Seizure Disorders.

Presented By: Maha AlKhalifah – Majd Alsarhani

Reem AlSaif.Dr Kareman Diab.

Seizures result from Uncontrolled, Excessive discharge of neurons in the brain.

* Seizure disorders are characterized by Recurrent Seizures.

* Epilepsy is the old term for recurrent seizures.

Classification of seizures.

Generalized seizures.

Partial Seizures.

Generalized

Seizure.

• Have multiple foci or origins in the deep structures of both hemispheres and the brain stem.

• Cause loss of consciousness.

Partial Seizure.

• Have a single or focal origin, often in the cerebral cortex.

• may or may not involve altered consciousness.

• Partial seizure may progress to generalized seizure.

Seizures may be primary (idiopathic) or secondary (acquired).

Pathophysiology

of Seizures.

Sudden, spontaneous, uncontrolled depolarization of neurons, leading to abnormal motor\ sensory activity that may result in loss of consciousness. The neurons are :

• Hyper excitable.

• “Irritable” to flashing lights.

Complication may arise from Generalized Tonic-Clonic seizures.

An individual with recurrent, continues seizures

without recovery has Status Epilepticus.

Signs and symptoms.

Signs and symptoms: Generalized seizures. Absence ( petit

mal )seizures.• More common in children than adults.

• The seizures lasts for 5 to 10 seconds and may occur many times during the day.

• Loss of awareness, transient facial movement. ( twitches of the eyelids or lip smacking)

No memory of the episode is retained,Child stares into space for a moment then resume activity.

Signs and symptoms: Tonic-Clonic (grand mal) seizures.

• May occur spontaneously or after simple seizure.

• There is a pattern for this type of seizure, which usually ends spontaneously:

Prodromal signs. Nausea,

irritability, depression or

muscle twitching.

An aura.Peculiar vision,

auditory sensation, loss

of consciousness.

Strong tonic muscle contraction

Clonic stage. Muscle alternately contracts and relax.

Signs and symptoms: Partial seizure simple partial or focal seizures.

Repeated motor activity.Jerking and turning head or eye aside

Auditory or visual experiences.

Ringing in the ears, sensation of light.

Memory and consciousness remain.

(awareness is reduced)

Etiologyof Seizures.

o Idiopathic.o Children with congenital

disorders. (Cerebral Palsy)

Etiology.

Initiated by:

Tumors.

Hemorrhage.Infection.

High fever in Infants\ young children.

No history of previous seizures:

Systemic disorders:

• Renal Failure.• Hypoglycemia

. Sudden Withdrawal From:

• Alcohol.• Sedative Drugs.• Cocaine.

What Could Be Triggering to Seizures?

Physical Stimuli:

• Loud Noises.• Flashing Lights.• Bright Colors.

Biochemical Stimuli:• Stress.• Excessive

Premenestural Fluid Retention.

• Hypoglycemia.• Medication Change.• Hyperventalation.

(Alkalosis)

Diagnosis and Treatment.

Diagnostic test:

• A detailed medical history and

description of the seizure is required. • EEG(electroencephalogra

m) will determine the type and the location of the seizure.

• MRI (magnetic resonance imaging) can detect any structural abnormality in the brain.

Treatment:Any primary cause should be treated

and the specific factors that precipitate seizures should be

Identified and avoided.

• Anticonvulsants drugs such as: phenytoin (Dilantin)

are prescribed to raise the threshold for neural stimulation and prevent seizures.

(A choice of anticonvulsants drugs is available to treat different types of seizures for optimum control in an

individual patient)

• In many cases anticonvulsants drugs are combined with sedatives such as phenobarbital to allow a reduction in the dosage and side effect of the drugs. While simultaneously decreasing the occurrence of seizures.

“ sudden withdrawal can cause severe seizures or status epilepticus with its risk to brain damage.”

• Single episode require no medical treatment unless the individual continues to be disoriented.

• Prolonged or recurrent seizures are life threatening and require hospital treatment with medications such as IV diazepam, oxygen and fluid.

Side Effects:Phenobarbital increases liver enzymes activity and

therefore affect the dosage of other medications.

Phenytoincause gingival hyperplasia which can cause difficulty in maintaining

good oral hygiene and create cosmetic problem for the patient.

Many anticonvulsant reduce leukocyte

count thus predisposing the

patient to infection.

Pregnant women who have increase

number of seizures have an

increased incidence of congenital

abnormalities in children.

Several drugs reduce the blood

clotting capability.

Thank You