experiential
symptoms
• Symptoms with out
LOC
Classification of Seizure1s B7y: IM
Seizures
Partial Generalized
Simple Partial
With somatosensory
or special sensory symptoms
With motor signs
With autonomic
symptoms or signs
With psychic or
experiential symptoms
19. 19
Psychic auras often originate from the temporal lobe,
associated with simple partial seizures:
Psychic Aura Definition
Déjà vu: An illusion of a familiar memory
Jamais vu: When what should be a familiar visual experience becomes
unfamiliar
Déjà entendu: An auditory illusion of something familiar
Jamais entendu: When what should be a familiar auditory experience
becomes unfamiliar
Autoscopy: Seeing oneself in external space, as if the mind has left the
body
Derealization: A feeling of unreality of the outside world; the world seems
strange and unreal.
Depersonalization: A feeling of unreality in one’s sense of self; feeling as
if in a dream or watching oneself act
Macro-/Micropsia: Objects appear larger or smaller than usual
Macr-/Micracusia: Sounds are louder or softer than usual
20. 20
An epileptic disorder can be symptomatic, idiopathic, or
cryptogenic.
Symptomatic is a term that means the etiology is
known—usually a structural lesion within the brain.
Idiopathic is a term that refers to an epilepsy of
presumed genetic etiology without a structural brain
lesion or other neurological signs or symptoms. The
term has been replace by “genetic”
Cryptogenic is a term that refers to an
epilepsy that is presumed to be symptomatic but the
etiology is unknown (1989). The term
cryptogenic has been replaced by “probably
symptomatic”
The observable manifestation of the seizures, is known
as semiology.
22. Complex Partial Seizures:-
• Complex partial seizure
• Often called temporal lobe
seizures.
• LOC
• Patient have no recollection
or incomplete memory of
events that occurred during
seizures
Partial Sz with secondary
generalization.
• When a seizure start focally
and spread to the whole
limb or become generalized,
it is called Jacksonian
march or partial seizure
with secondary
generalization.
11-06-2012
Classification of Seizures
By: IM
22
Seizures
Partial Generalized
Complex Partial
Secondarily
Generalized
24. Generalized Seizures
• GENERALIZED SEIZURES.
• • Seizures that occur on bilateral limbs and with out
focal onset are grouped as generalized seizures.
TYPES OF GENERALIZED SEIZURE.
1.Absence (Petit mal Seizures)
• Usually occur in childhood and rarely persist
into adult hood
• Impairment of consciousness
• With mild clonic component
• With also atonic and tonic component
• With automatisms
Classification of Seizures By: IM
24
25. Absence Sz’s Cont’d. . .
• Absence seizures:-
Simple (typical) absence or typical seizure
Complex (atypical) absence or atypical seizure
Simple absence or Typical seizures
Impairment of consciousness
Some patient retain awareness during the attacks
but cannot respond with movement or speech.
Attacks are triggered by hyperventilation and photic
stimulation
Seizures lasted in seconds
Background usually normal during interictal phase.
Typical EEG findings 3 Hz spike & waves discharges
with abrupt onset and off set & clinically consistent
with unresponsiveness and eyes staring or blinking.
Findings are bilaterally symmetrical
Classification of Seizures By: IM
25
28. Absence Sz’s Cont’d. . .
Complex absence or Atypical seizures:-
28
• Brief episodes of LOC
• Including mild clonic component
• Reduction in body tone
• Seizures durations are in minutes
• EEG background usually abnormal during interictal
phase.
• EEG findings are more heterogeneous, may include
irregular spike-&-slow-wave complexes (2-4Hz), fast
activity or other paroxysmal activity.
• Abnormalities are bilateral but often irregular and
asymmetrical .
Classification of Seizures By: IM
30. 3.Myoclonous seizures:-
• In Myoclonic seizures clinically single or multiple
repetitive jerks are noted
• It mainly occur during sleep and when patient
wake up from sleep early in morning.
• It consists of isolated or Gen. body jerks for few
seconds
• EEG findings include spikes, polyspikes, sharp-&-
slow waves complexes are seen.
• Absence component may be present in the seizures
manifestation
• Generally hyperventilation & especially photic
stimulation activation maneuvers are provoking
measures of ictal or interictal abnormalities .
30
Classification of Seizures By: IM
33. SALAAM ATTACKS:-
• 4.Infantile spasm/ salaam spells
• Sudden flexor spasm of trunk, Extension of arm,
Drawing up of legs, quick nodding or jack-knife
movements of the body are noted.
• Usually occur in the age of 3-9months
• Last up till the age of 3yrs
• After that patient became mentally retarded.
• EEG findings showed chaotic background, with
multifocal, independent and burst suppression like
epileptic form complexes.
• West syndrome is the classical triad of infantile
spasms, hypsarrythmia (a typical EEG Pattern) and
mental retardation.
Classification of Seizures By: IM
33
34. 34
Classification of Seizures By: IM
Hypsarrhythmia with increased inter-hemispheric
synchrony
36. 36
Classification of Seizures
CLONIC SIZURES:-
5.Clonic seizures
• Clonic seizures consist of generalized
rhythmical myoclonic movements which
usually last for 1 min or more and are
associated with loss of consciousness.
• These seizures commonly occur as febrile
Seizures in childhood
• EEG findings may include spikes, polyspikes-&-
wave complexes in ictal or interictal period.
By: IM
38. Tonic seizures:-
Classification of Seizures By: IM
38
6.Tonic seizures
• Tonic means stiffening
• Tonic seizures consist of contractions of the axial
musculature of the entire body and produce
flexor positions. They usually last up to 1 min &
are associated with loss of consciousness.
• EEG background is often abnormal for age.
Rhythmic discharges are seen in ictal or interictal
phase.
39. 39
Tonic clonic seizures (grand mal seizures):-
7.Tonic clonic seizures (grand mal seizures)
• Tonic clonic seizures are the most severe form of
Generalized seizure in adults
• They begin suddenly with loss of consciousness
• & sometime preceded by shrill cry
• Frothing, up rolling of eyes, jerking of limbs,
urinary & fecal incontinence may occur in these
seizures.
• EEG findings may include rhythmic decreasing in
frequency and increasing in amplitude during
tonic phase, interrupted by slow waves during
clonic phase.
Classification of Seizures By: IM
40. Atonic seizures:-
8. Atonic seizures;-
Consists of sudden loss of muscle tone.
Sudden droop or fall attack
May be associated with Myoclonic jerks to
form Myoclonic atonic seizures
Possible EEG findings:-
• Generalized spikes, polyspikes, sharp and
slow waves complexes.
• Epileptic burst suppression pattern could be
found in EEG recording during , between or after
seizure event.
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Classification of Seizures By: IM
42. UNCLASSIFIED EPILEPTIC SEIZURES
• This category includes all seizures that cannot
be classified because of inadequate or
incomplete data and some that defy
classification in hitherto (Until now) categories.
• This includes some neonatal seizures e,g
rhythmic eye movements, chewing and
swimming movements.
Classification of Seizures By: IM
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43. ADDENDUM:-
• Repeated epileptic seizures occur under a variety of
circumstances.
• As fortuitous (Accidental) attacks coming unexpectedly
and without any apparent provocation.
• As cyclic attacks at more or less regular intervals
• As attacks provoked by non sensory factors or sensory
factors sometimes referred to as reflex seizures.
• Prolonged or repetitive seizures. The term status
epilepticus is used whenever a seizure persists for a
sufficient length of time or is repeated frequently
enough that recovery between attacks does not occur.
Status epilepticus may be divided into partial or
generalized. When much localized motor status occurs
it is referred to as epilepsia patialis continua.
•
Classification of Seizures By: IM
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44. Semiology:
By the observable manifestations of the seizures,
known as semiology.
Or
The appearance/morphology and
clinical/electrographical activity which can be
determined/categorized in a specific/organized
way, would be termed as semiology.
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45. 10-second EEGs: Seizure Evolution
Classification of Seizures By: IM
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Normal Pre-Seizure
Seizure Onset Post-Seizure
46. References:-
• Fisch & Spehlmann’s EEG Primer By Bruce J.Fisch, M.D
• ILAE Classification of Seizures Journal “Epilepsia”.
• A Clinical Approach to the Classification of seizures &
the epileptics Syndromes by Luder & R.Lesser (Eds).
• Primer of EEG With a Mini-Atlas By James Rowan M.D
• Ernst Niedermeyer (Basics of Electroencephalography)
4th edi
• Abu Khalil (EEG atlas)
• Practical Guide for Clinical Neurophysiologic
Testing: EEG by Thoru Yamada & Elizabeth Meng
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Classification of Seizures By: IM
47. • Thanks for the patience
Classification of Seizures By: IM
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