Post by Admin on Jan 17, 2015 12:45:50 GMT -4
Epilepsy Symptoms
While many types of repetitive behavior may represent a neurological problem, a doctor needs to establish whether or not they are seizures.
Generalized seizures: All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures.
The person experiencing such a seizure may cry out or make some sound, stiffen for several seconds to a minute and then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping.
Eyes are generally open.
The person may appear to not be breathing and actually turn blue. This may be followed by a period of deep, noisy breathes.
The return to consciousness is gradual and the person may be confused for quite some time -- minutes to hours.
Loss of urine is common.
The person will frequently be confused after a generalized seizure.
Partial or focal seizures: Only part of the brain is involved, so only part of the body is affected. Depending on the part of the brain having abnormal electrical activity, symptoms may vary.
If the part of the brain controlling movement of the hand is involved, then only the hand may show rhythmic or jerky movements.
If other areas of the brain are involved, symptoms might include strange sensations like a full feeling in the stomach or small repetitive movements such as picking at one's clothes or smacking of the lips.
Sometimes the person with a partial seizure appears dazed or confused. This may represent a complex partial seizure. The term complex is used by doctors to describe a person who is between being fully alert and unconscious.
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Absence or petit mal seizures: These are most common in childhood.
Impairment of consciousness is present with the person often staring blankly.
Repetitive blinking or other small movements may be present.
Typically, these seizures are brief, lasting only seconds. Some people may have many of these in a day
Types of Epilepsy
In this article
Idiopathic Generalized Epilepsy
Idiopathic Partial Epilepsy
Symptomatic Generalized Epilepsy
Symptomatic Partial Epilepsy
Epilepsy is the occurrence of sporadic electrical storms in the brain commonly called seizures. These storms cause behavioral manifestations (such as staring) or involuntary movements (such as grand mal seizures).
There are several types of epilepsy, each with different causes, symptoms, and treatments.
When making a diagnosis of epilepsy, your doctor may use one of the following terms: idiopathic, cryptogenic, symptomatic, generalized, focal, or partial. Idiopathic means there is no apparent cause. Cryptogenic means there is a likely cause, but it has not been identified. Symptomatic means that a cause has been identified. Generalized means that the seizures are involving the whole brain at once. Focal or partial means that the seizure starts from one area of the brain.
Major Types of Epilepsy
Types of Epilepsy Generalized Epilepsy Partial Epilepsy
Idiopathic (genetic causes) - Childhood absence epilepsy
- Juvenile myoclonic epilepsy
- Epilepsy with grand-mal seizures on awakening Others - Benign focal epilepsy of childhood
Symptomatic (cause unknown) or cryptogenic (cause unknown) - West syndrome
- Lennox-Gastaut syndrome
- Others
- Temporal lobe epilepsy
- Frontal lobe epilepsy Others
Idiopathic Generalized Epilepsy
In idiopathic generalized epilepsy, there is often, but not always, a family history of epilepsy. Idiopathic generalized epilepsy tends to appear during childhood or adolescence, although it may not be diagnosed until adulthood. In this type of epilepsy, no nervous system (brain or spinal cord) abnormalities, other than the seizures, can be identified on either an EEG or imaging studies ( MRI). The brain is structurally normal on a brain magnetic resonance imaging (MRI) scan, although special studies may show a scar or subtle change in the brain that may have been present since birth.
People with idiopathic generalized epilepsy have normal intelligence and the results of the neurological exam and MRI are usually normal. The results of the electroencephalogram (EEG -- a test which measures electrical impulses in the brain) may show epileptic discharges affecting a single area or multiple areas in the brain (so called generalized discharges).
The types of seizures affecting patients with idiopathic generalized epilepsy may include:
Myoclonic seizures (sudden and very short duration jerking of the extremities)
Absence seizures (staring spells)
Generalized tonic-clonic seizures (grand mal seizures)
Idiopathic generalized epilepsy is usually treated with medications. Some people outgrow this condition and stop having seizures, as is the case with childhood absence epilepsy and a large number of patients with juvenile myoclonic epilepsy.
Idiopathic Partial Epilepsy
Idiopathic partial epilepsy begins in childhood (between ages 5 and 8) and may be part of a family history. Also known as benign focal epilepsy of childhood (BFEC), this is considered one of the mildest types of epilepsy. It is almost always outgrown by puberty and is never diagnosed in adults.
Seizures tend to occur during sleep and are most often simple partial motor seizures that involve the face and secondarily generalized (grand mal) seizures. This type of epilepsy is usually diagnosed with an EEG.
Symptomatic Generalized Epilepsy
Symptomatic generalized epilepsy is caused by widespread brain damage. Injury during birth is the most common cause of symptomatic generalized epilepsy. In addition to seizures, these patients often have other neurological problems, such as mental retardation or cerebral palsy. Specific, inherited brain diseases, such as adrenoleukodystrophy (ADL) or brain infections (such as meningitis and encephalitis) can also cause symptomatic generalized epilepsy. When the cause of symptomatic general epilepsy cannot be identified, the disorder may be referred to as cryptogenic epilepsy. These epilepsies include different subtypes -- the most commonly known type is the Lennox-Gastaut syndrome.
Multiple types of seizures (generalized tonic-clonic, tonic, myoclonic, tonic, atonic, and absence seizures) are common in these patients and can be difficult to control. Learn more about these seizure types.
Symptomatic Partial Epilepsy
Symptomatic partial (or focal) epilepsy is the most common type of epilepsy that begins in adulthood, but it does occur frequently in children. This type of epilepsy is caused by a localized abnormality of the brain, which can result from strokes, tumors, trauma, congenital (present at birth) brain abnormality, scarring or "sclerosis" of brain tissue, cysts, or infections.
Sometimes these brain abnormalities can be seen on MRI scans, but often they cannot be identified, despite repeated attempts, because they are microscopic.
This type of epilepsy may be successfully treated with surgery that is aimed to remove the abnormal brain area without compromising the function of the rest of the brain. Epilepsy surgery is very successful in a large number of epilepsy patients who failed multiple anticonvulsant medications (at least two or three drugs) and who have identifiable lesions. These patients undergo a presurgical comprehensive epilepsy evaluation in dedicated and specialized epilepsy centers.
Part 2 :
Migraine and epilepsy are both common neurological disorders with migraine affecting 12% of the population and epilepsy, 0.5 to 1%. But among migraineurs, 5.9% develop migraine after an incident of epilepsy. Both are considered to run in families and hence likely have a significant genetic component. Most migraineurs do not have epilepsy.
Underlying both conditions is a state of brain hyperexcitability, which can be attributed to genetic factors or an environmental event such as a head injury. Both are episodic disorders with symptoms occurring sporadically; during the time between attacks, individuals are symptom free.
Research suggests that the underlying pathophysiology of both relates to alteration in ion channels or ion transporters. Attacks for both disorders begin with neuronal firing in the brain. In migraine, this activity is described a cortical spreading depression (CSD) which is a relatively organized pattern of electrical disruption whereas in epilepsy the electrical disruption is much more chaotic.
Other similarities between migraine and epilepsy include:
Triggers or risk factors produce an attack by reducing the excitability threshold. Common triggers are stress or let-down stress, sleep disturbance, hormonal changes, alcohol intake, and certain foods
5 phases are ascribed to the progress of the attacks associated with the disorders
Prodromal symptoms
Aura
Seizure or headache
Resolution
Postdrome
Antiepileptic drugs (AEDs) are used to prevent both disorders and believed to be effective by reducing neuronal hyperexcitability. Used as a preventive medication for frequent attacks of migraine, the prescribed dose of AEDs is usually much lower than for someone with epilepsy (for example, valproate and topiramate)
Recently, researchers studied 501 families that included 2 or more individuals with epilepsy. There were 730 epilepsy patients in the study. The results indicated that those who had close relatives with seizures also had the highest risk for attacks of migraine. The conclusion was that the link between epilepsy and migraine was due to shared biology.
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