Seizure

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Revision as of 09:51, 16 March 2023 by Oldver>Mehrdad (→‎Clinic)
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Clinic

  • Seizure is a period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain.
  • Seizure is a spectrum of different disease vary from
    • 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.


Seizures

  • 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