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Seizure Disorder


SEIZURE DISORDER (Epilepsy)

Seizures or Convulsions occur because the brain becomes irritated and an "electrical storm" occurs. This "electrical storm" occurs because the normal connections between the cells in the brain do not function properly. This causes the brain to try to shut down because of the electrical surge. The muscle shaking occurs because the brain is ending out signals to every muscle group, asking them to contract. Most seizures are self-limiting and are followed by a so-called post-ictal period, in which the brain can be considered to "reboot and restart" all its programs, similar to a computer when it is rebooted.

Epilepsy was one of the first brain disorders to be described. It was mentioned in ancient Babylon more than 3,000 years ago. The strange behavior caused by some seizures has contributed through the ages to many superstitions and prejudices. The word epilepsy is derived from the Greek word for "attack." People once thought that those with epilepsy were being visited by demons or gods. However, in 400 B.C., the early physician Hippocrates suggested that epilepsy was a disorder of the brain -- and we now know that he was right.

What Is Epilepsy?

Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. Neurons normally generate electrochemical impulses that act on other neurons, glands, and muscles to produce human thoughts, feelings, and actions. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior, or sometimes convulsions, muscle spasms, and loss of consciousness. During a seizure, neurons may fire as many as 500 times a second, much faster than normal. In some people, this happens only occasionally; for others, it may happen up to hundreds of times a day.

Epilepsy is not contagious and is not caused by mental illness or mental retardation. Some people with mental retardation may experience seizures, but seizures do not necessarily mean the person has or will develop mental impairment. Many people with epilepsy have normal or above-average intelligence.

What Causes Epilepsy?

Epilepsy is a disorder with many possible causes. Anything that disturbs the normal pattern of neuron activity - - from illness to brain damage to abnormal brain development -- can lead to seizures.

About half of all seizures have no known cause. However, in other cases, the seizures are clearly linked to infection, trauma, or other identifiable problems.

Genetic Factors: Research suggests that genetic abnormalities may be some of the most important factors contributing to epilepsy. Some types of epilepsy have been traced to an abnormality in a specific gene. Many other types of epilepsy tend to run in families, which suggest that genes influence epilepsy.

Disorders which can lead to epilepsy

Brain tumors, alcoholism,and Alzheimer's disease,frequently lead to epilepsy because they alter the normal workings of the brain
In some cases, head injurycan lead to seizures or epilepsy.
Strokes, heart attacks,and other conditions that deprive the brain of oxygen
Meningitis, AIDS, viral encephalitis,and other infectious diseases can lead to epilepsy
Hydrocephalus-a condition in which excess fluid builds up in the brain.
A parasiticinfection of the brain called neuro-cysticercosis.
Maternal infections, poor nutrition,and oxygen deficiencies are just some of the conditions that may take a toll on the brain of a developing baby.
Seizures can result from exposure to lead, carbon monoxide, and many other poisons.
They also can result from exposure to street drugs and from overdoses of antidepressantsand other medications.

Seizures may stop once these disorders are treated successfully. However, the odds of becoming seizure -free after the primary disorder is treated are uncertain and vary depending on the type of disorder, the brain reg ion that is affected, and how much brain damage occurred prior to treatment.

Triggers:

Seizures are often triggered by factors such as lack of sleep,alcohol consumption, stress,or hormonal changes associated with the menstrual cycle. These seizure triggers do not cause epilepsy but can provoke first seizures or cause breakthrough seizures in people who otherwise experience good seizure control with their medication. For this reason, people with epilepsy should make sure to get enough sleep and should try to stay on a regular sleep schedule as much as possible

For some people, light flashing at a certain speed or the flicker of a computer monitor can trigger a seizure; this problem is called photosensitive epilepsy.

Smoking cigarettes also can trigger seizures. The nicotinein cigarettes leads to increased neuronal firing.

Seizures are not triggered by sexual activity except in very rare instances.

What Are the Different Kinds of Seizures?

Seizures are divided into two major categories -- focal seizures and generalized seizures.

Focal Seizures

Focal seizures, also called partial seizures, occur in just one part of the brain. These seizures are frequently described by the area of the brain in which they originate.

The symptoms of focal seizures can easily be confused with other disorders. For instance, the dreamlike perceptions associated with a complex focal seizure may be misdiagnosed as migraine headaches, which also may cause a dreamlike state. The strange behavior and sensations caused by focal seizures also can be mistaken for symptoms of narcolepsy (Excessive daytime sleepiness), fainting, or even mental illness. It may take many tests and careful monitoring by an experienced physician to tell the difference between epilepsy and other disorders.

Generalized Seizures

Generalized seizures are a result of abnormal neuronal activity on both sides of the brain. These seizures may cause loss of consciousness, falls, or massive muscle spasms.

There are many kinds of generalized seizures.

In absence seizures, the person may appear to be staring into space and/or have jerking or twitching muscles.
Tonic seizures cause stiffening of muscles of the body, generally those in the back, legs, and arms.
Clonic seizures cause repeated jerking movements of muscles on both sides of the body.
Myoclonic seizures cause jerks or twitches of the upper body, arms, or legs. Atonic seizures cause a loss of normal muscle tone. The affected person will fall down or may drop his or her head involuntarily.
Tonic-clonic seizures cause a mixture of symptoms, including stiffening of the body and repeated jerks of the arms and/or legs as well as loss of consciousness. Tonic-clonic seizures are sometimes referred to by an older term: grand mal seizures.

What Are the Different Kinds of Epilepsy?

Just as there are many different kinds of seizures, there are many different kinds of epilepsy.

Epilepsy syndromes are frequently described by their symptoms or by where in the brain they originate. People should discuss the implications of their type of epilepsy with their doctors to understand the full range of symptoms, the possible treatments, and the prognosis.

Absence Seizures: People with absence epilepsy have repeated absence seizures that cause momentary lapses of consciousness. These seizures almost always begin in childhood or adolescence, and they tend to run in families, suggesting that they may be at least partially due to a defective gene or genes.

Some people with absence seizures have purposeless movements during their seizures, such as a jerking arm or rapidly blinking eyes. Others have no noticeable symptoms except for brief times when they are "out of it." Immediately after a seizure, the person can resume whatever he or she was doing. However, these seizures may occur so frequently that the person cannot concentrate in school or other situations. Childhood absence epilepsy usually stops when the child reaches puberty. Absence seizures usually have no lasting effect on intelligence or other brain functions.

Temporal lobe epilepsy, or TLE, is the most common epilepsy syndrome with focal seizures. These seizures are often associated with auras. TLE often begins in childhood.

Neocortical epilepsy is characterized by seizures that originate from the brain's cortex, or outer layer. The seizures can be either focal or generalized. They may include strange sensations, visual hallucinations, emotional changes, muscle spasms, convulsions, and a variety of other symptoms, depending on where in the brain the seizures originate.

When Are Seizures Not Epilepsy?

While any seizure is cause for concern, having a seizure does not by itself mean a person has epilepsy. First seizures, febrile seizures, nonepileptic events, and eclampsia are examples of seizures that may not be associated with epilepsy.

Febrile Seizures: Sometimes a child will have a seizure during the course of an illness with a high fever. These seizures are called febrile seizures (febrile is derived from the Latin word for "fever") and can be very alarming to the parents and other caregivers.

Non-epileptic Events: Sometimes people appear to have seizures, even though their brains show no seizure activity. This type of phenomenon has various names, including nonepileptic events and pseudoseizures. Both of these terms essentially mean something that looks like a seizure but isn't one. Nonepileptic events that are psychological in origin may be referred to as psychogenic seizures. Psychogenic seizures may indicate dependence, a need for attention, avoidance of stressful situations, or specific psychiatric conditions.

Psychogenic seizures cannot be treated in the same way as epileptic seizures. Instead, they are often treated by mental health specialists.

Eclampsia: Eclampsia is a life-threatening condition that can develop in pregnant women. Its symptoms include sudden elevations of blood pressure and seizures. Pregnant women who develop unexpected seizures should be rushed to a hospital immediately.

How is Epilepsy Diagnosed?

EEG: When someone has experienced a first seizure, the doctor will usually order an electroencephalogram, or EEG, to determine what type of seizure the person may have had and if there are any detectable abnormalities in the person's brain waves.

Brain Scans: The most commonly used brain scans include CT (computed tomography), PET (positron emission tomography) and MRI (magnetic resonance imaging). CT and MRI scans reveal the structure of the brain, which can be useful for identifying brain tumors, cysts, and other structural abnormalities.

Taking a detailed medical history, including symptoms and duration of the seizures, is still one of the best methods available to determine if a person has epilepsy and what kind of seizures he or she has.

Blood Tests: These blood samples are often screened for metabolic or genetic disorders that may be associated with the seizures. They also may be used to check for underlying problems such as infections, lead poisoning, anemia, and diabetes that may be causing or triggering the seizures.

FIRST AID POINTS TO BE REMEMBERED

Employees with a history of seizure or epilepsy should:

Always carry medical identification card in their pocket Inform the doctor/admin staff about the history, it can be of help during emergencies
Avoid potentially dangerous activities, such as swimming, gymnastics or mountain climbing without someone near by
If on medication, do not suddenly stop taking it or change the dosage without consulting your doctor
Many over-the-counter drugs can interfere with your medications.
Alcohol can decrease the effectiveness of your medication
First Aid Action Points for bystanders:

Loosen clothing around the person's neck
Do not try to hold the person down or restrain him or her, this can result in injury
Do not insert any objects in the person's mouth; this can also cause injury
Reassure bystanders who may be panicking and ask them not to crowd over the victim Remove sharp objects (glasses, furniture and other objects) from around the person to prevent injury
Carefully observe the events which need to be told to the doctor
After the seizure, lay the person on his or her side to maintain an open airway and prevent the person from inhaling any secretions
The patient may be confused for a period of time and should not be left alone Call for help and organize to shift the patient to hospital