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| Volume 1, Issue 14 | NOVEMBER 2003 |
| Inside This Issue | |||||
| 1 | Seizure Disorder | ||||
| 2 | Updates and Announcements | ||||
Medical Information Fact Sheet
Epilepsy
Approximately 2 million people have epilepsy, a chronic disorder of the brain that causes a tendency to have recurrent seizures. Two or more seizures must occur to receive a diagnosis of epilepsy, also known as a seizure disorder.
It is not uncommon for children to have at least one seizure. An estimated 5%-10% of the population will experience at least one seizure in their lifetime.
Seizures can occur when there is a sudden change in the way brain cells communicate with electrical signals. During a seizure, some brain cells will send abnormal signals, which can alter other cells from working properly. This abnormality can cause temporary changes in sensation, behavior, movement or consciousness.
Epilepsy begins most commonly during childhood and after age 65, but it can occur at any age.
Signs & Symptoms:
Because abnormal brain activity causes seizures, having a seizure can result in the sudden occurrence of any activity that is coordinated by the brain. This may include temporary confusion, complete loss of consciousness, a staring spell, muscle spasms, or uncontrollable, jerking movements of the arms or legs. Seizures that occur in the temporal lobe of the brain are associated with a sense déjà vu, anxiety and panic, or simply and uneasy sensation in your stomach.
Signs and symptoms may vary depending on the type of seizure. Most people will experience the same type of seizure, with similar symptoms each time they have a seizure, but others can experience a wide range of types and symptoms.
Classification of the seizure is either partial or generalized depending on how the abnormal brain activity begins. If the abnormal activity during a seizure is in one part of the brain it is a partial seizure. If the abnormal activity during a seizure is in many parts of the brain then it is called generalized.
Both classifications can be broken down into smaller more specific categories.
Partial seizures are separated into simple partial, complex partial and secondary generalized seizures.
Primary generalized seizures are separated into absence (petit mal), myoclonic, atonic and generalized tonic-clonic (grand mal) seizures.
Primary Seizures:
Some people experience a sensation, called an aura, before one of the following partial seizures begins:
- Simple partial seizures begin in a small part of the brain and do not result in a loss of consciousness. They can cause uncontrollable shaking of an arm, leg or other part of the body; alter emotions; change the way things look, smell, feel, taste, or sound; or cause speech disturbance.
- Complex partial seizures begin in a small part of the brain. They alter consciousness and usually cause memory loss (amnesia). They can cause staring and nonpurposeful movements, such as repeated hand rubbing, lip smacking, posturing of your arm, vocalization or swallowing. After the seizure is over the person may be confused or sleep for a few minutes and may be unaware the seizure took place. Seizures of the temporal lobe are the most common type of complex partial seizures.
- Secondary Generalized Seizures (partial seizures with secondary generalization) occur when simple or complex seizures involve the entire brain. They can begin as a complex partial seizure with staring and nonpurposeful movements. Then it becomes more intense, leading to generalized convulsions that are characterized by stiffening and shaking of your extremities and your body.
Generalized seizures:
- Absence (petit mal) seizures are characterized by staring, subtle body movement and brief lapses of awareness. They tend to be brief and most often no confusion or sleepiness occur when the seizure ends.
- Myoclonic seizures often appear as sudden jerks of the arms and legs. Most often they affect only one side of the body, they can affect both sides. These seizures may last only a short time from less than a second for single jerks and a few second for repeated jerks.
- Atonic seizures also know as drop attacks, cause a person to suddenly collapse or fall down. After a few seconds, a person regains consciousness and is able to stand and walk.
- Generalized tonic-clonic (grand mal) seizures are the most intense of all seizures. They are characterized by loss of consciousness, body stiffening and shaking, and sometimes tongue biting or loss of bladder control. After the shaking ends, a period of confusion or sleepiness occurs, lasting from a few minutes to a few hours.
Epilepsy can often be traced to an accident, disease or medical trauma?such as a stroke?that injures the brain or deprives it of oxygen, ofte4n causing a small scar in the brain. Rarely epilepsy can be cause by a brain tumor. In most cases the cause is not identifiable.
Epilepsy is not a mental disease, although mental health can influence the control of seizures. Epilepsy doesn’t cause psychiatric problems or mental retardation, but people with epilepsy can also be affect by those conditions.
Some research suggests that genetic abnormalities contribute to epilepsy. If there is a family history the risk increases.
Head injuries are responsible for most cases of epilepsy. Risk can be reduced by wearing a seatbelt in a car and wearing a helmet.
Strokes and other vascular diseases can lead to brain damage that can trigger epilepsy. The risks for these diseases can be reduced by limiting alcohol intake, a healthy diet, managing weight, exercise regularly and avoid cigarettes.
Other risk factors for epilepsy include Alzheimer’s disease, brain infections, and poisonings from exposure to lead, carbon monoxide and other toxins.
When diagnosed with epilepsy the person does not need to seek medical advice each time a seizure occurs if they are well versed in what to do when the seizure occurs. Seek medical advice the first a seizure occurs. Also seek medical advice if any of the following occur:
- The seizure last longer than five minutes
- Recovering from the seizure is slow
- A second seizures follows immediately
- The person is pregnant or has diabetes
- Signs of injury or illness occur
- The seizures changes in frequency or severity
- There is a change in the way the person feels during and after the seizures
- The seizure is preceded by a sudden, severe headache or other signs and symptoms of stroke, including weakness or numbness on one side of the body, vision loss, confusion, coordination or speech
- The seizure medication is changed or the person begins to take other medications
If you see someone having a seizure, call for medical help and then follow these tips:
- Gently roll the person onto their side and put something soft under their head
- Loosen tight neckwear
- Don not put anything in their mouth, the tongue cannot be swallowed
- Do not try to restrain them
- Look for a medical alert bracelet. The bracelet may list a contact person and the medications their taking as well as any allergies.
- Stay with them until medical personnel arrive and watch closely so you can document the signs and symptoms and how long the seizure lasts
Due to the many causes of seizure the doctor will obtain a thorough medical history including description of past seizures. A physical and neurological exam will be conducted including testing reflexes, muscle tone and strength, function of the senses, gait, posture, coordination and balance. Blood tests may be ordered to test chemical imbalances.
Also an EEG may be done to record electrical activity of the brain. A CT scan or MRI may also be ordered to look for any brain structure abnormalities or strokes and tumors.
Recurrent seizures may put the person and others at risk of physical harm. Seizures can cause injuries associated with falling, such as head injury. If a seizure occurs while swimming, drowning can occur. Be aware that driving is extremely dangerous and can be restricted in certain states. People can have life threatening complications from epilepsy. Those who have prolonged or continuous seizures (status epilepticus) are at increase risk for permanent brain damage or death.
Most people with epilepsy can be free from seizures by taking medications. For some people the medications can make the seizures less intense and less frequent. Half of children with epilepsy can eventually stop their medications and live a seizure free life. Adults can sometimes stop the medications if they go two or more years without a seizure.
Finding the right medication and dosage can be complex. It may take more than one drug or trying several drugs until the right one is found. The medications do contain side effects but many people take the medications for years without significant problems. If a woman is pregnant then she should speak with her doctor because some of the medications can cause birth defects.
Surgery can be done if the medications are not working. Surgery is usually done on those with seizures occurring in the side region (temporal lobe) or the front regions (frontal lobes) of the brain. Surgery is rarely an option if the seizures start in several areas of the brain or if the seizures originate from a region of the brain that controls vital functions.
Here are some tips that can make living the condition better. Take medication correctly. Keep a detailed record of seizure activity. Take care of your health and wear a medical bracelet.
Febrile Seizures:
A febrile seizure is a convulsion that occurs in children that is triggered by a high fever. Febrile means pertaining to or characterized by a fever. A febrile seizure can last 5 minutes or less. Most children who experience febrile seizures are between the ages of 6 months and 5 years old. Although it is very alarming, the seizure is usually harmless to the child and does not usually indicate a long term problem. You should always seek medical advice especially to determine the cause of the fever.
Febrile seizures are the most common during childhood. They occur in about 4% of children under the age of 4. Most children will only have one seizure. Many children tend to inherit a tendency to have seizures along with a fever. Febrile seizures usually stop by the time the child is 5-6 years old.
Signs of febrile seizures include:
- Repeated rhythmic jerking or stiffening of the child’s arms or legs.
- Eyes rolled back in child’s head
- Lack of consciousness
The child may cry or be sleepy following the seizure.
Most febrile seizures occur due to a rapidly developing fever which is cause by an infection in any part of the child’s body. The fever is usually caused by a typical childhood illness, such as middle ear infection.
The doctors may need to run lab tests to help determine the cause of the infection.The vast majority of febrile seizures stop on their own within 5 minutes. However, if the seizure last longer that 5 minutes or if the child has 2 or more seizures contact emergency medical attention.
If the seizure continues when the child arrives in the emergency room the doctor may give the child some medications to stop the seizure.If the child is susceptible to febrile seizures, it may be possible to prevent the seizures by taking quick action to control fever when the child has an illness.
Although the seizures are usually harmless the parent can take the same safety precautions as those listed above for persons having a seizure disorder.
Mayo Clinic. (2003, August 11). Epilepsy. Retrieved on September 10, 2003 from the World Wide Web: http://www.mayoclinic.com/invoke.cfm?id=DS00342
Mayo Clinic. (2002, April 11). Febrile Seizures. Retrieved on September 10, 2003 from the World Wide Web: http://www.mayoclinic.com/invoke.cfm?objectid=3C238DA4-7A06-4ED1-AF959E54F6001E4A
HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!!
We would like to Welcome Nicole Boyd to the HCPCFC program. She will be covering the Southwest Juvenile Court.
Welcome Nicole!
Editor: Kristen Thompson, PHN
Contributors: William Chavez, PHN, MBA, Interim Assistant Nurse Manager and Judy Earp, MHA, Director of Public Health Nursing.
