Download Epileptic seizure PPT

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Download Epileptic seizure PPT
the result of temporary dysfunction of cortical neurons caused by a self-limited, abnormal synchronous electrical discharge of cortical neurons-usually these electrophysiologic disturbances could be detected by EEG
The clinical presentation depends on
-part of cerebral cortex which is involved in beginning
The function of this region where seizures originates
The subseqent pattern of electrical ictal discharges
Epileptic seizure is not an epilepsy (single attack-25% epilepsy)
Seizures could occur as result of acute medical or neurological illness
Prevalence-40 mln people worldwide

ETIOLOGY of epilepsy in all cases of newly diagnosis seizures
•Idiopathic or cryptogenic 65.5%
•Vascular 10.9%
•Congenital 8.0%
•Trauma 5.5%
•Neoplastic 4.1%
•Degenerative 3.5%
•Infection 2.5%

International League Against Epilepsy
Classification by clinical symptoms supplemented by EEG
1.Partial (focal seizures)
A.Simple partial seizures (conscioussness not impaired)
1.With motor signs (jacksonian, versive, postural)
2.With sensory symptoms (visual, somatosensory, auditory, olfactory, gustatory)
3.With psychic symptoms (dysphasia, dysmnesia, affective changes, hallucinations)
4.With autonomic symptoms (epigastric sensation, pallor, flushing, pupillary changes)
B. Complex partial seizures (conscioussness is impaired)
1.Simple partial onset followed by impaired conscioussness
2.With impairment of conscioussnessat the onset
3.With automatisms
C. Partial seizures secondary generalized

International League Against Epilepsy
II. Generalized seizures of nonfocal origin (convulsive or non-convulsive)
A.Absence seizures
1. with impaired conscioussnessonly
2. with one or more of the following: atonic components, tonic components, automatisms, autonomic components
B. Myoclonic seizures
C. Tonic-clonic seizures
D. Tonic seizures
E.Atonic seizures
III. Unclassified epileptic seizures

History and examination
-age of onset
-clear picture of seizure
-seizures precipitants (fotostimuli, sleep, alkohol)
-risk factors for seizures (febrile, family history, head injury, encephalitis or meningitis, stroke,
-response for previous treatment
-detailed description of aura

Photosensitive epilepsy g-m

History and examination
-nature of repetitive automatisms, presence of myoclonus,
-Nonspecific postictal findings of lethargy or confusion must be distinquished from focal neurologic signs as hemiparesis or aphasia
-neurologic examination (usually normal)

•Ictal discharges start in epileptogenic focus
•Could be generalized to complex partial or g-m
•No impairment of consiousness
•Simple motor seizure-jacskonian seizure”, adversive, dysphasic
•Unilateral sensory disturbance to complex emotional, psychoillusory, hallucinatory, dysmnesic phenomen
•especially common aura with epigastric rising sensation, fear, feeling of unreality, deja vu, jamais,olfactory hallucinations
Simple partial seizure

Simple motor seizure

Adversive seizure

•motor arrest or motionless staring, oroalimentary automatisms, or non-specific extremity automatisms.
•Oroalimentary automatisms, mainly lip smacking, chewing and swallowing movements are suggestive of temporal lobe involvement. Spitting and drinking automatisms suggest right temporal localization.
Complex partial seizure

Complex partial seizure