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Epilepsy (Seizure Disorder)
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In the News

Seizures more common during full moon
Folklore has long described changes in human behavior such as increased seizure activity, increased childbirth, and exacerbated psychiatric disturbances associated with the lunar phase of the month. Although previous studies investigating this potential association have yielded conflicting results, a recent study of 859 people with epilepsy did in fact show a significant relationship between increased seizure activity during full-moon days. In this study, 34.2 percent of seizures occurred on full-moon days versus 21.4 percent of seizures occurred on days in which there was a new moon. Neurology

About Epilepsy
About 2 million people (1 in 100) in the U.S. have had an unprovoked seizure or have been diagnosed with epilepsy. This disorder is a condition affecting the brain characterized by a susceptibility to recurrent seizures.  A seizure is caused by abnormal electrical discharges of neurons (clusters of nerve cells) in the brain.   A seizure may have a wide variety of manifestations from strange sensations, emotions, and behavior to muscle spasms, convulsions and loss of consciousness.
Causes About half of all seizures have no known cause.
  • head injury
  • birth trauma
  • eclampsia
  • brain tumor
  • stroke
  • genetic predisposition for seizures
  • medication toxicity
  • toxins (mercury, lead, or carbon monoxide)
  • alcohol or drug intoxication
  • alcohol or drug withdrawal
  • metabolic disorders such as low blood sugar or hypoparathyroidism
  • heat stroke
Symptoms and Classifications of Seizures

I. Generalized: occur from a generalized electrical abnormality within the brain and include several distinct types:

  • Absence (petit mal): there is a brief change in level of consciousness such as a short period of staring, fluttering eyelids, or twitching in the face. Typically it lasts just 1 to 10 seconds. This can recur as often as 100 times a day if not treated. In  This type usually occurs in childhood but can affect adults as well.
  • Myoclonic : Characterized by brief, involuntary, repetitive muscular jerks of the body or extremities, which may occur in a rhythmic fashion.
  • Tonic-clonic (grand mal):typically begins with a loud cry, (precipitated by air rushing from the lungs through the vocal cords); the person loses consciousness and falls down. The muscles of the body get very stiff (tonic phase). then alternate between episodes of muscular spasm and relaxation (clonic phase). In this type, all 4 extremities are involved.  The person may bite their tongue or lose urinary continence.  The breathing may be labored or the person may stop breathing altogether, during this time, with subsequent cyanosis. The seizure stops in 2 to 5 minutes.  Following the seizure, there may be a period of extreme drowsiness, confusion, difficulty talking and need to sleep. Upon reawakening, there may be no recollection of the seizure.

II. Partial seizures arise from a localized area of the brain causing specific symptoms and include:

  • Simple partial seizures: a localized motor seizure without alteration of awareness or consiousness.    It typically produces a stiffening or jerking in one extremity, accompanied by a tingling sensation in the same area.  For example, it may start in the thumb and spread to the hand and arm. 
  • Complex partial seizures: a localized motor seizure with alteration of awareness or consciousness.  The symptoms are variable but usually include purposeless behavior.  It may begin with an aura (the sensation felt just before a seizure, ie a certain smell, unusual taste, visual disturbance, gastrointestinal symptom, or an unusual dreamy feeling.) Symptoms of the complex partial seizure might be a glassy stare, picking at one's clothes, aimless wandering, lip-smacking or chewing motions, or unintelligible speech.  Mental confusion may last several minutes after the seizure. 

III. Unclassified seizures

  • Febrile seizures 88% of all febrile seizures occur in the 1st two years of life.
  • Status epilepticus Repetitive generalized seizures without return to consciousness between seizures.  The most life-threatening example is generalized tonic-clonic status epilepticus, a continuous generalized tonic-clonic seizure without intervening return of consciousness.
Diagnosis
Having a seizure does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. EEGs and brain scans are common diagnostic tests for epilepsy.
Treatment

Generally, treatment for epilepsy consists of drug therapy specific to the type of seizure.  If drug therapy fails, treatment may include surgical removal of the abnormal lesion.  For about 80 percent of those diagnosed with epilepsy, seizures can be controlled. However, about 20 percent of people with epilepsy will continue to experience seizures even with the best available treatment.  In certain situations, seizure activity can eventually become quiescent. 

Note: There are many new drugs now available to control seizures.  It's important to consult with your physician on a regular basis to find out what may be best for you.  Be sure to let your physician know if there has been any change in the pattern of your seizures, ie occurring more frequently, lasting longer, etc. 

Video Tutorial about Epilepsy
Epilepsy at Medline Plus. At the Home Page, locate the "Interactive  Tutorials" button  in the upper R hand column: Scroll down to "Seizures and Epilepsy" This will take you to an easy-to-understand and informative video about epilepsy. Medline Plus is a service of the National Library of Medicine and the National Institute of Health.
References
--Written by N Thompson, ARNP in collaboration with M Thompson, MD, Internal Medicine, Last updated June 2006

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