SEIZURE DISORDER
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There are more than 20 different seizure
disorders. One in ten Americans will have a seizure at some time,
and at least 200,000 have at least one seizure a month.
Epilepsy affects 1-2% of the population of the United States.
Although epilepsy is as common in adults over 60 as in children
under 10, 25% of all cases develop before the age of five. One in
every two cases develops before the age of 25. About 125,000 new
cases of epilepsy are diagnosed each year, and a significant number
of children and adults that have not been diagnosed or treated have
epilepsy.
Most seizures are benign, but a seizure that lasts a long time can
lead to status epilepticus, a life-threatening condition
characterized by continuous seizures, sustained loss of
consciousness, and respiratory distress. Non-convulsive epilepsy can
impair physical coordination, vision, and other senses. Undiagnosed
seizures can lead to conditions that are more serious and more
difficult to manage.
Types of seizures
Generalized epileptic seizures occur when electrical abnormalities
exist throughout the brain. A partial seizure does not involve the
entire brain. A partial seizure begins in an area called an
epileptic focus, but may spread to other parts of the brain and
cause a generalized seizure. Some people who have epilepsy have more
than one type of seizure.
Motor attacks cause parts of the body to jerk repeatedly. A motor
attack usually lasts less than an hour and may last only a few
minutes. Sensory seizures begin with numbness or tingling in one
area. The sensation may move along one side of the body or the back
before subsiding.
Visual seizures, which affect the area of the brain that controls
sight, cause people to see things that are not there. Auditory
seizures affect the part of the brain that controls hearing and
cause the patient to imagine voices, music, and other sounds. Other
types of seizures can cause confusion, upset stomach, or emotional
distress.
Generalized seizures
A generalized tonic-clonic (grand-mal) seizure begins with a loud
cry before the person having the seizure loses consciousness and
falls to the ground. The muscles become rigid for about 30 seconds
during the tonic phase of the seizure and alternately contract and
relax during the clonic phase, which lasts 30-60 seconds. The skin
sometimes acquires a bluish tint and the person may bite his tongue,
lose bowel or bladder control, or have trouble breathing.
A grand mal seizure lasts between two and five minutes, and the
person may be confused or have trouble talking when he regains
consciousness (post-ictal state). He may complain of head or muscle
aches, or weakness in his arms or legs before falling into a deep
sleep.
Primary generalized seizures
A primary generalized seizure occurs when electrical discharges
begin in both halves (hemispheres) of the brain at the same time.
Primary generalized seizures are more likely to be major motor
attacks than to be absence seizures.
Absence seizures
Absence (petit mal) seizures generally begin at about the age of
four and stop by the time the child becomes an adolescent.
Absence seizures usually begin with a brief loss of consciousness
and last between one and 10 seconds. A person having a petit mal
seizure becomes very quiet and may blink, stare blankly, roll his
eyes, or move his lips. A petit mal seizure lasts 15-20 seconds.
When it ends, the person who had the seizure resumes whatever he was
doing before the seizure began. He will not remember the seizure and
may not realize that anything unusual has happened. Untreated, petit
mal seizures can recur as many as 100 times a day and may progress
to grand mal seizures.
Myoclonic seizures
Myoclonic seizures are characterized by brief, involuntary spasms of
the tongue or muscles of the face, arms, or legs. Myoclonic seizures
are most apt to occur when waking after a night's sleep.
A jacksonian seizure is a partial seizure characterized by tingling,
stiffening, or jerking of an arm or leg. Loss of consciousness is
rare. The seizure may progress in characteristic fashion along the
limb.
Limp posture and a brief period of unconsciousness are features of
akinetic seizures, which occur in young children. Akinetic seizures,
which cause the child to fall, are also called drop attacks.
Partial seizures
Simple partial seizures do not spread from the focal area where they
arise. Symptoms are determined by what part of the brain is
affected. The patient usually remains conscious during the seizure
and can later describe it in detail.
Complex partial seizures
A distinctive smell, taste, or other unusual sensation (aura) may
signal the start of a complex partial seizure.
Complex partial seizures start as simple partial seizures, but move
beyond the focal area and cause loss of consciousness. Complex
partial seizures can become major motor seizures. Although a person
having a complex partial seizure may not seem to be unconscious, he
does not know what is happening and may behave inappropriately. He
will not remember the seizure, but may seem confused or intoxicated
for a few minutes after it ends. |
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