Epilepsy Flashcards
Definition
A condition that affects the brain and causes frequent seizures
A seizure is a convulsion or transient abnormal event caused by a paroxysmal discharge of cerebral neurones.
– epilepsy is the continuing tendency to have such seizures
Epidemiology
Common
2% of the UK population having 2 or more seizures during their lives, and in 0.5%, epilepsy is an active problem
Classification of seizures
Classified clinically as partial or generalised.
Partial- involve only a portion of the brain at their onset (e.g: temporal lobe)
Generalised seizure types:
– Myoclonic seizures
– absense seizures
– tonic seizures
– akinetic seizures
Partial seizure types:
– electrical activity starts in one area of the brain
Aetiology
Flashing lights or flickering television may provoke an attack
A cause for epilepsy is found in less than 1/3 of cases
Known causes are:
– cerebrovascular disease (15%)
– cerebral tumours (6%)
– alcohol-related seizures (6%)
– post-traumatic epilepsy (2%)
Hippocampal sclerosis is the main cause for temporal lobe epilepsy
Around 30% of patients have a first-degree relative with epilepsy
Occasionally:
– metabolic disturbances such as- hyperglycaemia, acute hypoxia, hypocalcaemia, hyponatraemia, uraemia and heptatocellular failure present with convulsions
Risk factor
Childhood febrile convulsions (main RF)
Clinical presentation
General symptoms:
– confusion
– stiff muscles (tonic and akinetic)
– Uncontrollable jerking movements of the arms and legs (myoclonic)
– loss of consciousness and awareness
– psychological symptoms like anxiety, fear or deja vu
Generalised tonic-clonic seizures (grand-mal seizures):
– sudden onset of rigid tonic phase, followed by convulsion, where the muscles rhythmically jerk and the eyes stay open
Myoclonic, tonic and akinetic seizures (partial):
– isolated muscle jerking (myoclonic)
– intense stiffening of the body (tonic)
– cessation of movement, falling and loss of consciousness (akinetic)
