SEIZURE DISORDERS IN INFANTS AND CHILDREN.doc

SEIZURE DISORDERS IN INFANTS AND CHILDREN.doc - SEIZURE...

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SEIZURE DISORDERS IN INFANTS AND CHILDREN Definitions Seizure: A seizure represents the clinical expression of abnormal, excessive, synchronous discharges of neurons residing primarily in the cerebral cortex. This abnormal paroxysmal activity is intermittent and usually self-limited, lasting seconds to a few minutes. A seizure is a discrete event, a symptom of brain dysfunction. Convulsion: It is a violent spasm (a sudden involuntary contraction of one or more muscles) or series of jerkings of the face, trunk, or extremities Epilepsy: A chronic disorder characterized by paroxysmal brain dysfunction due to excessive neuronal discharge, and usually associated with some alteration of consciousness. The names convulsive disorder, seizure disorder, and cerebral seizures are synonymous with it. They all refer to recurrent paroxysmal (sudden) episodes of central nervous system dysfunction manifested by stereotyped alterations in behavior. An individual is considered to have epilepsy when seizures recur over a period of time without obvious precipitants. If the disorder is recurrent and unprovoked, the patient has epilepsy. Epilepsy is not a specific disease, but rather a condition arising from a variety of pathological insults involving the cortex, such as tumors or genetic channelopathies A focal seizure has a restricted regional onset followed by spread to neighboring or remote brain regions. It may spread to deep subcortical regions and result in a generalized tonic-clonic seizure. This is called a secondarily generalized seizure, to differentiate it from seizures that are generalized from the onset, primarily generalized seizures.
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When the seizure is prolonged or immediately recurrent without a return of consciousness, this is status epilepticus. In about 60% of diagnosed epileptics, no reasonable cause for the seizure is found, and the condition is referred to as idiopathic. A single seizure in the presence of a significant lesion on neuroimaging or a diagnostic electroencephalogram (EEG) qualifies as epilepsy Most nonepileptic seizures are clonic-tonic, whereas the most common form of epilepsy is the complex partial seizure. Etiology A seizure may be an isolated event with no obvious precipitating cause that never recurs. It may be triggered by a transient disruption of cortical neuronal function such as: A disturbed metabolic state: ~ High fever (Hyperpyrexia) ~ Hypocalcemia ~ Hyponatremia (Cerebral edema) Temporary cortical disturbance after minor head trauma (concussion), Ischemia (Cerebral hypoxia) Use of convulsive or toxic drugs Chemical/inflammatory excitation caused by infection ~ Meningitis ~ Encephalitis ~ Sepsis Bleeding ~ Intraparenchymal ~ Subarachnoid hemorrhage A seizure can also be the manifestation of a chronic disturbance of neuronal function caused by a remote event such as:
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Perinatal asphyxia In-utero stroke The expression of a genetic syndrome
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  • Spring '12
  • JAMES
  • Seizure, Seizures, complex partial seizure

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