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| General
Illness Information |
Medical
Term: |
EPILEPSY |
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Common
Name: |
Seizures |
| Description: |
Epilepsy is a disorder characterized by
recurrent seizures. These are attacks of abnormal brain function
characterized years. by brief periods of altered consciousness,
motor activity or inappropriate behavior. A seizure (or a fit) is an
abnormal focus of sudden electrical activity in the
brain.
It affects approximately 0.5% of the population
in the United States and Canada and affects males and females
equally.
It is not contagious. Can affect all ages, but
usually begins between the ages of 2 and 20.
Seizures are classified into 3 major
groups:
1) Partial seizures (seizures begin locally), (A)
without impairment of consciousness, (B) with complex symptoms (with
impairment of consciousness).
2) Generalized seizures (bilaterally symmetrical and
without local onset).
3) Unclassified epileptic seizures.
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| Causes: |
No cause can be found in 40 to 70% of
patients with seizures.
Epilepsy is a symptom caused by many non-specific
acute and chronic central nervous system (CNS) injuries or
disorders such as : Brain damage; Alcohol or drug abuse; Brain
infection; Brain tumor; Chronic subdural
haematoma; Vascular disease; Degenerative diseases of
the central nervous system; Toxins; Genetic and metabolic
disorders.
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| Prevention: |
No specific prevention. However, seizures
may be avoided by maintaining adequate epileptic drug therapy and by
ensuring compliance of treatment.
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| Signs
& Symptoms |
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Epilepsy is usually classified by its clinical
signs and symptoms. |
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Partial seizures: Simple partial seizures and
complex partial seizures. Partial seizure : sometimes
initiated with an aura such as an unpleasant taste or
unexplained fear. If the patient remains remains alert, it is
defined as "simple partial seizure", if there is an alteration
or complete loss of consciousness it is termed a "complex
partial seizure". This may be accompanied by jerking movement
of a part of the body depending on the part of the brain
affected e.g. jerking or shaking of the right
leg. |
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Generalized Seizures including: |
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Absence seizures (Petit mal). This mostly
affects children and frequently ceases by the age of 20 years.
The affected person suddenly loses consciousness with
motionless stare lasting about 30 seconds. This may
occur several or more times a day It may be associated with
rhythmic eye blinking or automatisms such as lip smacking,
chewing, swallowing or fumbling hand movements. Seizure ends
suddenly with patient fully alert afterwards. |
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Atypical absences. These are more gradual in
onset and the spells last longer than Petit mal. |
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Myoclonic seizures: sudden, brief, irregular
involuntary contractions of limbs, trunk or facial muscles,
usually without loss of consciousness. |
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Tonic-clonic (Grand mal) seizures. This is
common and may affect all ages. It is characterized by a
sudden loss of consciousness, followed by sudden
uncontrollable twitching and jerking movements. There may be
associated loss of bladder control and tongue biting. The
seizure lasts for 1 to2 minutes and is followed by a
deep sleep or mental confusion. Prior to the seizure, the
patient may experience a tense feeling, or visual disturbance,
or strange smell, or hear strange noises. This is termed an
"aura". |
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Atonic seizures : there is sudden loss of
postural tone that may result in a fall, is extremely short in
duration, and may or may not occur with loss of
consciousness. | |
| Risk
Factors |
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| Diagnosis & Treatment |
| Diagnosis is based on the description of the seizure
behavior. Diagnostic tests include CT scan or MRI of the
brain, electroencephalogram (EEG), and laboratory blood
studies which include blood work. urine test for drug screen
and may include a lumbar puncture..
AN electroencephalogram (EEG) is a recording
of the brain's electrical activity. The procedure is simple
and painless. About 20 small electrodes are pasted to the
scalp, and the brain's activity is recorded under normal
conditions. Then, the person is exposed to various stimuli,
such as bright light or flashing lights, to help provoke a
seizure. During a seizure, electrical activity in the brain
accelerates, producing a jagged waveform pattern. Such
recordings of the brain waves helps identify epilepsy.
Different types of seizures have different wave
patterns.
EEG is the most important test and helps
differentiate partial from primary generalized seizures i.e.
focal EEG abnormality indicates a partial seizure disorder,
generalized abnormality indicates primary generalized seizure.
A normal EEG does not rule out a seizure disorder. An abnormal
EEG does not necessarily confirm the diagnosis. Diagnosis is
primarily based on a consistent clinical history.
24 hour ambulatory EEG monitoring, or
continuous in-hospital monitoring with video recording can
distinguish epileptic seizures from non-epileptic
events. |
| General
Measures: |
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Wear a medical alert type bracelet
or pendant that shows you have epilepsy in case you have a
seizure. |
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Avoid any circumstance that has triggered a
seizure previously |
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Treatment for epilepsy consists of drug
therapy specific to the type of seizure. |
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In event of seizure, loosen clothing, lay
person flat and protect from injury. Although frightening,
seizures are rarely harmful in themselves |
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If seizures are uncontrolled, avoid operating
heavy equipment, swimming, heights and driving. Seizure free
period of 6 to 12 months is required by most states before
patients with epilepsy can drive. |
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Periodic visits to the doctor, every 3
to 6 months ,to evaluate seizure control and side-effects to
anticonvulsants. | |
| Medications: |
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Anticonvulsant drugs. Your response
to treatment will be monitored. Medication changes or
adjustments are often necessary. Choice of anticonvulsant
depends on the type of seizure and the patients ability to
tolerate the side-effects. | |
| Activity: |
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No restrictions. Most states allow
persons with epilepsy to drive a vehicle after being
seizure-free for 1 year. | |
| Diet: |
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No special diet. Don't drink
alcohol. It may decrease the effectiveness of your medication
and provoke seizures. | |
| Possible
Complications : |
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Continuing seizures (despite
treatment) and mental deterioration (rare). |
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Drug
toxicity. | |
| Prognosis |
| Epilepsy is incurable,
except in relatively rare cases where epilepsy is caused by
treatable brain damage, tumors or infection. However,
anticonvulsant drugs can prevent most seizures and allow a
near-normal life. Seizure activity may become quiescent. If a
patient has been seizure-free for 2 years, withdrawal of
medication may be considered. Relapse rate after 3 years of
being off medications is
33%. | |
| Other |
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