THIS IS THE FIRST DRAFT AND VERY ROUGH. ALL MATERIAL REFERENCED OUTOF TWO DIFFERENT PUBLISHED BOOKS
Pathophysiology: Epilepsy of Nervous System
This report is on epilepsy also known as a seizure disorder. This is a brain condition
characterized by more then two seizures. These seizures are events associated with
abnormal electrical discharges of neurons in the brain. Discharges can trigger
convulsions, alter level of consciousness and interrupt sensations. This disorder affects
any person, any age, any race. about 2.5 million people live with epilepsy. It is most
common for this disorder to start in childhood in many cases. about 80% of patients on
meds have good seizure control. Diet, exercise, and rest play a big role in keeping
healthy and seizure free.
A group of neurons become affected and stimulated during a seizure.. These neurons are
hypersensitive and are easily triggered in response to the cellular environment. The
neurons become triggered and start to fire abnormally. This is when the seizure occurs.
It is all just misfiring of brain waves.
There are many reasons for people to have seizure disorders. about half of the cases are
idiopathic, meaning there are of unknown origin. The other 50% can be from strokes,
brain tumors, encephalitis, brain lesions, cysts, infections, being febrile, brain injuries
like a Motor Vehicle Accident.
There are so many kinds of seizures. When you say the word seizure people always think
of someone foaming at the mouth, convulsing on the floor and being incontinent. But
that is only one kind of seizure. It is most easily recognized due to the blatantly obvious
motions. Here are a few examples of different kinds of seizures.
Generalized Tonic Clonic. This is the most widely recognized seizure. It will normally
begin with a loud cry. This cry is the lungs expelling the air within as it spasms. The
patient will fall to the ground and they loose consciousness. The body will then stiffen.
This is the Tonic Phase. Then it will spasm, or convulse. This is the Clonic
Phase. Cyanosis can occur due to lack of oxygen. Incontinence, tongue biting and
labored breathing are all associated with Tonic Clonic seizures. Generally the duration of
a Tonic Clonic is 2-5 minutes. Anything after 5 minutes is considered status. You would
want to call for help if they haven’t come to yet. This seizure is very hard on the body.
You may experience a post ictal stage for up to a week after the event.
Absence seizures. Absence seizures are more common in children. This seizure starts
with a brief change in consciousness. The patients eyes will blink and have a blank,
vacant stare. Patients appear quite normal. They retain their body position. This seizure
normally lasts anywhere from 1-10 seconds. They are so quick the patient doesn’t
always know they are having them. These can occur up to one hundred times a day.
They can easily generalize (spread) into a Tonic Clonic. Most often teachers or parents
mistake these seizure for “day dreaming” or “staring into space”. They may mistake it
for a lack of attention, not realizing it is a seizure.
Partial Seizures. There are two types of partial seizures. Complex & Simple. Both you
do not loose total consciousness. There come from one area of the brain. Can easily
generalize. There partials have an altered state of consciousness. People may tug at their
clothes a lot during this. They may pick at their skin and smack their lips. People can
carry out functions during these seizures. Functions like walking and talking. The
patient may not make much sense because a part of the brain is seizing at that time.
These partial include auras. They are simple partials in themselves. They can give you
an unusual taste in your mouth. Give you a dreamy feeling, nausea, a sinking feeling,
Sensory Seizures. Sensory seizure symptoms include flashing lights, tingling sensations,
vertigo, hallucinations, déjà vu, smelling foul odors. Smelling odors of something
burning like wood or fire.
Diagnostic tests include MRI and CT Scan. Both rule out tumors or lesions on the brain.
EEG’s are most common to find the focal (trigger) points in the brain. EEG shows the
abnormalities of the neurons misfiring. There are many kinds of EEG’s. You must have
a seizure while hooked up for it to show in the recording. Some seizure activity occurs so
deep within the brain that they aren’t picked up by the electrodes on the scalp. Other
diagnostic tests are serum chemistries and other blood work. Possible Skull X-Ray if
Treatments include Drug Therapy. During drug therapy you med levels have to be
checked through blood work you make sure you are having a therapeutic dosage. Drug
therapy can help control the frequency and control or prevent reoccurrence of future
seizures. The drug chose is specific to the patients seizure disorder. It depends on what
lobe in the brain is misfiring and why. Neurologists or Epiliptologists generally know
which drug works best for each type of seizure. Sometimes they need to put the patient
on a cocktail of meds to get them controlled. You must patient educate. You must
explain the side effects of these meds and warn about alcoholic beverages. Refer patients
to the Epilepsy Foundations Association or Support groups in town or online.
25 years old