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Central Nervous System Alterations: Seizures and Epilepsy

Learn about episodes of abnormal electrical discharge in the brain, causes, assessment tests, types of seizures, and postictal states. Comprehensive guide on seizure types and epilepsy. Video from faculty animation included.

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Central Nervous System Alterations: Seizures and Epilepsy

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  1. ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM SEIZURES AND EPILEPSY

  2. SEIZURE • Episodes of abnormal sudden, excessive, uncontrolled electrical discharge of neurons within the brain • May result in alteration in consciousness, motor or sensory ability and/or behavior

  3. CAUSE OF SEIZURES • Birth trauma/Asphyxia during birth • Head injuries/ brain tumors • Infectious disease • Toxicity (carbon monoxide and lead poisoning) • Fever • Drug/alcohol intoxication • Metabolic disturbances • Inherited • Idiopathic (unknown cause)

  4. ASSESSMENT AND DIAGNOSTIC TESTS • History • MRI/ CT scan • EEG • SPECT (single photon emission computed tomography) – helps identify zone giving rise to seizures, can then be removed surgically • Blood chemistry test

  5. EPILEPSY • Chronic disorder • Recurrent unprovoked seizure activity CAUSE OF EPILEPSY • abnormal electrical neuronal activity • Imbalance of neurotransmitters: Gamma aminobutyric acid (GABA)

  6. STATUS EPILEPTICUS • Two or more consecutive seizures that occur without full recovery of consciousness between attacks • Also includes continuous electrical seizures lasting at least 30 minutes

  7. Types of Seizures • Generalized seizures -involves both cerebral hemispheres • Partial seizures (focal or local) • Begins in a part of one cerebral hemisphere • Complex- may cause loss of consciousness • Simple-remains conscious • Unclassified seizures

  8. Video from faculty animation only chapter 44 partial seizure

  9. GENERALIZED SEIZURES 6 TYPES • TONIC-CLONIC SEIZURE • Lasts up to a min. • Starts with tonic movements: stiffening or rigidity of the muscles of arms and legs • Loss of consciousness • Incontinent bladder/bowel • Clonic movements follow: rhythmic jerking of all extremities • May bite tongue • Followed by a postictal phase

  10. POST-ICTAL STATE • POST-ICTAL STATE: after seizure Pt is confused and hard to arouse, may sleep for hours

  11. GENERALIZED SEIZURES CONTINUED • Tonic seizures: • Abrupt increase in muscle tone • Loss of consciousness • Loss of autonomic signs for 30 sec to several minutes • Clonic seizure: • Lasts several minutes • Muscle contraction and relaxation

  12. GENERALIZED SEIZURES CONTINUED • Absence seizure • Common in children ( familial) • Brief (seconds) loss of consciousness • Blank starring, returning to normal • May occur frequently throughout day • Myoclonic seizure: • Brief jerking/stiffening extremities • Singly or in groups • Lasts few seconds

  13. GENERALIZED SEIZURES CONTINUED • Atonic(akinetic)seizure • Sudden loss of muscle tone for a few seconds, may fall • Followed by POSTICTAL(after seizure) confusion

  14. Partial Seizures • Partial- only involves one side of the brain • Simple: person remains conscious • Complex: impaired consciousness bizarre behavior amnesia

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