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Seizures and Epilepsy – Overiew

admin — Fri, 14 Feb 2020 06:11:24 +0000

Seizures And Epilepsy are not the same.

What happens in the brain during a seizure?

The electrical activity is caused by complex chemical changes that occur in nerve cells.

Brain cells either excite or inhibit (stop) other brain cells from sending messages. Usually there is a balance of cells that excite and those that can stop these messages. However, when a seizure occurs, there may be too much or too little activity, causing an imbalance between exciting and stopping activity. The chemical changes can lead to surges of electrical activity that cause seizures.

Seizures are not a disease in themselves. Instead, they are a symptom of many different disorders that can affect the brain. Some seizures can hardly be noticed, while others are totally disabling.

Epilepsy is a chronic disorder, the hallmark of which is recurrent, unprovoked seizures. A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.

The seizures in epilepsy may be related to a brain injury or a family tendency, but often the cause is completely unknown. The word “epilepsy” does not indicate anything about the cause of the person’s seizures or their severity.

Common causes of seizures by age:

In Newborns:

Brain malformations

Lack of oxygen during birth

Low levels of blood sugar, blood calcium, blood magnesium or other eletrolyte problems

Inborn errors of metabolism

Intracranial hemorrhage

Maternal drug use

In Infants and Children:

Fever (febrile seizures)

Brain tumor (rarely)

Infections

In Children and Adults:

Congenital conditions (Down’s syndrome; Angelman’s syndrome; tuberous sclerosis and neurofibromatosis)

Genetic factors

Progressive brain disease (rare)

Head trauma

In Seniors:

Stroke

Alzheimer’s disease

Trauma

Triggers of Seizures:

Specific time of day or night

Sleep deprivation – overtired, not sleeping well, not getting enough sleep

At times of fevers or other illnesses

Flashing bright lights or patterns

Alcohol or drug use

Stress

Associated with menstrual cycle (women) or other hormonal changes

Not eating well, low blood sugar

Specific foods, excess caffeine or other products that may aggravate seizures

Use of certain medications

An Accurate Diagnosis is the First Step

Knowing if a person is having a seizure and diagnosing the type of seizure or epilepsy syndrome can be difficult. There are many other disorders that can cause changes in behavior and can be confused with epilepsy. Since the treatment of seizures depends on an accurate diagnosis, making sure that a person has epilepsy, and knowing what kind is a critical first step.

What happens during a seizure is one of the most important pieces of information. And, since seizures rarely happen in a doctor’s office, the information given to the doctor and other health care professionals by you or other witnesses is extremely important.

Types of Seizures

Seizures are generally described in two major groups:

1.Generalized seizures

2. Focal seizures.

The difference between types of seizures is in how and where they begin in the brain.

There are now 3 major groups of seizures.

Generalized Onset Seizures:

These seizures affect both sides of the brain or groups of cells on both sides of the brain at the same time. This term was used before and still includes seizures types like tonic-clonic, absence, or atonic to name a few.

Focal Onset Seizures:

The term focal is used instead of partial to be more accurate when talking about where seizures begin. Focal seizures can start in one area or group of cells in one side of the brain.

Focal Onset Aware Seizures: When a person is awake and aware during a seizure, it’s called a focal aware seizure. This used to be called a simple partial seizure.

Focal Onset Impaired Awareness: When a person is confused or their awareness is affected in some way during a focal seizure, it’s called a focal impaired awareness seizure. This used to be called a complex partial seizure.

Unknown Onset Seizures:

When the beginning of a seizure is not known, it’s now called an unknown onset seizure. A seizure could also be called an unknown onset if it’s not witnessed or seen by anyone, for example when seizures happen at night or in a person who lives alone.

As more information is learned, an unknown onset seizure may later be diagnosed as a focal or generalized seizure.

How are different symptoms during a seizure described?

Many different symptoms happen during a seizure. This new classification separates them simply into groups that involve movement.

For generalized onset seizures:

Motor symptoms may include sustained rhythmical jerking movements (clonic), muscles becoming weak or limp (atonic), muscles becoming tense or rigid (tonic), brief muscle twitching (myoclonus), or epileptic spasms (body flexes and extends repeatedly).

Non-motor symptoms are usually called absence seizures. These can be typical or atypical absence seizures (staring spells). Absence seizures can also have brief twitches (myoclonus) that can affect a specific part of the body or just the eyelids.

For focal onset seizures:

Motor symptoms may also include jerking (clonic), muscles becoming limp or weak (atonic), tense or rigid muscles (tonic), brief muscle twitching (myoclonus), or epileptic spasms. There may also be automatisms or repeated automatic movements, like clapping or rubbing of hands, lipsmacking or chewing, or running.

Non-motor symptoms: Examples of symptoms that don’t affect movement could be changes in sensation, emotions, thinking or cognition, autonomic functions (such as gastrointestinal sensations, waves of heat or cold, goosebumps, heart racing, etc.), or lack of movement (called behavior arrest).

For unknown onset seizures:

Motor seizures are described as either tonic-clonic or epileptic spasms.

Non-motor seizures usually include a behavior arrest. This means that movement stops – the person may just stare and not make any other movements.

What if I don’t know what type of seizures I or my loved one have?

It’s not unusual that a person doesn’t know the type of seizure they have. Often seizures are diagnosed based on descriptions of what an observer has seen. These descriptions may not be fully complete or one can’t tell where a seizure begins from this information.

When seizures are difficult to diagnose or seizure medicines are not working to stop seizures, talk to your doctor or treating health care provider.

Seeing an epilepsy specialist or having an evaluation at an epilepsy center can help find out if you are having seizures. Not all events are due to epilepsy.

An epilepsy center help you explore other treatment options, such as surgery, devices, dietary therapy, new or add-on seizure medications, or a clinical trial.

Having tests like an MRI (magnetic resonance imaging) scan to look at the brain and EEG (electroencephalogram) tests to record the electrical activity of the brain are very helpful to diagnose types of seizures and epilepsy properly.

Keep asking questions so you get the right tests and right treatment for your type of seizures and epilepsy.

“What should I do if I have a seizure? What should I do if I see someone else have a seizure?”

Feeling helpless watching a loved one, friend, even a stranger, have a seizure is difficult. This section will help you be prepared to respond to seizures safely and appropriately.

Stay calm with the person until they are awake & alert after the seizure.
Keep the person away from the harmful objects.
Turn the person on to their side, if they are not awake or aware.
Do Not Restrain
Do not put any objects into their mouth, it may choke their airways

Epilepsy:

Epilepsy is a neurological condition which affects the nervous system. Epilepsy is also known as a seizure disorder. It is usually diagnosed after a person has had at least two seizures (or after one seizure with a high risk for more) that were not caused by some known medical condition.

Epilepsy and seizures can develop in any person at any age. Seizures and epilepsy are more common in young children and older people.Epilepsy is the 4th most common neurological condition and epilepsy affects more than 65 million people worldwide.

More men than women have epilepsy overall by a small amount

When are people most likely to get epilepsy?

New cases of epilepsy are most common among children, especially during the first year of life.

The rate of new cases of epilepsy gradually goes down until about age 10 and then becomes stable.

After age 55, the rate of new cases of epilepsy starts to increase, as people develop strokes, brain tumors, or Alzheimer’s disease, which all can cause epilepsy.

seizures do happen frequently in people who have had a traumatic injury to the brain. This may include a fall, blow to the head, gunshot wound, or other traumatic injury.

The main symptom of epilepsy is recurrent seizures. However, if a person experiences one or more of the following symptoms, they should seek medical attention, as it may indicate epilepsy:

a convulsion with no fever
short blackouts or confused memory
intermittent fainting spells, during which they lose bowel or bladder control, frequently followed by extreme tiredness
temporary unresponsiveness to instructions or questions
sudden stiffness for no apparent reason
sudden falling for no apparent reason
sudden bouts of blinking without apparent stimuli
sudden bouts of chewing without any clear reason
temporarily seeming dazed and unable to communicate
repetitive movements that seem involuntary
fearfulness for no apparent reason
panic or anger
peculiar changes in senses, such as smell, touch, and sound
jerking arms, legs, or body, which will appear as a cluster of rapid jerking movements in babies

It is vital to seek consultation with a doctor if any of these symptoms occur repeatedly.

Treatment

There is currently no cure for most types of epilepsy.

A doctor may prescribe antiepileptic drugs to help prevent seizures. If these drugs do not work, some other potential options include surgery, vagus nerve stimulation, or a special diet.

Doctors’ objective is to prevent further seizures. They also aim to prevent side effects so that the person can lead an active and productive life.

It is important to note that some drugs may prevent seizures in one person but not in another. Also, even when a person finds the right drug, it may take some time to find the ideal dosage.

Surgery

If at least two medications have been ineffective in controlling seizures, a doctor may consider recommending epilepsy surgery. A 2013 study from Sweden found that 62% of adults and 50% of children with epilepsy had no seizures for around 7 years after epilepsy surgery.

According to the National Institute of Neurological Disorders and Stroke, some surgical options include:

Lobectomy: During this procedure, a surgeon will remove the section of the brain in which seizures start. This is the oldest type of epilepsy surgery.
Multiple subpial transection: During this procedure, a surgeon will make several cuts to limit seizures to one part of the brain.
Corpus callosotomy: A surgeon will cut the neural connections between the two halves of the brain. This prevents seizures from spreading from one side of the brain to the other.
Hemispherectomy: In extreme cases, a surgeon may need to cut out a hemisphere, which is one half of the cerebral cortex of the brain.

For some people, undergoing surgery may reduce the frequency and severity of their seizures. However, it is often important to continue taking antiseizure medication for several years following the procedure.

Another surgical option is the implantation of a device in the chest to stimulate the vagus nerve in the lower neck. The device sends preprogrammed electrical stimulation to the brain to help reduce seizures.

Diet

Diet may play a role in reducing seizures. A 2014 review of research that appeared in the journal Neurology suggested that high fat, low carbohydrate diets could benefit children and adults with epilepsy.

Five of the studies in the review used the ketogenic diet, while another five used a modified Atkins diet. Typical foods in these diets include eggs, bacon, avocados, cheese, nuts, fish, and certain fruits and vegetables.

The review found that 32% of study participants adhering to the ketogenic diet and 29% of those following the modified Atkins diet experienced at least a 50% drop in the regularity of seizures. However, many participants had difficulty maintaining these diets.

Specific diets may be beneficial in some cases, but more research is needed to confirm this.

Diagnosis

A doctor will review an individual’s medical history and the symptoms they have experienced, including a description and timeline of past seizures, to diagnose epilepsy.

They may also request tests to determine the type of epilepsy and the type of seizures the person has. Based on these results, the doctor will be able to recommend treatment options, such as antiseizure medications.

Testing for epilepsy

An EEG can help doctors test for epilepsy.

Several types of imaging test can help a doctor diagnose epilepsy. These tests include:

an EEG, to look for abnormal brain waves
CT and MRI scans, to detect tumors or other structural irregularities
functional MRI scans, which can identify normal and abnormal brain function in specific areas
single-photon emission CT scans, which may be able to find the original site of a seizure in the brain
a magnetoencephalogram, which can identify irregularities in brain function using magnetic signals

The doctor may also use blood tests to identify any underlying conditions that could be causing the epilepsy. Neurological tests may also help a doctor determine the type of epilepsy the person has.

Seizures can lead to drowning, falling, vehicle accidents, or other injuries that could be fatal. Although it is rare, SUDEP can also occur.

Cases of SUDEP typically occur during a seizure or immediately after it. For example, the seizure may cause the person to go too long without breathing, or it could result in heart failure.

The exact cause of SUDEP is unclear,

According to the CDC, people are at more risk of SUDEP if they have had epilepsy for many years, or if they have regular seizures. Following these steps can help reduce the risk of SUDEP:

taking all doses of antiseizure medication
limiting alcohol intake
getting sufficient sleep

Regularly taking prescribed medication may also help prevent status epilepticus, a condition wherein seizures last for longer than 5 minutes.

A 2016 study found that treating status epilepticus within 30 minutes reduced the risk of death.

Is it curable?

There is currently no cure for epilepsy, but people with the condition can usually manage their symptoms.

According to the WHO, up to 70% of people with epilepsy can experience a reduction in their seizure frequency and severity with antiseizure medications. Around half of all people with epilepsy may be able to stop taking medications after 2 years without a seizure.

In some cases, surgery can also reduce or eliminate seizures when drugs are ineffective.

This can have long-term benefits. In one 2018 study, 47% of the participants reported no debilitating seizures 5 years after surgery, and 38% reported the same after 10 years.

Prevention

The WHO explain that around 25% of epilepsy cases are preventable. People can reduce the risk of developing epilepsy by following these steps:

wearing a helmet when riding a bicycle or motorcycle, to help prevent head injuries

seeking perinatal care, to prevent epilepsy from birth injuries

managing risk factors for stroke and heart disease, which could cause brain damage that results in epilepsy

practicing good hygiene and preventative methods to avoid cysticercosis, an infection that is the most common cause of epilepsy around the world, according to the CDC.

A 2015 review of research in the journal Seizure also suggested that regular physical activity may help prevent the development of epilepsy and reduce how often seizures occur.

It is not possible to prevent all cases of epilepsy. However, taking the above steps may help reduce the risk.

Complications

Depending on the situation, seizures may lead to negative outcomes such as drowning or vehicle accidents. Long lasting seizures, or status epilepticus, may also cause brain damage or death.

People with epilepsy are eight times more likely than people without it to experience certain other chronic conditions, including dementia, migraine, heart disease, and depression. Some of these conditions could also make seizures worse.

To Get More Information about#Seizure,#Epilepsy Email us at query@gtsmeditour.com or you can Directly call on Ph:080 25470833 . Share reports & get second opinion with us.

Meningitis

admin — Fri, 08 Feb 2019 03:07:35 +0000

Meningitis is deadly that it can kill in a matter of hours.Though some cases of meningitis improve without treatment,others can be life-threatening and require emergency treatment.
Meningitis occur when the fluid surrounding the meningis become infected causing inflamamtion of meningis. Meningis are three delicate protective membranes of brain and spinal cord.

Causes

Meningitis is caused by bacterial,viral or fungal infection,viral infected ideas being the most common.It can also be caused by other factors such as cancer,drug irritations.Like any other infection,meningitis can be contagious too which can be transmitted through touch,sneezing etc.

Bacterial meningitis
Though it is rare,it can be fatal if not treated right away.Bacterial meningitis can cause stroke, hearing loss, and permanent brain damage.The disease can occur when certain bacteria invade the meninges directly or when the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infectionor nasal sinus infection (sinusitis).Several bacteria can first cause an upper respiratory tract infection and then travel to brain via bloodstream.

Pneumococcal meningitis is the most serious form of bacterial meningitis,caused by the bacterium Streptococcus pneumoniae.It also causes pneumonia, blood poisoning (septicemia), and ear and sinus infections.
Meningococcal meningitis is caused by the bacterium Neisseria meningitides. If diagnosed, people in close contact should be given preventative antibiotics.
Haemophilus influenzae meningitis.

Viral meningitis
Also called aseptic meningitis ,it is usually caused by common viruses that enter the body through the mouth and travel to the brain and surrounding tissues.Many of the enteroviruses viruses that cause meningitis are common, such as those that cause colds, diarrhea and the flu.Other viruses that cause meningitis include varicella zoster (chicken pox virus),, mumps, HIV, and herpes simplex type 2 (genital herpes).

Fungal meningitis
The most common of this is caused by the fungus cryptococcus neoformans(found mainly in dirt and bird droppings). Fungal infectionns can affect brain.Although treatable, fungal meningitis often recurs in 50 % of the affected persons.
Meningitis can affect anyone .Children,people with weakened immune systems( including persons with HIV or taking immunosuppressant drugs) are at increased risk.

Symptoms

Significant signs of meningitis are

sudden fever
severe headache
nausea or vomiting
double vision, drowsiness
sensitivity to bright light
stiff neck.

In infants ,fever, lethargy, not waking for feedings, vomiting, body stiffness, unexplained irritability, and bulging fontanel (the soft spot on the top of the head) are important signs of meningitis and should be watched for.
Distinctive rashes called meningitis rash are seen in some forms of the disease.This is one late sign of bacterial meningitis.These are faint rashes and may not be easily visible in dark skinned people.Rash will become more obvious as infection worsen and spots grow darker. Meningococcal meningitis damages capillary cells leading to capillary damage and mild blood leaks.
Meningitis can also cause septicaemia.It is the blood poisoning caused by the same germs that cause meningitis.It is the more life threatening form of the disease. Septicaemia can occur with or without meningitis.

Diagnosis

Early diagnosis is vital, as symptoms can appear suddenly and escalate to brain damage, hearing and/or speech loss, blindness, or even death.
Diagnostic tests include:

series of physical examination tests designed to assess motor and sensory function, nerve function, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior.
screening of blood, urine, and body secretions can help detect and identify brain and/or spinal cord infection.
Cerebrospinal fluid is tapped to detect the presence of bacteria, blood, and viruses. Analysis of the fluid can also reveal infections in the brain and/or spinal cord, acute and chronic inflammation, and other diseases.

Brain imaging is used to detect signs of brain inflammation, internal bleeding or hemorrhage.Following are noninvasive painless imaging procedures routinely used

Computed tomography, also known as a CT scan to produce rapid, clear, two-dimensional images of organs, bones, and tissues.
Magnetic resonance imaging (MRI) can help identify brain and spinal cord inflammation, infection, tumors, and other conditions.

Furthermore, electroencephalography(EEG) can identify abnormal brain and diagnose patterns that may suggest specific viral infections such as herpes virus and to detect seizures.

Treatment

Early treatment of bacterial meningitis involves antibiotics that can cross the blood-brain barrier . Appropriate and immediate antibiotic treatment for most types of meningitis can greatly reduce the risk casualties. Anticonvulsants to prevent seizures and corticosteroids to reduce brain inflammation may be prescribed.Infected sinuses may need to be drained. Corticosteroids such as prednisone are usually prescribed to relieve brain pressure, swelling and to prevent hearing loss that is common in Haemophilus influenza meningitis.Viral meningitis can ease without treatment over a few weeks.Fungal meningitis is treated with intravenous antifungal medications.

Vaccination

Vaccinations offer protection against certain causes of meningitis.These include the:

meningitis B vaccine – offered to babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at 1 year
6-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age
pneumococcal vaccine – offered to babies at 8 weeks, 16 weeks and 1 year old
Hib/MenC vaccine – offered to babies at 1 year of age
MMR vaccine – offered to babies at 1 year and a second dose at 3 years and 4 months
meningitis ACWY vaccine – offered to teenagers, sixth formers and “fresher” students

Outcome generally depends on the the severity of the illness and how quickly treatment is given. In most cases, meningitis can make a full recovery although the process may be slow. Individuals may need long-term therapy, medication, and supportive care in more serious cases where disease has caused permanent damages like brain and nerve damage,blindness,memory loss,seizures,lack of muscle control etc