Epilepsy

Epilepsy

Definition

Epilepsy? An abnormal movement of skeletal muscles due to abnormal, paroxysmal uncontrolled, electrical activity. It is recurrent attack of loss of activity sensory phenomena and behavioral abnormalities. It is a paroxysmal disorder of nervous system.

Epilepsy is the fourth most common neurological disorder in which brain activity becomes abnormal, and causing seizures and sometimes loss of awareness. It can affect people of all ages, but usually starts either in childhood or after 60 years of age. Almost 65 million people around the world and 3 million people in the United States are effected with epilepsy.

Epilepsy varies from person to person. In epilepsy brains electrical activity disruption occurs, which temporarily disturbs the messaging system between brain cells.

Seizures

Epilepsy causes recurrent seizures, which are a result of excessive electrical discharges in a group of brain cells. A seizure is defined as a sudden behavioural change due to a temporary imbalanced electrical functioning of the brain.

Normally, the brain continuously generates tiny electrical impulses that travel along neurons throughout the body via chemical messengers called neurotransmitters. In patients with seizures, a sudden and synchronized bursts of electrical energy affects person’s consciousness, movement or sensations.

The seizures in epilepsy may be related to a brain injury or a family history, but often the cause is completely unpredictable and can cause other health problems. A person is diagnosed with epilepsy if he has two unprovoked seizures without any other medical condition like alcohol withdrawal or extremely low blood sugar, while one seizure does not signify epilepsy.

Types of Epileptic Seizures

There are many different types of epileptic seizures, as seizures are the main symptoms of epilepsy.They all start in the brain but affect just one part of the brain.

Simple Focal (Partial) Seizures

  • Don’t cause a loss of consciousness
  • Involuntary jerking of a body part
  • Alterations to sense of smell, feel, sight, taste and hearing
  • Tingling and dizziness
  • An intense feeling of fear
  • Complex feeling that’s hard to describe
  • Feelings that same event has happened before

Complex Focal (Partial) Seizures

  • Involve loss of consciousness
  • Staring into space
  • Responding abnormally
  • Performing repetitive movements like hand rubbing, lips smacking, chewing or swallowing

Generalized Seizures

Generalized seizures involve all areas of the brain. There are six types of generalized seizures exist.

01) Absence Seizures

  • Often occurs in childhood
  • Brief loss of awareness
  • Staring blankly into space
  • Jerking movements of body or limbs
  • Flickering of eyes
  • Lasts usually in 15 seconds
  • May occur several times a day

02) Tonic Seizures

  • All muscles suddenly become stiff
  • Person becomes unconscious and falls backwards

03) Atonic Seizures

  • Muscles suddenly become relax and floppy
  • usually falls forwards

04) Clonic Seizurres

  • body feel jerk and shake
  • usually neck, face and arms are affected
  • loss of bladder or bowl control
  • Tongue or inside cheek bite
  • Difficulty in breathing

05) Myoclonic Seizures

  • Sudden body twitches or jerk
  • Often happens after waking up
  • Person don’t lose conscious

06) Tonic-Clonic Seizures

  • Abrupt loss of conscious
  • Body stiffness and shaking
  • Loss of bladder control

Causes

  • Unknown
  • Hypoxemia
  • Vascular insufficiency
  • Fever
  • Head Injury
  • Hypertension
  • Infection of CNS
  • Metabolic change
  • Brain tumour
  • Drug withdrawal
  • Allergy
  • Degenerative brain disorder etc.

Symptoms

  • Impaired consciousness
  • Loss of muscle tone or movement
  • trouble of behaviour, mood sensation and perception
  • Disturbance of autonomic functions of the body
  • Cyanosis
  • Fixed jaw
  • Dilated and fixed pupils
  • Body stiffness
  • Incontinence of urine
  • Staring blankly into space
  • Sudden Collapsing
  • Panic or anger
  • Short blackouts or confused memory

Diagnostic Evaluation

  • History of seizures
  • Electroencephalograph
  • CT scan
  • Neuropsychological tests for epilepsy
  • MRI

Medical Management

Your doctor and nurse will perform the following actions and prescribe some medications.

  • Takes a history of seizures
  • Observation of patient
  • Assesses knowledge level of patient
  • Altered tissue perfusion related to disease
  • Ineffective airway clearance related to spasm
  • Handle the injury related to unconsciousness
  • Activity intolerance related to disease
  • Knowledge deficit
  • Antiepileptic medication ( Carbamazepine, Phenobarbital, Valproate, Primidone, Phenytoin)

Coping with Epilepsy 

Epilepsy can be best managed by a team of doctors that provide medical, social, psychological and educational support. The most important step you should take is to seek help as soon as you feel less able to cope. You should discuss with a member of the epilepsy team, if you have a problem with school, work, finances, relationships or daily activities. Taking early action and discussion with epilepsy team members will enable you to understand and deal with the many effects of epilepsy.

Risk Factors

  • Premature birth or weak birth
  • Lack of oxygen during birth
  • Seizures after birth up to one month
  • Abnormal brain shape at birth
  • Bleeding into the brain
  • Brain tumours
  • Serious brain injury and infections of the brain
  • Mental abnormalities
  • Long fever-related seizure
  • Alcohol and drug abuse
  • Blockage of arteries can cause stroke

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