| Epilepsy and Seizure Disorders (Some of this material was taken from an article by Ward Dean, M.D.) Another name for "seizure-disorder" is Paroxysmal Disorder. These are very common problems. The group of these disorders is quite varied by mechanism, characteristics and prognosis. Epilepsy makes up only one part of these paroxysmal processes. Transient loss of consciousness is not always due to epilepsy (30% of the time they are other paroxysms). One of the difficulties is that there is no relationship between an abnormal EEG and the nature of the seizure. The description is the key to explaining what type of event occurred. An epileptic seizure refers to a sudden change in the electrical activity in the brain usually accompanied by subjective or objective symptoms or signs in the patient. A non-epileptic seizure is one where there is objective or subjective activity without a change in the electrical activity in the brain. The problem is that it rarely occurs that you can observe the electrical activity and thus it is just "educated guessing" as to whether it is a true epileptic event. The true epileptic seizure is a transient clinical event resulting from excessive activity of synchronized neurons. It results in disorganization of brain function manifested by motor, sensory or psychic phenomena. The electrical activity underlying this is the "epileptic discharge". There doesn't have to be a reaction - it can be a subclinical event where the "discharge" occurs without the patient experiencing anything. These events can occur from: fever, low blood sugar, acute CNS infections or of unknown origin (these are the type we will be discussing). It is the unknown etiology type that we call epilepsy, the other we call "occasional seizure". The epilepsy is a chronic condition where epileptic seizures occur repeatedly as a result of a structural or functional injury to the brain. Convulsions are involuntary motor movements and don't have to be epileptic. An epileptic seizure can have electrical activity going on deep in the brain and may not be detected on the scalp with electrodes. The cause of the epilepsy is thought to be from a genetic defect in inhibitory mechanisms possibly related to the GABA neurotransmitter system. Other important research relates to the excitatory neurotransmitters glutamate and aspartate. The causes of seizures reads like the following: Intracranial infections Metabolic abnormalities Hypocalcemia [low calcium] Hypomagnesemia [low magnesium] Hyponatremia [low sodium] etc. Intoxication Diabetic Hepatic [liver] Uremic [kidney] Hypertensive Trauma Acute Cerebral: Drowning Cardiac Arrest Cerebrovascular Events Thrombosis Embolism Hemorrhage Genetics and the modes of inheritance, as it relates to single simplistic genetic transmission, only accounts for 1% of epilepsy. Brain damage, even if not visible on scans, probably plays the most prominent role in epilepsy. The term "brain damaged" is used in mainstream neurology to mean lesion that produce clinical or gross radiological signs and cognitive problems. There are many types of seizures: Partial Seizures Simple: motor signs, postural, phonatory, visual etc. Complex: impaired consciousness |
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