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Epilepsy/Seizures
Published in Charles Theisler, Adjuvant Medical Care, 2023
Epilepsy, or seizure disorder, is characterized by recurring seizures and is the fourth most common neurological disorder. Common causes of epilepsy are idiopathic (65% of cases), vascular abnormalities (11%), congenital malformations (8%), and trauma (5%).1 A person is diagnosed with epilepsy if they have two unprovoked seizures not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar. There are two main types of seizures: (1) generalized seizures affect the whole brain and (2) partial or focal seizures that affect just one part of the brain. A generalized seizure that causes loss of awareness or control can be dangerous, leading to vehicular accidents, falls, drownings, etc.
A history of blackouts
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Epilepsy affects approximately 1 in 200 people. In over 60% of cases there are no identifiable causes. However the likelihood of an identifiable cause is higher in older patients. Particular attention should be paid to the management of acute generalised seizures and the investigation of the patient with a first fit.
Classification of Seizures and Epilepsy
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Generalized seizures are subdivided into several specific types. The classic generalized tonic-clonic (“grand mal”) seizure is characterized by tonic extension of the limbs followed by synchronous muscle jerking. In some patients, clonic jerks precede the tonic-clonic sequence, and in others, there may be only a tonic or a clonic phase. Postictally, the patient is lethargic, very confused, and prefers to sleep. Full recovery takes many minutes or even hours, and EEG recordings can demonstrate postictal effects for a day or more.
Role of cerebrospinal fluid tau protein levels as a biomarker of brain injury in pediatric status epilepticus
Published in International Journal of Neuroscience, 2023
Shivanjali Sood, Chandrika Azad, Jasbinder Kaur, Pankaj Kumar, Vishal Guglani, Seema Singla
This study is first of its kind in prospective assessment of children with SE and CSF t-tau levels. It was planned to evaluate if CSF t-tau helped as a diagnostic or prognostic tool in paediatric SE. Since t-tau is considered a good biomarker of neuronal damage we hypothesized that it would increase in refractory SE and status caused by inflammatory disorders like meningitis/encephalitis and, further since disability after SE is caused by neuronal damage, patient with poor outcome would have higher tau levels. The children with CSE (n = 50) and controls (n = 15) between the age of 6 months −12 years of age were enrolled. Mean (SD) duration of CSE was 64 (47) minutes. Seventy-eight percent patients had generalized seizures. Mean (SD) GCS at presentation was 12.54 (2.97) in cases and 14.67 (1.29) in controls (p = 0.009). Fourteen percent patients had refractory SE. Most common etiology of CSE was acute symptomatic (52%). Five cases and 1 control died. Poor outcome was seen in 30% cases. CSF t-tau was significantly elevated (p = 0.004) in controls compared to cases. There was no significant correlation seen between CSF t-tau and type, duration, etiology of SE and AED responsiveness. Further, no significant correlation was noted between CSF t-tau and poor GCS, outcome at discharge and critical care needs.
Management of epileptic disorders using nanotechnology-based strategies for nose-to-brain drug delivery
Published in Expert Opinion on Drug Delivery, 2021
Mihika Shringarpure, Sankalp Gharat, Munira Momin, Abdelwahab Omri
According to the International Classification of Epileptic Seizures, epileptic seizures can be classified into three major groups based on their onset- generalized onset, focal onset (may become secondarily generalized), and unclassified seizures [34]. Generalized seizures are a consequence of abnormal and rapid neuronal activity on both hemispheres of the brain simultaneously. The various kinds of generalized seizures include absence seizures, tonic seizures, clonic seizures, myoclonic seizures, atonic seizures, tonic-clonic seizures, and secondary generalized seizures. Focal seizures originate and affect a limited area of one hemisphere of the brain and occur in approximately 60% of cases. Focal seizures generally progress to secondary generalized tonic-clonic seizures. Partial seizures are split into two main categories, namely, simple partial seizures and complex partial seizures [28].
Interactions of antiepileptic drugs with drugs approved for the treatment of indications other than epilepsy
Published in Expert Review of Clinical Pharmacology, 2020
Kinga K. Borowicz-Reutt, Stanisław J. Czuczwar, Marta Rusek
Epilepsy, affecting around 65 million people worldwide, no doubt may be regarded as the most common and serious neurological disease, defined by the International League Against Epilepsy as a disorder of the brain which is capable of generating epileptic seizures. This particular feature may produce neurobiological, cognitive, psychological, and social consequences [1]. An epileptic seizure results from the transient, abnormal, synchronous, and excessive neuronal activity, which is manifested by a number of signs and/or symptoms [2]. Focal (formerly partial) seizures are generated within one side of the brain whilst generalized seizures begin in both hemispheres, cortical and subcortical structures being rapidly affected. Usually, the convulsive symptoms may be observed in a limited body region [3]. Consciousness is involved in the classification of focal seizure, which may be either Focal Aware Conscious Seizures (formerly simple partial seizures) or Focal Impaired Consciousness Seizures (formerly complex partial seizures) [4]. In contrast, generalized seizures engage bilaterally and rapidly cortical and subcortical brain regions resulting in the generation of generalized tonic-clonic convulsions associated with loss of consciousness and involving the entire body [3,5]. When generalized seizures arise in the thalamo-cortical loop, then they are classified as absences (non-convulsive seizures) [2,6].