|
|
Understanding Epilepsy
What is Epilepsy?
Epilepsy is a common neurological condition that affects millions of people throughout the world. The term "Epilepsy" is
a general name that refers to many different disorders in which people tend to experience seizures. Other conditions, such
as high fever, the use of or withdrawal from drugs or alcohol, or a blow to the head, can cause an isolated seizure. Only
those people who have had two or more seizures are diagnosed as having epilepsy.
What causes Epilepsy?
Many cases of epilepsy are said to be symptomatic. This means they are the result of other conditions such as a birth injury,
head injury, stroke, brain tumor, infection, or congenital abnormality. Genetic factors may also play a role in the cause
of epilepsy. Some cases of epilepsy, presently cannot determine.
How the brain works?
Although it appears to be solid, the brain is made up of billions of cells, including a network up of billions of cells
called neuron. These neurons branch out, much like branches on a tree. This neural network enables communication within
the brain and between the brain and the rest of the body.
When a neuron "fires" it sends small electrical impulses along its brances toward surrounding cells. At the end of each
branch is a small gap or synapse, which the impulse must overcome in order to continue its journey.
When an impulse reaches the end of a branch, chemicals called neurotransmitters are released to flood the synapse.
Some are excitatory, stimulating the neighboring cell to fire. Others are inhibitory, making the next cell less likely to
fire.
The brain's ability to turn electrical impulses "on" and "off" allows it to control messages and work effectively. Since
normal behavior is the result of many neurons working together, a fine balance of excitatory and inhibitory factors is
needed to insure that the correct neurons fire at the appropriate times. In people with epilepy, however, this fine
balance is upset, making the brain unable to limit the spread of electrical activity. When too many neurons fire at
once, an electrical storm is created within the brain.
The brain is divided into two hemispheres. The right half controls the left side of the body and the left half control the right
side of the body. Each hemisphere is divided into four lobes. Within the lobes there are even smaller areas, each
associated with specific functions.
What is a seizure?
A seizure is an excessive discharge of electrical activity within the brain, which leads to a change in movement, sensation,
experience or consciousness. There are many types of seizures. The effect they have on the body varied greatly, depending on
where in the brain the seizure starts and where it spreads.
Phases of seizure
Aura: an unusual sensation or peculiar feeling often felt prior to a more widespread seizure. It can also be called a
simple partial seizure.
Ictus: The whole seizure, including the aura.
Post-ictal: Time after a seizure may experience muscle weakness or deep sleep.
Seizure can cause
- A twitching muscle
- Convulsive movements
- A tingling sensation
- Sweating
- The perception of an unusual smell or taste
- Hallucination
- Fear or anxiety
- Changes in awareness
- Loss of consciousness
- Other changes
If someone has a seizure ?
Although big seizures may be frightening to witness, they are usually not medical emergencies. In most cases
the seizure itself is not harmful to the individual who is having it and therefore should be allowed to
run its course. An ambulance is usually not necessary unless the seizure lasts longer than ten minutes,
there are multiple, repeated seizures, or the person is injured, diabetic or pregnant. There is nothing
family or friends can do to stop seizure, but certain steps can be taken to prevent further injury.
You should:
- Stay calm
- Help the person lie down and roll onto one side to prevent choking.
- Loosen tight, restrictive clothing and remove eyeglasses.
- Protect the person's head with soft object such as a pillow or jacket.
- Gently guide a conscious but confused person away from hazards.
- Remain with the person until he/she is awake and alert.
- Be comforting and reassuring.
You should not:
- Put anything into person's mouth
- Try to restrain the person
Generalized seizures
These seizures affect both hemispheres of the brain at the same time. Abnormal activity is not focused in one
specific area and there are generally is no aura the start.
Main forms of Generalized Seizures
Absence seizures
Typical absence seizures (formerly called Petit mal) result in brief episodes of impaired awareness. There
are also may small motor movements, changes in muscle tone, or automatic behaviors.
Atonic seizures associated with a sudden loss of muscle tone in a limb or throughout the entire body.
The person having the seizure will often drop things or fall to the ground.
Myoclonic seizures sudden shock-like jolt to one or more muscles which increases muscle tone and causes
movement. These sudden jerks are like those that occur in healthy people as they fall asleep.
Tonic-clonic seizures (formerly called "grand mal") begin with simultaneous loss of consciousness and the tonic
phase (stiffening of the body). The person falls to the ground and often emits a loud cry as the chest muscles
stiffen. Next comes the clonic phase, during which the muscles rhythmically jerk.
Partial Seizures
These seizures begin in a part of one hemisphere, generally in the temporal or frontal lobe. The two types
of partial seizures, called simple and complex, are based on whether a person remains fully conscious during
a seizure.
Main forms of Partial Seizures
3 simple partial seizures (sometimes called "auras")
Seizure activity is focused in a specific area of the brain.
A person remains alert and afterward is able to remember what happened. An aura or simple partial seizure
may constitute the entire seizure or may precede a complex partial or generalized seizure. Symptoms vary depending on the
area of the brain involved.
Motor seizures cause a change is muscle activity and may involve jerking or stiffening of a part of the body.
Sensory seizures may cause abnormal function in any of the five senses.
Autonomic seizures affect involuntary functions and may cause a rapid heartbeat or breathing rate. sweating, or an
unpleasant sensation in the abdomen, chest, throat or head.
Psychic seizures may affect perception and memory or stimulate emotions such as fear.
Complex partial seizures?
Seizure is accompanied by impaired consciousness and recall. It may also involve starting, automatic behaviors such as
lip smacking, chewing, fumbling, picking, walking, grunting, repetition or words or phrases, or other
symptoms and signs.
Diagnosing Epilepsy?
There is no single test for epilepy. The doctor will make a diagnosis based on description of past seizures. Since those
who have had a seizure are often unaware of what took place, the doctor may rely on others who witnessed the event.
Details about what took place, the doctor may rely on others who witnessed the event. Details about how the patient
felt before the attack and how it took place are very useful. The doctor will alse review the patient's personal and
family medical history, and will give a physical exam to check for other conditions that may have cause the attack.
There are tests designed to gather information about a patient's condition. The most commonly used test is an
electroencephalogram (EEG). An EEG involves attaching a series of metal discs called electrodes to the patient's head
to measure the brain's electrical activity. Most types of seizures are detectalbe with the EEG, but some abnormal
activity may affet too small an area on the brain's surface or be located too deep to be detected. Other tests
such as computed tomography (CT) and magnetic resonance imaging (MRI) can provide additional information about the
brain. A doctor may order these tests to look for causes of the attack, such as a tumor, congenital malformation, or
other changes in the brain.
|
