epilepsy

epilepsy,

a chronic disorder of cerebral function characterized by periodic convulsive seizures. There are many conditions that have epileptic seizures. Sudden discharge of excess electrical activity, which can be either generalized (involving many areas of cells in the brain) or focal, also known as partial (involving one area of cells in the brain), initiates the epileptic seizure. Generalized seizures are classified as tonic-clonic (grand mal), in which there is loss of consciousness and involuntary contraction of all the muscles of the body, lasting a few minutes; or absence (petit mal), in which there is clouding of the consciousness for about 1 to 30 sec and no falling, with as many as 100 attacks occurring daily. Partial seizures include Jacksonian epilepsy, characterized by jerking in the hand and face on the side opposite the brain activity; and psychomotor seizures, in which there may be localized convulsion with no loss of consciousness, as well as incoherent speech and various involuntary movements of the body. Often these are accompanied by a warning cluster of signs and symptoms called an aura. First aid, such as cushioning the head, is used to prevent the person from self-inflicted injuries during seizures.

The cause is unknown in over half the cases of epilepsy, especially in those with onset under age 20. Predisposing factors in other cases include familial history, head injury, alcohol withdrawal, infections (such as meningitis or by pork tapeworm larvae), and abnormalities (such as tumors) of the brain.

The recording of brain waves by electroencephalographyelectroencephalography
, science of recording and analyzing the electrical activity of the brain. Electrodes, placed on or just under the scalp, are linked to an electroencephalograph, which is an amplifier connected to a mechanism that converts electrical impulses into the
..... Click the link for more information. is an important diagnostic test for epilepsy. Other diagnostic technologies include CAT scanCAT scan
[computerized axial tomography], X-ray technique that allows relatively safe, painless, and rapid diagnosis in previously inaccessible areas of the body; also called CT scan.
..... Click the link for more information. and magnetic resonancemagnetic resonance,
in physics and chemistry, phenomenon produced by simultaneously applying a steady magnetic field and electromagnetic radiation (usually radio waves) to a sample of atoms and then adjusting the frequency of the radiation and the strength of the magnetic field
..... Click the link for more information. imaging (MRI). Standard treatment of epilepsy is with antiseizure drugs (also known as anti-epileptic and anticonvulsive drugs), including carbamazepine, phenytoin, valproic acid, and others; proper treatment requires a careful analysis of seizure motor activity, anatomical cause, precipitating factors, age of onset of the disorder, severity, daily rhythms, and prognosis. Roughly 70% of persons with epilepsy are successfully treated with drugs, and many people with the disease lead normal lives. Repeated seizures that lead to unconsciousness, however, appear to be associated with damage to the hippocampus in the brain and sudden unexpected death.

Some cases of childhood epilepsy (which is often eventually outgrown) have been successfully treated with surgery or a very high-fat "ketogenic" diet. The diet results in a natural buildup of ketones in the body, which appear to inhibit the seizures. A number of different surgical procedures may be used if medication does not control the seizures; the procedures vary according to the focus of the seizure in the brain, and surgery is not always appropriate. If a patient with uncontrolled seizures is not a good surgical candidate, a vagus nerve stimulator or a responsive neurostimulator may be implanted in some cases. The former is implanted in the chest and connected by a wire to the vagus nerve (a cranial nerve) in the neck; like a pacemaker, the device regularly stimulates the nerve to counteract seizures. It also may be activated by the patient in response to a seizure. The responsive neurostimulator is implanted in the skull, and wires connect it to brain regions that are the focus of seizures. In reaction to developing seizure, it electrically stimulates those regions in an effort to stop the seizure. Patients with such devices take antiseizure medications as well, and these devices typically reduce but do not eliminate seizures.

Bibliography

See H. Reisner, ed. Children with Epilepsy (1988); R. J. Gunnit, Living Well with Epilepsy (1990); O. Devinsky, A Guide to Understanding and Living with Epilepsy (1994); publications of the Epilepsy Foundation of America.

Epilepsy

or falling sickness, a chronic brain disease in man that varies in its etiology and is chiefly characterized by recurrent seizures and gradual personality changes. Epilepsy is one of the most common nervous or mental diseases, affecting approximately 0.5–1 percent of the population. It generally occurs between the ages of 10 and 15 years.

The various forms of epilepsy were traditionally divided into two groups. Cases of unknown origin, or cause, were classified as “true” epilepsy (also called idiopathic or essential epilepsy). The term “symptomatic epilepsy” was used to designate epileptic manifestations that were either residual symptoms of organic brain damage (for example, as a result of injury) or symptoms of a particular disease (such as a tumor or cysticercosis of the brain). Because of the many different causes of epilepsy, some investigators consider it preferable to subdivide all epileptic seizures into epileptic reactions (solitary attacks provoked by an extreme stimulus, such as intoxication), epileptic syndromes (epileptic seizures accompanying various diseases—for example, brain tumor), and epilepsy proper (an independent disease).

According to most investigators, the principal causes of epilepsy are the fetus’ pathological intrauterine development, pathological delivery, brain injuries, previous inflammations of the meninges and brain tissues (meningitis, arachnoiditis, and arach-noencephalitis), and acute and chronic intoxication. Hereditary predisposition plays an important role in epilepsy, as shown by clinical, genetic, and experimental data on the pathogenesis of epileptic seizures.

In certain genetic strains of animals (mice, rats, rabbits, and monkeys), seizures may occur spontaneously or may be evoked by a stimulus—for example, by a flashing light or a noise. These animals are thus distinguished by their greater “convulsion readiness.” The phenomenon is apparently based on a genetic metabolic defect in the nervous system.

The point at which convulsive “discharges” begin is called the epileptic focus. It may be situated either in the cerebral cortex or in the underlying sections of the brain. A seizure is initiated by the appearance of impulse discharges among the neurons of the epileptic focus and by their simultaneous avalanche-like spread to other parts of the brain. But the epileptic focus, which may be found by means of electroencephalography, need not manifest itself through convulsions. Consequently, the possibility of convulsive discharges spreading from the focus depends both on the intensity of excitation in the focus itself and on the functional condition of the regions of the brain to which they spread. It is common knowledge that an epileptic attack can be induced, intensified, or suppressed through the mechanism of the conditioned reflex.

Epileptic seizures differ in character. The most obvious manifestations are those associated with grand mal epilepsy. The attack begins suddenly or (less commonly) is preceded by an aura—that is, by peculiar and short-lived feelings and sensations, including visual, auditory, and emotional ones. The aura is followed by loss of consciousness and tonic convulsions (during which the subject suddenly falls to the ground), and these give way to clonic convulsions. The average duration of an attack is between two and three minutes. The subject remembers only the aura.

An epileptic attack may also be manifested as a sudden momentary loss of consciousness without convulsions and without the subject falling down (absentia epileptica) or in conjunction with myoclonus (a variant of the type of epilepsy known as petit mal) or other paroxysms (for example, autonomic paroxysms). In some cases the convulsions involve only certain muscle groups (as in jacksonian epilepsy, named after J. Jackson). Other types of attacks, known as epileptic equivalents, take such forms as sudden changes in mood (dysphoria), twilight states, somnambulism, and trances. Sometimes epilepsy is accompanied by epileptic psychoses, which may be acute or chronic and may be manifested as affective disturbances (fear, melancholy, anger, or exaltation) or as delirium or hallucinations.

The frequency of epileptic attacks varies, from a few over the course of the subject’s lifetime to daily attacks, which may recur several times a day. Sometimes a condition develops, known as status epilepticus, in which the attacks recur at short intervals. The most severe forms of status epilepticus, which are accompanied by convulsions, result in functional impairment of the respiratory, cardiovascular, and other systems. The patient is unconscious during such attacks. Alcohol consumption and irregular use of antiepileptic drugs as well as infections and various other diseases contribute to the development of this form of epilepsy.

In addition to seizures, another feature often found in epilepsy is a gradual personality change, which takes the form of mental retardation, egocentrism, abrupt changes in mood (from honeyed affability to anger and aggressiveness) and sluggishness of mind (with a tendency toward getting bogged down in details), combined with the inability to distinguish between the important and the unimportant, a meager vocabulary (oligologia, or oligophasia), loss of memory, and intellectual decline to the point of feeblemindedness.

Treatment of epilepsy depends on the form of the disease, its causes, and the nature of its course. In the case of sporadic attacks (epileptic reactions), specific therapy is used only while the causative factor is active. Epileptic syndromes require treatment of the basic disease that has brought on the attacks. Treatment of idiopathic epilepsy with antiepileptic agents is strictly individualized and of long duration. In addition to anticonvulsants, other types of preparations may be prescribed—for example, preparations that promote tissue dehydration or that have a generally restorative effect. Surgery is sometimes performed when a distinct epileptic focus is present and medication is ineffectual. In the case of status epilepticus, the patient is placed in a hospital department of resuscitation and anesthesiology. Favorable social and family circumstances are an important factor in the rehabilitation process.

REFERENCES

Davidenkov, S. N. “Epilepsiia.” In Mnogotomnoe rukovodslvo po nevrologii, vol. 6. Moscow, 1960.
Boldyrev, A. I. Epilepsiia u vzroslykh. Moscow, 1971.
Karlov, V. A. Epilepticheskii status. Moscow, 1974.
Saradzhishvili, P. M., and T. Sh. Geladze. Epilepsiia. Moscow, 1977.
Lennox, W. I. Epilepsy and Related Disorders, vols. 1–2. Boston, 1960.
Janz, D. Die Epilepsien. Stuttgart, 1969.

A. I. BOLDYREV, V. A. KARLOV, and S. A. DOLINA

epilepsy

[′ep·ə‚lep·sē] (medicine) A condition characterized by the paroxysmal recurrence of transient, uncontrollable episodes of abnormal neurological or mental function, or both.

Epilepsy

Myshkin, Princesuffered fits from early youth, affecting his physical and mental health. [Russ. Lit.: Dostoevsky The Idiot]Vitus, St.his chapel at Ulm famed for epileptic cures. [Christian Hagiog.: Brewster, 291]

epilepsy

a disorder of the central nervous system characterized by periodic loss of consciousness with or without convulsions. In some cases it is due to brain damage but in others the cause is unknown
www.apa.org/science/efa.html

epilepsy

[ep´ĭ-lep″se] paroxysmal transient disturbances of nervous system function resulting from abnormal electrical activity of the brain. Epilepsy is not one specific disease, but rather a group of symptoms that are manifestations of any of a number of conditions involving overstimulation of nerve cells of the brain. The estimated incidence is 0.5 per cent of the population, making this a relatively common disease. Over 70 per cent of patients have their first attack (or seizure) either during childhood or after age 50. The type of seizure varies with age of onset. Types. There are several methods for classifying types of epilepsy. On the basis of origin, it may be either idiopathic (cryptogenic, essential, genetic) or symptomatic (acquired, organic). Symptomatic epilepsy has a physical cause, such as a brain tumor, injury to the brain at birth, a wound or blow to the head, or an endocrine disorder.
One classification of epileptic seizures, called the Clinical and Electroencephalographical Classification of Epileptics of the International League Against Epilepsy, identifies four main types: (1) partial seizures, including those that begin locally, which are subdivided into (A) partial seizures with elementary symptomatology, (B) partial seizures with complex symptomatology (those with impairment of consciousness only, psychomotor symptomatology, and psychosensory symptomatology), and (C) partial seizures that are secondarily generalized; (2) generalized seizures that are bilaterally symmetrical and without local onset; (3) unilateral seizures (those involving only one hemisphere); and (4) other unclassified epileptic seizures.Types According to Symptoms. The manifestations of epilepsy depend on the area of the brain where the abnormal discharge occurs. Simple partial seizures, called also focal seizures, result from a localized cortical discharge. The symptoms may be either motor, sensory, autonomic, or any combination of the three. Complex partial seizures, as in psychomotor (temporal lobe) epilepsy, usually, but not always, originate in the temporal lobe of the brain, often with a preceding aura. As the name implies, there are many different cognitive, affective, and psychomotor symptoms. There is either loss or alteration of consciousness when the seizure begins, and afterwards the patient may feel drowsy or confused.
An attack of petit mal (absence) epilepsy lasts only a few seconds and has sudden onset with no aura or warning and no postictal symptoms. Seizures of this type usually affect children between the ages of 5 and 12 years and may disappear during puberty, but they can continue throughout life. There typically is a twitching about the eyes or mouth, the patient remains sitting or standing, and appears to have had no more than a lapse of attention or a moment of absent-mindedness.
An attack of grand mal (tonic-clonic) epilepsy usually begins with bilateral jerks of the extremities or focal seizure activity. There is loss of consciousness and both tonic and clonic type convulsions. The patient may be incontinent during the attack and there is danger of tongue biting. In the postictal phase the patient is confused and drowsy.
Atonic or akinetic seizures are characterized by loss of body tone that can produce nodding of the head, weakness of the knees, or total collapse and falling. The patient usually remains conscious during the attack.Diagnosis. A complete assessment of the patient's status is necessary, including a medical history, physical and neurological examination, and laboratory studies of the blood and spinal fluid. The latter are especially useful in determining whether an infection is the cause of the seizures. A CT scan may demonstrate a causative lesion. The diagnosis is confirmed by an electroencephalogram, which is helpful in locating the site and possibly the cause of the seizures. Treatment. Medical management with anticonvulsant drugs is the preferred therapy for about 95 per cent of patients with epilepsy. Surgical intervention for the remaining 5 per cent involves removal of the portion of brain tissue believed to be responsible for the seizures. Because of the dangers inherent in the surgery, this mode of therapy is reserved for those patients who do not respond to medical management and in whom the focus of seizure activity is accessible.
The major antiepileptic drugs are phenytoin (Dilantin), which is usually the drug of choice, phenobarbital, primidone (Mysoline), carbamazepine (Tegretol) for complex partial tonic-clonic seizures, and ethosuximide (Zarontin) and clonazepam (Klonopin) for absence seizures. Valproic acid (Depakene) is also used in the treatment of absence seizures. The choice of drug and calculation of optimal dosage is very difficult and highly individualized.
All of the anticonvulsant drugs can produce unpleasant side effects. They include gingival hyperplasia, rash, and, in the case of Dilantin, fever and leukopenia. Physical dependence can become a problem in patients taking phenobarbital or primidone, which is largely converted to phenobarbital in the blood stream. Toxic side effects are also common and include drowsiness, ataxia, nausea, sedation, and dizziness. The untoward effects of anticonvulsant drug therapy require close monitoring of the patient's response to therapy and regulation of dosage as indicated. Patient Care. Emergency care of the patient having a seizure includes clearing the immediate area to protect the patient and others, administering 100 per cent oxygen by face mask, and intravenous administration of antiepileptic medication. No one should force an object into the patient's mouth to hold it open (such as a comb, bite block, or wallet), as such objects might obstruct the airway. Do not attempt to restrain the patient, as that may cause harm to both the rescuer and the patient.
Until a diagnosis of epilepsy is confirmed, observations made before, during, and after each of the seizures can provide important information to the diagnostician. Such data also can help prepare an effective plan of care for managing the seizures once a definitive diagnosis is made.
Just before a seizure (the preictal stage) the patient may experience an abnormal somatic, visceral, or psychic sensation called an aura. The presence or absence of the aura and its nature (if it is present) should be noted and recorded. If a patient does experience a particular kind of aura just before each seizure, this information can be useful when planning care for prevention of injury. It also is helpful to note what the patient was doing just before the seizure began. If a particular emotional event or environmental or physiologic condition is found to trigger the seizures, the patient might be able to use this information to avoid or minimize the recurrence of seizures.
During the interictal stage (while the seizure is occurring) significant data include the time the seizure begins and its duration; where in the body the seizure begins and what parts of the body are involved; whether the head or eyes turn to one side and, if so, to which side; whether there is incontinence of urine or stool, bleeding, or foaming or frothing at the mouth; effects of the seizure on the vital signs; and changes in skin color or profuse perspiration.
During the postictal period the patient is assessed for lethargy, confusion, impaired speech, and reports of headache or muscle soreness.
The successful long-term management of epilepsy requires coordinated effort on the part of the patient, family, and health care professionals. Patient and family education and support are essential components of any plan of care. Epileptic patients must take their prescribed medications on their own and actively participate in the management of their illness. They and those upon whom they are dependent (as in the case of children) must know the nature of the illness, the purpose and expected effects of treatment, the side effects of the drug they are taking and its potential for interaction with other drugs that could inhibit or enhance its anticonvulsant action, and the signs and symptoms of drug intolerance that should be reported to the physician or nurse.
Education should also include information about possible seizure triggers and ways in which they might be avoided. Alcohol is especially dangerous for epileptic persons because most antiepileptic drugs are sedatives and cardiopulmonary depressants. The combination of drug and alcohol could cause loss of consciousness or even death. Moreover, alcohol acts as a seizure trigger in some persons.
It is important that patients with epilepsy wear some form of medical identification. In spite of efforts to educate the general public about the nature of epilepsy and its effects on those who have it, there remains some social stigma attached to epilepsy. Therefore, many patients do not want their friends, classmates, or employers to know they have the disease. Efforts must be made to improve the self-esteem of these people. Local chapters of the Epilepsy Association of America offer programs and opportunities for social interaction and group support to help persons with epilepsy and their families deal with the psychosocial effects of the disease. Information and guidance to a local chapter can be obtained by contacting the Epilepsy Association of America, 111 W. 55th St., New York, NY 10019.
The Epilepsy Foundation of America, 4351 Garden City Dr., Suite 406, Landover, MD 20785, supplies information on all aspects of epilepsy and can refer patients and their families to specialists and clinics in their locality.
One of the major challenges to persons working in the health field and concerned with the care of patients with epilepsy is the dispelling of myths and superstitions about the disease and the propagation of accurate information. Most persons with epilepsy can lead normal lives with few restrictions, but many are subjected to unfair employment practices and social stigma because of prejudices resulting from the general public's ignorance of the effects of epilepsy.absence epilepsy petit mal epilepsy.audiogenic epilepsy reflex epilepsy brought on by sound.grand mal epilepsy a form attended by loss of consciousness and convulsive movements, as distinguished from petit mal epilepsy. See epilepsy.jacksonian epilepsy a form of epilepsy characterized by unilateral clonic movements that start in one group of muscles and spread systematically to adjacent groups, reflecting the march of the epileptic activity through the motor cortex. myoclonus epilepsy any form of epilepsy accompanied by myoclonus; one type is Lafora's disease.petit mal epilepsy a relatively mild type of epilepsy in which the person loses consciousness only momentarily, in contrast to grand mal epilepsy; called also absence epilepsy. See epilepsy.photogenic epilepsy reflex epilepsy brought on by flickering light.psychomotor epilepsy temporal lobe epilepsy.reflex epilepsy epileptic seizures occurring in response to sensory stimuli (tactile, visual, auditory, or musical).temporal lobe epilepsy a type manifested by impaired consciousness of variable degree, with the patient carrying out bizarre but coordinated movements; called also psychomotor epilepsy. See epilepsy.

ep·i·lep·sy

(ep'i-lep'sē), A chronic disorder characterized by paroxysmal brain dysfunction due to excessive neuronal discharge, and usually associated with some alteration of consciousness. The clinical manifestations of the attack may vary from complex abnormalities of behavior including generalized or focal convulsions to momentary spells of impaired consciousness. These clinical states have been subjected to a variety of classifications, none has been universally accepted to date and, accordingly, the terminologies used to describe the different types of attacks remain purely descriptive and nonstandardized; they are variously based on: the clinical manifestations of the seizure (motor, sensory, reflex, psychic or vegetative); the pathologic substrate (hereditary, inflammatory, degenerative, neoplastic, traumatic, or cryptogenic); the location of the epileptogenic lesion (rolandic, temporal, diencephalic regions); and the time of day at which the attacks occur (nocturnal, diurnal, menstrual). Synonym(s): convulsive state, epilepsia, falling sickness [G. epilēpsia, seizure]

epilepsy

(ĕp′ə-lĕp′sē)n. pl. epilep·sies Any of various neurological disorders marked by sudden recurring attacks of motor, sensory, or cognitive dysfunction, with or without convulsive seizures or loss of consciousness. Also called seizure disorder.

epilepsy

Neurology Any syndrome characterized by paroxysmal, usually transient, defects in cerebral function which are manifest as episodic impairment of neurologic activity, loss of consciousness, abnormal motor activity, sensory defects and alterations in the autonomic nervous system Imaging MRI, PET, SPECT. See Absence, Automatic epilepsy, Focal epilepsy, Gelastic epilepsy, Juvenile myoclonic epilepsy, Progressive myoclonus epilepsy, Seizure disorder.

ep·i·lep·sy

(ep'i-lep'sē) A chronic disorder characterized by paroxysmal brain dysfunction due to excessive neuronal discharge, and usually associated with some alteration of consciousness. The clinical manifestations of the attack may vary from complex abnormalities of behavior including generalized or focal convulsions to momentary spells of impaired consciousness. These clinical states have been subjected to a variety of classifications, none universally accepted to date and, accordingly, the terminologies used to describe the different types of attacks remain purely descriptive and nonstandardized; they are variously based on the clinical manifestations of the seizure (motor, sensory, reflex, psychic, or vegetative); the pathologic substrate (hereditary, inflammatory, degenerative, neoplastic, traumatic, or cryptogenic); the location of the epileptogenic lesion (rolandic, temporal, diencephalic regions); and the time period during which the attacks occur (nocturnal, diurnal, menstrual).
Synonym(s): seizure disorder. [G. epilēpsia, seizure]

epilepsy

A physical indication of an abnormal electrical discharge in the brain. Epilepsy takes various forms. These include generalized epilepsy, or ‘grand mal’ which is a major fit affecting all the muscles of the body with a massive contraction (tonic stage) followed by a succession of jerky contractions (clonic stage); partial seizures, which may affect only a few muscles (simple partial seizures) or may also involve almost any of the functions of the brain and cause elaborate hallucinations (complex partial seizures); and absence attack, or ‘petit mal’ in which the affected person, usually a child, is momentarily inaccessible but does not fall or appear to lose consciousness.

epilepsy

a nervous condition due to abnormalities in the brain cortex that results in seizures ranging from a sense of numbness in certain body areas (petit mal) to extreme muscular convulsions and fits (grand mal). Epileptics exhibit large, abnormal brain waves, which can be detected on an EEG.

Epilepsy

A neurological disorder characterized by recurrent seizures with or without a loss of consciousness.Mentioned in: Antianxiety Drugs, Anticonvulsant Drugs, Benzodiazepines, Biofeedback, Electroencephalography

ep·i·lep·sy

Patient discussion about epilepsy

Q. what are the chances for a one time epileptic seizure? I had an epileptic seizure a few years ago and after all the tests it appeared to be a one time seizure. I know having one indicates my tendency for this kind of seizures so should I be afraid now to do things that might bring it up again- like alcohol, drugs, being exposed to flashing lights or having lack of sleep? what are the chances of it to come back after 5 years? any help will be very appreciated....thanks!A. After 5 years with no recurrence of seizures after a one time episode, tha chances of having another one are low, almost exact to the general population. I would not advise you to start heavily drinking alcohol and doing drugs, because these things can certainly have an effect, however you need not be afraid.

Q. if some one gets a one time epileptic seizure- he have to take medication all his life? how do they decide if it's a one timer or it's going to continue from this day forth?A. I had a one time epileptic seizure 5 years ago (due to lack of sleep- probably) and didn't have to take any medication though I did have some tests made like EEG and CT every half a year for some time. Like everything else in life- you can't decide it's not a one time till you get the second- which I hope you wont of course...
:)

Q. will my son get over his epilepsy he has had seizers since he was 6 months old he is know 3 and a half

More discussions about epilepsy

epilepsy

ep·i·lep·sy

epilepsy

ep•i•lep•sy

ep·i·lep·sy

epilepsy

epilepsy

epilepsy

epilepsy

epilepsy,

Bibliography

Epilepsy

REFERENCES

epilepsy

Epilepsy

epilepsy

epilepsy

epilepsy

ep·i·lep·sy

epilepsy

epilepsy

ep·i·lep·sy

epilepsy

epilepsy

Epilepsy

ep·i·lep·sy

Patient discussion about epilepsy

Epilepsy

epilepsy

Words related to epilepsy

noun a disorder of the central nervous system characterized by loss of consciousness and convulsions

Related Words