Pathophysiology and management of convulsive disorders.ppt

Pathophysiology and management of convulsive disorders.ppt...

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Pathophysiology and management of convulsive disorders
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Definition A seizure or convulsion is defined as a paroxysmal, involuntary disturbance of brain function resulting from abnormal electrical activity in the brain that may be manifested as an impairment or loss of consciousness, abnormal motor activity, behavioral abnormalities, sensory disturbance, or autonomic dysfunction. Epilepsy is considered to be present when two or more unprovoked seizures occur at an interval greater than 24 hr apart. The seizures are triggered recurrently from within the brain.
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Introduction Seizures are a common neurologic disorder in the pediatric age group and occur in 10% of children. Epilepsy occurs in 0.5–1.0% of the population and begins in childhood in 60% of cases. Seizures do not constitute a diagnosis but are a symptom of an underlying central nervous system (CNS) disorder that requires a thorough investigation and management plan. In most children, a cause of the seizure cannot be determined, and a diagnosis of idiopathic epilepsy is made.
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Introduction Although the outcome for most uncomplicated seizures in children is good, 10–20% have persistent seizures refractory to drugs, and these pose a diagnostic and management challenge. EPILEPSY Epilepsy : condition where a person has two or more recurrent seizures due to chronic underlying process mainly in the brain. It is not a single seizure, or recurrent ones 2 o correctable etiologies e.g.. febrile convulsion.
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Introduction It’s a clinical phenomenon - many forms and causes and not a single d’se entity. Highest incidence in childhood and late adulthood. • world wide incidence is 0.3% to 0.5% in different populations. Annual prevalence is 0.5 – 0.8% because children outgrow epilepsy.
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CAUSES OF SEIZURES AND EPILEPSY. SEIZURE result from imbalance between excitation and inhibition within the CNS. Three clinical observations emphasize how a variety of factors determine seizures/epilepsy in a patient. 1. Normal brain is capable of having a seizure under appropriate circumstances, and there is individual difference in the threshold for seizures. • Seizures affect a relatively small proportion of children, indicating some endogenous factors influence threshold for seizures include genetic factors - likelihood of seizures in normal individual high if there is family history of epilepsy.
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Clinical observations influencing seizure development . 2. Variety of conditions have an extremely high likelihood of resulting in a chronic seizure disorder (epilepsy.) e.g. a penetrating head trauma. • Injury results in a long lasting pathological change in CNS transforming a normal neural network into one that is highly hyperexcitable . • This process is termed epileptogenesis , and the specific changes that result in a lowered seizure threshold can be considered epileptogenic factors.
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Cont.
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  • Spring '12
  • JAMES

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