Seizure

Clinic

• Seizure is an Entity, that is characterized with abnormally excessive or synchronous neuronal activity in the brain.
• We have a lot of seizure. They are all disease which have a common entity, which is named Seizure.
• Since Seizure entity could be mistaken with Seizure diseases, I name them with such a suffix to prevent that problem
  • Tonic-clonic seizure: Involuntary shaking movements involving much of the body with loss of consciousness
  • Focal seizure: Shaking only parts of body with variable levels of consciousness
  • Absence seizure: Subtle momentary loss of awareness

• Mostly, these episodes last less than two minutes and it takes some time to return to normal.
• Loss of bladder control may occur.

Seizures may be

• Provoked: Due to Hypoglycemia, Hyponatremia, Alcohol withdrawal, Medication, Fever, Brain infection or Concussion.
• Conditions that look like epileptic seizures but are not include: Fainting, Non-epileptic psychogenic seizure and Tremor.

Seizure diease

• 60% of seizures are convulsive which involve involuntary muscle contractions.
• Remaining 40% of seizures are non-convulsive E.G Absence seizure

• One-third begin as generalized seizures from the start, affecting both hemispheres of the brain and impairing consciousness.
• Two-thirds begin as focal seizures which may progress to generalized seizures.

Aura

• Certain experiences, known as auras often precede focal seizures.
• The seizures can include sensory (visual, hearing, or smell), psychic, autonomic, and motor phenomena depending on which part of the brain is involved.
• Muscle jerks may start in a specific muscle group and spread to surrounding muscle groups in which case it is known as a Jacksonian march.
• Automatisms

Main types of generalized seizures

1. Tonic-clonic: They occur with a contraction of the limbs followed by their extension and arching of the back which lasts 10–30 seconds (the tonic phase). A cry may be heard due to contraction of the chest muscles, followed by a shaking of the limbs in unison (clonic phase).
2. Tonic: Constant contractions of muscles + Cyanosis due to stopped breathing
3. Clonic: Unison shaking of limbs
4. Myoclonic: Very brief spasms of muscles in either a few areas or all over, may cause the person to fall.
5. Absence / Focal seizure: Subtle with only a slight turn of head or eye blinking + Impaired consciousness
6. Atonic seizures: Losing muscle activity for greater than one second, typically occurring on both sides of the body.
7. Rarer seizure types: Involuntary unnatural laughter (Gelastic), crying (Dyscrastic), or more complex experiences such as déjà vu.
8. Reflex seizures: About 6% Seizures that are triggered by specific events
9. Sleep seizures: They happen more often during sleep or only when sleeping.

Post-ictal

• It is typically a period of recovery during which there is confusion, before a normal level of consciousness returns.
• It usually lasts 3 -15 minutes but may last for hours.
• Other common symptoms include Feeling tired, Headache, Difficulty speaking, and Abnormal behavior.
• Psychosis is common (6–10%)
• Often people do not remember what happened during this time.
• Todd's paralysis (Localized weakness) may also occur after a focal seizure

Psycho social accompaniments

Certain disorders occur more often in people with epilepsy, depending partly on the epilepsy syndrome present. These include

• Depression
• Anxiety
• OCD
• Migraine
• ADHD
• Autism