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Sunday, May 16, 2021

Seizure Management

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A seizure refers to a sudden surge of electrical activity in the brain and it usually affects a person’s appearance and actions for a transient period. In fact, the activities that the brain and the body can do normally can also happen during a seizure episode.

According to Medline Plus, the word seizure is typically used in conjunction with convulsion. As per the publication, convulsions occur when a person’s body shakes very fast without control. During the episode, the person’s muscles contract and relax in a repetitive fashion.

 

Incidence

SUDEP is a term that refers to the sudden, unexpected death of a person with epilepsy, despite of being healthy. In this condition, autopsy does not reveal any other cause of death. According to Epilepsy Foundation, more than one out of 1,000 people with epilepsy die from SUDEP annually and the risks of death from SUDEP escalates to more than one out of 150 if the seizure is uncontrolled. As per the publication, the sudden pediatric deaths are uncommon, but it stands as the lead cause of death in adults with uncontrolled seizures.

 

Causes

Seizure is caused by several causes. According to Healthline, seizures are caused by epilepsy, a neurological condition due to brain cell malfunction; a head injury to the brain, skull, or scalp; eclampsia, a rare but serious condition during pregnancy; alcohol withdrawal delirium, the most serious form of alcohol withdrawal; intracranial hemorrhages, or bleeding inside the skull; cerebral palsy, a disorder that influences muscle movement and coordination; concussion, a mild traumatic brain injury; cerebral hypoxia, or decreased oxygen in the brain; hyponatremia, or low blood sodium; skull fractures, or break in the cranial bone; and brain cancer, among others.

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Types of Seizures

Seizures may be classified into two general categories: generalized and partial (focal), as per Web MD. A generalized seizure affects both sides of the brain from the beginning of the attack and it can be sub-classified into three: tonic-clonic (grand mal) seizure, absence (petit mal) seizure, and febrile (infantile) spasms. In tonic-clonic (grand mal) seizure, electrical discharges instantaneous involve the whole brain and usually lasts one to five minutes. On the other hand, epileptic activity occurs throughout the entire brain in absence (petit mal) seizure and it begins and ends abruptly without warning.

Some people experience a partial seizure preceding a generalized seizure, which is called an aura. As per Epilepsy Ontario, an aura may be emotional, physical, or sensory.

The third type of generalized seizure includes the febrile and infantile spasms, which occur in young children.

In focal or partial seizure, the episode begins and concentrates in one part of the brain hemisphere and this type of seizure can be simple partial or complex partial. Simple partial is also referred as focal cortical seizure and it affects the cortex or the limbic system. In the contrary, complex partial seizure occurs when epileptic activity involves both temporal lobes in the brain, usually starting in the temporal lobe.

 

Management

The treatment goal in patients with epileptic seizures is to have a seizure-free status free of adverse effects. According to Emedicine, anticonvulsants provided success in more than 60 percent of patients, though adverse effects from the drugs were experienced. Monotherapy is also advised, since it reduces the likelihood of adverse effects and it prevents drug to drug interactions. Social and vocational rehabilitation may be necessary in people with psychos-ocial adjustments.

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Organizations that deal with epilepsy and seizures raise public awareness on the disease process, in addition to research, to prevent SUDEP. If a person learns that he has a family member who had SUDEP, it is important to talk about it with the doctor for general identification of risk factors, assessment, and early preventive intervention.

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