Epilepsy: Difference between revisions
Kingrajinix (talk | contribs) |
|||
(20 intermediate revisions by 4 users not shown) | |||
Line 1: | Line 1: | ||
===Definition=== | ===Definition=== | ||
Epilepsy is a condition characterised by recurrent seizures. A [[seizure]] is hypersynchornous neuronal activity. "Hypersynchronous", in plain English, means "unsynchronised" and "a lot". So a seizure is a lot of unsynchronised neuronal activity. | |||
Strictly speaking, "epilepsy" is not a disease in that it is not a pathophysiological process. In fact, the colloquial term is what is medically considered "idiopathic epilepsy". | |||
===Epidemiology=== | ===Epidemiology=== | ||
===Pathophysiology=== | ===Pathophysiology=== | ||
===Risk Factors=== | ===Risk Factors=== | ||
===Classification Of Seizures=== | |||
The first division to make is into ''partial'' and ''generalised'' which describe the area of the [[brain]] affected. The definitions are: | |||
*'''Partial''' seizures involve a '''localised area of the brain''' | |||
*'''Generalised''' seizures involve the '''whole brain''' | |||
====Partial Seizures==== | |||
Partial seizures can be further divided into ''simple'' and ''complex'' which describe the effect on consciousness. The definitions are: | |||
*'''Simple''' partial seizures do '''NOT cause a [[loss of consciousness]]''' | |||
*'''Complex''' partial seizures '''DO cause a loss of consciousness''' | |||
====Generalised seizures==== | |||
These always results in a loss of consciousness and as such cannot be classified in this way. The most important types of generalised epilepsy are: | |||
*'''Absences''' | |||
*'''Tonic-clonic seizures''' | |||
There are four other types of seizure which are considered generalised but are less common: ''myoclonic'' seizures, ''clonic'' seizures, ''tonic'' seizures and ''atonic'' seizures. | |||
A final addendum is those seizures which are considered epileptic but cannot be defined. These are "unclassified epileptic seizures". This is not the same a [[non epileptic attack disorder|non epileptic attack disorder (NEAD)]] which is considered a psychogenic disorder with no area of uncontrolled, unsynchronised brain activity. | |||
===Clinical Features=== | ===Clinical Features=== | ||
=== | ====Partial Seizures==== | ||
====Generalised Seizures==== | |||
===Investigations=== | ===Investigations=== | ||
EEG | |||
[[FBC]] | |||
Look for | |||
*[[U+Es]] for electrolyte disturbance ([[hyponatraemia]] & [[hypernatraemia]]) | |||
*hypoglycaemia | |||
*INR PTT LFTs - looking for liver encephalopathy. | |||
*CT Abscess - looking for brain abscess or tumour | |||
*LP - if there is no CT result | |||
==Management== | |||
===Prognosis=== | ===Prognosis=== |
Latest revision as of 15:15, 12 January 2010
Definition
Epilepsy is a condition characterised by recurrent seizures. A seizure is hypersynchornous neuronal activity. "Hypersynchronous", in plain English, means "unsynchronised" and "a lot". So a seizure is a lot of unsynchronised neuronal activity.
Strictly speaking, "epilepsy" is not a disease in that it is not a pathophysiological process. In fact, the colloquial term is what is medically considered "idiopathic epilepsy".
Epidemiology
Pathophysiology
Risk Factors
Classification Of Seizures
The first division to make is into partial and generalised which describe the area of the brain affected. The definitions are:
- Partial seizures involve a localised area of the brain
- Generalised seizures involve the whole brain
Partial Seizures
Partial seizures can be further divided into simple and complex which describe the effect on consciousness. The definitions are:
- Simple partial seizures do NOT cause a loss of consciousness
- Complex partial seizures DO cause a loss of consciousness
Generalised seizures
These always results in a loss of consciousness and as such cannot be classified in this way. The most important types of generalised epilepsy are:
- Absences
- Tonic-clonic seizures
There are four other types of seizure which are considered generalised but are less common: myoclonic seizures, clonic seizures, tonic seizures and atonic seizures.
A final addendum is those seizures which are considered epileptic but cannot be defined. These are "unclassified epileptic seizures". This is not the same a non epileptic attack disorder (NEAD) which is considered a psychogenic disorder with no area of uncontrolled, unsynchronised brain activity.
Clinical Features
Partial Seizures
Generalised Seizures
Investigations
EEG FBC Look for
- U+Es for electrolyte disturbance (hyponatraemia & hypernatraemia)
- hypoglycaemia
- INR PTT LFTs - looking for liver encephalopathy.
- CT Abscess - looking for brain abscess or tumour
- LP - if there is no CT result