Seizure Disorders (Epilepsy)

Question 1

Seizure Disorder

Epilepsy

Answer 1

Seizure= abnormal electrical activity in the brain that causes one or more of the following:

1. an aura that signals the onset of the seizure (a feeling, odor or noise).
2. loss of consciousness
3. some type of abnormal movement.

Diagnosis: medical history, physical exam, EEG/electroencephalograph (abnormal electrical activity in brain), CT, MRI can be used to see if seizure is related to brain lesion or other abnormality.

Question 2

Types of Seizures

Generalized and Partial

Answer 2

Generalized Seizures= bilaterally symmetrical and do not have a focal onset.

1. Tonic-clonic (grand mal) seizure: tonic is muscles contract and the body stiffens; clonic is the rhythmic shaking of the limbs; postictal (post-seizure) depression or confusion with amnesia for the ictal event.
2. Absence (petit mal) seizure: brief attacks with loss of consciousness w/o prominent motor symptoms. Blank stare with frequent eye blinking. Thalamus plays a role in these absence seizures.

Partial Seizures = begin on one side of brain and affect one side of the body initially, and may spread and become generalized seizures.

1. Simple Partial Seizures do not involve loss of consciousness, while complex partial seizures entail some alteration in consciousness.
2. arise in various regions of the brain but most often due to abnormal electrical activity in lobes of the cerebral cortex, with temporal lobe epilepsy being most common.

Question 3

Symptoms of

Temporal

Frontal

**Parietal **

**Occipital Lobe **

Seizures

Answer 3

1. Temporal Lobe: automatisms (lip smacking, chewing); hallucinations; sudden feeling of fear, happy, sad, labile mood; sense of deja vu or jamais vu (feeling of familiarity or unfamiliarity with object or place), change in personality, change in sex behavior, automonmic signs (flushed, pupillary dilation, heart and breathing rates).
2. Frontal Lobe: motor symptoms (jerky movement of the arm/leg in the opposite side of body), speech arrest, speech distrubances, olfactory hallucinations or illusions; autonomic symptoms
3. **Parietal Lobe: **unusual physical sensations on the opposite side of the body (numbing, tingling, or burning).
4. **Occipital Lobe: **rapid eyeblinking, unusual visual phenomena (flashing lights, balls of light, strange colors int he visual field opposite the affected lobe).

Question 4

Multiple Sclerosis

Answer 4

MS = progressive disease of the nervous system that involves the degeneration of the myelin that surrounds the nerve fibers int he brain and spinal cord.

1. autoimmune response that produces antibodies that attack the myelin and triggered by genetic, viral or env. factors.
2. more common in women, onset between 20-40yo.
3. *Relapsing-Remitting Type (80-85%) = *Alternating periods of relapse (acute worsening) and remission (partial or complete recovery).
4. Secondary Progressive Type: majority of the first type convert to this, which is gradual worsening of symptoms w/o periods of relapse.
5. symptoms depend on location and severity of demyelination, but common initial symptoms are:
   
   1. optic neuritis, fatigue, motor impairments, sensory abnormalities, electric sensation down back to legs.
   2. tumors, speech/swallowing problems, hearing loss, depression, cognitive, sex, bladder/bowel control.
   3. Cognitive impairments affects 50-70% of people with MS, but mostly mild, but may be due to depression or other treatable factors.
   4. cognitive dysfunction increases as the disease progresses.