Epilepsy

Description

Seizures are defined as sudden alteration of behavior, characterized by a sensory perception or motor activity without or with change in awareness or consciousness, due to aberrant cortical electrical activity. Partial seizures begin locally without impairment of consciousness, and with complex symptoms (with impairment of consciousness). Generalized seizures occur bilaterally, symmetrically and are without local onset. A third classification of seizures are unclassified epileptic seizures.



Seizure symptoms:

focal motor - convulsive jerking

somatosensory - parasthesias or tingling

Jacksonian - spread or march to different area

sensory - flashing lights, bad smells, buzzing, voices, songs

autonomic - flushing, sweating, epigastric sensation, arrhythmia

psychic - deja vu (familiarity), jamais vu (un-familiarity), fear, pleasure, anger



Partial seizures are confined to one part of the brain

simple partial seizures are limited to one part of the body, or one aspect of behavior

complex partial seizures have symptoms that change during the attack, loss of consciousness.



Generalized seizures involve neuronal discharge in both sides of the brain and may evolve from partial seizures. Characteristic - usually an alteration or loss of consciousness.

An absence seizure usually begins between ages 2-12, often with a positive family history.

A simple absence seizures usually lasts 1-2 seconds, and is characterized by a blank stare.

A complex absence seizure usually lasts 15-20 seconds. The head drops and arms jerk.



Causes

Causes of seizures include: Brain tumor, Cerebral hypoxia (breath holding, carbon monoxide poisoning, anesthesia), Cerebrovascular accident (infarct or hemorrhage), Convulsive or toxic agents (lead, alcohol, cocaine, camphor, chloraquine, pentylenetetrazol, picrotoxin, strychnine), Eclampsia (during pregnancy), Exogenous factors (sound, light, cutaneous stimulation), Head injury, Hyperpyrexia (acute infection, heat stroke), Metabolic disturbances (hypoglycemia, hypoparathyroidism, phenylketonuria, uremia, hepatic failure, electrolyte abnormality) or Anaphylaxis (foreign serum or drug allergy).

Convulsions may also occur as a withdrawal symptom after chronic use of alcohol, hypnotics, or tranquilizers.



Conventional Labs

Conventional lab tests include serum tests for glucose, sodium, potassium, calcium, phosphorus, magnesium, BUN, and ammonia; Anticonvulsant levels (inadequate level of anticonvulsant medication is the most common cause of recurrent seizures in children, and many adults); Drug and toxic screens (including alcohol); and a complete blood count (which may be helpful in evaluating infection).

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