[26] Seizures

• Seizures: an abnormal, unregulated electrical discharge that occurs within the brain's cortical gray matter and transiently interrupts normal brain function
• Provoked Seizures

  • due to specific conditions
  • 25 % - 30 %
• Unprovoked Seizures

  • Not linked to a current medical condition
  • Includes seizures that occur >7 days after a specific cause
  • More common
• Seizure Disorder

  • umbrella term for seizure symptoms
  • more than 1 seizure to be considered seizure disorder
• Epilepsy

  • chronic neurologic condition that should have a recurrent of >/ 2 unprovoked seizures for more than 24 hrs
• CP and epilepsy are neurological conditions that co-exist with one another but not outcomes of each other
• Worldwide

  • Incidence: 50 in 100000
  • Prevalence: 700 in 100000
• PH prevalence: 0.9 %
• Focal Seizures: one area of the brain within the hemisphere

  • most common: 60%
• Focal Seizure preceded by aura such as

  • visual changes
  • dyspepsia
  • deja vu
  • hearing disturbances
  • sensation of abnormal taste or smell
• Motor movement

  • Automatism (coordinated, purposeless, repetitive motor activity)
• Motor movement

  • Atonic (focal loss of muscle tone)
• Motor movement

  • Clonic (focal rhythmic Jerking)
• Motor movement

  • Epileptic Spasm (focal flexion or extension of arms and flexion of trunk)
• Motor movement

  • Myoclonic (irregular, brief focal jerking)
• Motor movement

  • tonic (sustained focal stiffening of one limb or one side of the body)
• Behavioral Manifestation

  • Autonomic Dysfunction: change in heart rate
  • Behavioral Arrest: brief pause and unresponsive
  • Cognitive Dysfunction: language impairment
  • Emotional Dysfunction: fear, anxiety
  • Sensory Dysfunction: hallucination
• Generalized Seizures: abnormal neural activity in both side of the brain's hemisphere
• Nonmotor onset (absence seizures)
• Nonmotor onset (absence seizures)

  • Typical
  • Atypical
  • Myoclonic
• generalized seizures with impaired awareness last for about 5-15 seconds then the person is full alert after
• Typical absence seizures

  • blank stare
  • cessation of consciousness
  • slight twitch muscle
• Atypical

  • mas brief sa typical
  • less abrupt start/termination of consciousness
  • abnormal changes in muscle tone
• Myoclonic: short loss of consciousness before jerking movements
• Generalized Motor Onset Seizures: tonic-clonic (combination of symptoms)
• Prognosis

  • Frequency of Seizures
  • Number of Seizure Types
  • Presence of comorbidities
• Medical Precaution

  • alcohol consumption or withdrawal
  • dehydration or hunger
  • stress
  • hormonal changes
  • sleep deprivation
  • visual stimulation (photosensitive epilepsy)
• Seizure First Aid

  • ease the person to the floor
  • turn one side to help breathe
  • clear the area around to prevent injury
  • put soft or flat under head
  • remove eyeglasses or loosen ties to help breathe
  • time for 5 mins, call for help
• Most people with seizures do not present communication difficulties

  but some may experience

  • attention difficulties
  • expressive and receptive language delays
  • language disorders
  • issue in social communication skills
• Speech

  • Dysarthria: poor motor coordination and movements
• Swallowing

  • poor drooling
  • palatal-glossopharyngeal weakness: diff. in closing airway, pharynx, and tongue
• Management

  • Medication (anticonvulsant)
  • Diet therapy (Ketogenic)
  • Neurostimulation
  • Surgery: /> 2 medications that is not effective
• Support System: Philippine League Against Epilepsy