College aantekeningen

Epilepsy & Behavior

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Vak
Biochemical, physiological, neuroanatomic, genetic

Instelling
Biochemical, Physiological, Neuroanatomic, Genetic

This study assessed the strengths of association among perceived stress, felt stigma, and depression in adults with epilepsy, and evaluated whether felt stigma altered the association between perceived stress and depression. Felt stigma may potentiate the relationship between perceived stress and ...

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Geupload op 27 november 2022
Aantal pagina's 19
Geschreven in 2022/2023
Type College aantekeningen
Docent(en) Mrs samia afzaal
Bevat Alle colleges

gtcs or fbtcs
abnormal brain
hrqol
psychosocial
depression
emotional instability
felt stigma
perceived
beck depression inventory bdi
general self efficacy scale gses
chronic disorders of the brain

Vak
Biochemical, physiological, neuroanatomic, genetic

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1

EPILEPSY
The word “epilepsy” comes from the Greek and means to be taken, seized or attacked.
Epilepsy is a condition characterized by repeated seizures due to a disorder of the brain cells. It is a life-
long tendency, though the seizures may start at any time during life and occur sporadically or frequently.
Some of the epilepsies are confined to particular age groups. Some suffer from it their whole lives and
others only for a few years (average approximately 13 years).
Epilepsy may develop after a particular identifiable event (e.g., head injury, meningitis), in which case it
is called symptomatic epilepsy, or it may develop without any identifiable cause, and then it is called
idiopathic epilepsy.
Sometimes the term “secondary epilepsy” was used for symptomatic epilepsy and “primary epilepsy” for idiopathic
epilepsy. But this is confusing and should not be done any more. In this manual the terms primary and secondary are
only used in relation to seizures and not in relation to epilepsy.
A secondary generalized seizure is a seizure which starts in one place and then becomes generalized, while a
primary generalized seizure is one generalized from its onset.
SEIZURE
A seizure is a result of excessive nerve-cell discharges in the brain. It is seen as a sudden abnormal
function of the body, often with loss of consciousness, an excess of muscular activity, or sometimes a loss
of it, or an abnormal sensation.
The excessive nerve-cell discharges or excitation may remain in a small area of the brain (a localized
lesion or focus) giving rise to partial (focal) seizures, or start immediately in the whole brain or spread
from the small area (focus) to the whole brain and spinal cord giving rise to generalized seizures.
Not only may these discharges vary in site, but also in severity and extent, therefore a wide variation of
clinical forms is seen.
A seizure is also referred to as a convulsion, fit, or attack. However, the words “convulsion” or “fit” are
usually used to refer to seizures with tonic-clonic muscle movements.
PREVALENCE
Prevalence is the ratio of those with a certain disease to the entire population.
INCIDENCE
Incidence is the rate at which new cases of a disease occur within a given period (e.g., a year) in a given
population. In the case of epilepsy, the annual incidence is usually calculated per 100,000 population.
CAUSES OF A SEIZURE
1. Metabolic
 Hypoglycaemia
 Hypocalcaemia
 Uraemia

, 2

 Electrolyte imbalance
 Phenylketonuria(an inherited inability to metabolize phenylalanine which, if untreated,
causes brain and nerve damage)**

2. Infections
INTRACRANIAL EXTRACRANIAL
— meningitis* — febrile illnesses (febrile
— encephalitis* convulsions)*
— AIDS* — pertussis
— pertussis immunization
— cerebral malaria* — tetanus
— rabies
— toxoplasmosis
— cysticercosis
— encephalopathy (SSPE)
3. Trauma
Birth trauma*
Cold injury in newborns
Head injury in later life*
Hypothermia
Anoxia
Conditions later in life
4. Toxic
Alcohol and withdrawal from alcohol*
Carbon monoxide poisoning
Drugs (high dose i.v. penicillin, strychnine, etc.)
Lead poisoning
5. Space-occupying lesions
Haemorrhage
Tuberculoma*
Abscess
Tumour
6. Circulatory disturbances
Cerebro-vascular accident (stroke)
Sickle-cell crisis*
Vascular anomalies

, 3

7. Cerebral oedema
Hypertensive encephalopathy
Eclampsia
8. Congenital
Malformations of the brain (hydrocephalus, microcephaly, etc.)
Tuberous sclerosis (Bourneville disease)**
Neurofibromatosis (von Recklinghausen disease)**
9. Degenerative diseases
Niemann-Pick disease**
Dementias*
Cerebromacular degeneration**
10. Common precipitating factors
_ Flashing lights (resulting in reflex epilepsy)
– Hyperventilation
– Lower alertness, sleep itself and lack of enough sleep
– Emotion
– Physical stress
– Special smells, sounds or sensations of touch
– Alcohol
– Hormonal changes, e.g., during menses
– High fever
– Overhydration

Seizures
Four components of a seizure can be distinguished. Not all seizure types will have all these stages. The
presence or absence and the nature of them are important for diagnosing the seizure type.
Prodromal phase
This phase begins a few hours or even days before the actual seizure and should not be confused with the
aura. Prodromal symptoms are: headache, irritability, insomnia, bad temper, depression or increased
activity.
Aura
An aura precedes the seizure by seconds or a few minutes. It is the beginning of the seizure and signals
the focal onset of the seizure. The symptoms depend on the location of this focus. The feelings of the aura
are often vague and indescribable, leading to extreme fear. Strange epigastric sensations, dreamlike
experiences, unpleasant smells, etc may occur. The patient remembers the aura very well, and although

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