Friday, May 27, 2022

How Do Seizures Affect The Brain

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History And Physical Examination

So, What is Epilepsy?

An eyewitness report of the episode can be very helpful to doctors. An eyewitness can describe exactly what happened, whereas people who have an episode usually cannot. Doctors need to have an accurate description, including the following:

  • How fast the episode started

  • Whether it involved abnormal muscle movements , tongue biting, drooling, loss of bladder or bowel control, or muscle stiffening

  • How long it lasted

  • How quickly the person recovered

A quick recovery suggests fainting rather than a seizure. Confusion that lasts for many minutes to hours after consciousness is regained suggests a seizure.

Although eyewitnesses may be too frightened during the seizure to remember all details, whatever they can remember can help. If possible, how long a seizure lasts should be timed with a watch or other device. Seizures that last only 1 or 2 minutes can seem to go on forever.

Doctors also need to know what people experienced before the episode: whether they had a premonition or warning that something unusual was about to happen and whether anything, such as certain sounds or flashing lights, seemed to trigger the episode.

Doctors ask people about possible causes of seizures, such as the following:

A thorough physical examination is done. It may provide clues to the cause of the symptoms.

The Definition Of Febrile Convulsions

Some workers have included seizures that occurwhen children arefebrile because of an underlying meningitis or encephalitis . However, it has become generally accepted that seizures that are known to be symptomatic of an underlying infection should not be called febrile convulsions. The Commission on Epidemiology and Prognosis of the International League Against Epilepsy agreed on the following definition:

an epileptic seizure….occurring in childhood after age 1 month, associated with a febrile illness not caused by an infection of the CNS, without previous neonatal seizures or a previous unprovoked seizure, and not meeting criteria for other acute symptomatic seizures.

The Brain During A Seizure

During a seizure, excessive and abnormal electrical signals in your brain disrupt its normal activity. The way this affects body functions depends on 2 main factors. First is the location of the seizure in your brain. For instance, a seizure in a part of your brain that controls movement might cause your arm or leg to jerk.

The second factor is the spread of the seizure to other parts of the brain. For instance, a seizure that affects more of your brain may affect more of your body.

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What Do Doctors Do

Doctors who specialize in the brain and other parts of the nervous system are called neurologists . If you think you might have had a seizure, it’s important to tell your doctor about it. He or she will most likely refer you to a neurologist who will check for epilepsy or other conditions.

In addition to doing a physical examination, the neurologist will ask you about any concerns and symptoms you have, your past health, your family’s health, any medications you’re taking, any allergies you may have, and other issues. This is called the medical history. It’s important to give the most accurate description possible of the seizure . Identifying the type of seizure a person has helps the doctor decide how to treat it. Because people who’ve had seizures may not remember anything about them, it’s a good idea to get a detailed description from someone who saw it and write it down afterward.

The neurologist will most likely perform medical tests such as an electroencephalogram , or EEG test, to measure the electrical activity in the person’s brain. Scans of the brain, such as a computerized tomography scan or magnetic resonance imaging test, may also be done. All of these tests are painless.

A doctor also may recommend a ketogenic diet, a special diet that might help people with epilepsy who don’t respond well to medication alone. Sometimes doctors can help by performing surgery directly on the brain tissue when the condition can’t be controlled using other treatments.

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    Why Location Matters

    Different parts of our brain control different parts of our bodies. For example, a part of your brain called the hippocampus plays a big role in memory, while a part called the cerebellum affects how you walk.

    Depending what part of the brain causes your seizures, this will affect what kind of symptoms you have.

    When To See A Doctor

    It is important for a person to see a doctor if they experience a seizure that results in an injury. They should also seek medical advice if they have more than one seizure within 24 hours.

    A person should see a doctor after their first seizure. They will be able to diagnose any underlying conditions and prescribe treatment, if necessary.

    It is important to seek immediate medical treatment if a person severely injures themselves, has a seizure in water, or has an underlying health condition.

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    Symptoms Of Seizure Disorders

    An aura describes how a person feels before a seizure starts. Usually, it is part of a focal aware seizure that is just starting. An aura may include any of the following:

    • Abnormal smells or tastes

    • Butterflies in the stomach

    • Feeling as if something has been experienced before even though it has not or the opposite feelingsomething seems unfamiliar even though it is familiar in some way

    • An intense feeling that a seizure is about to begin

    Almost all seizures are relatively brief, lasting from a few seconds to a few minutes. Most seizures last 1 to 2 minutes.

    Occasionally, seizures recur repeatedly, as occurs in status epilepticus.

    Most people who have a seizure disorder look and behave normally between seizures.

    Symptoms of seizures vary depending on which area of the brain is affected by the abnormal electrical discharge, as in the following:

    • An intensely pleasant or unpleasant taste if the part of the cerebrum called the insula is affected

    • Visual hallucinations if the occipital lobe is affected

    • Inability to speak if the area that controls speech is affected

    • A convulsion if large areas on both sides of the brain are affected

    Seizures may be classified as

    • Motor: Involving abnormal muscle contractions

    • Nonmotor: Not involving abnormal muscle contractions

    Symptoms also vary depending on whether the seizure is

    • Focal-onset

    • Generalized-onset

    There are several types of focal and generalized seizures. Most people have only one type of seizure. Others have two or more types.

    What Happens In The Brain When You Have A Seizure

    Neuroscience: Epilepsy: Preventing Seizures with Brain Stimulations

    During a seizure, there is a sudden intense burst of electricity that disrupts how the brain usually works. This activity can happen on one small part of the brain and last for just a couple of seconds, or it can spread right across the brain and keep going for many minutes.

    To understand what seizures do to the brain, itâs important to understand how the brain normally works.

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    How Does Epilepsy Affect The Brain

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    HealthTap doctors are based in the U.S., board certified, and available by text or video.

    How Seizures Can Affect A Brain Injury Lawsuit

    An injury victim who has also experienced seizures may be at serious risk for additional complications and medical difficulties. They may develop difficulties in performing everyday tasks, communicating with loved ones, commuting, and performing various work tasks. Their relationships may undergo strain as a result of the drastic changes caused by the initial injury, as well as by the seizures.

    In many instances, seizures and brain damage or traumatic brain injury are the results of the actions of another person or party. For example, brain injuries can be caused by:

    • Negligence or recklessness, such as in a car accident where the other driver disregarded road safety laws
    • Intentional conduct, such as when a person strikes another person on the head
    • Medical malpractice cases, such as a botched brain surgery
    • Defective product injuries, especially those involving dangerous pharmaceuticals

    In such cases, it may be necessary to pursue legal action. Monetary damages awards can help provide compensation for medical bills, lost wages, lost earning capacity, pain and suffering, and other costs.

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    How Does Epilepsy Affect Daily Life

      Most people with epilepsy lead outwardly normal lives. Approximately 80 percent can be significantly helped by modern therapies, and some may go months or years between seizures. However, the condition can and does affect daily life for people with epilepsy, their family, and their friends. People with severe seizures that resist treatment have, on average, a shorter life expectancy and an increased risk of cognitive impairment, particularly if the seizures developed in early childhood. These impairments may be related to the underlying conditions tha cause epilepsy or to epilepsy treatment rather than the epilepsy itself.

      Behavior and Emotions

      People with epilepsy have an increased risk of poor self-esteem, depression, and suicide. These problems may be a reaction to a lack of understanding or discomfort about epilepsy that may result in cruelty or avoidance by other people. Many people with epilepsy also live with an ever-present fear that they will have another seizure.

      Driving and Recreation

      Education and Employment

      Pregnancy and Motherhood

      Women with epilepsy should be aware that some epilepsy medications can interfere with the effectiveness of oral contraceptives. Women who wish to use oral contraceptives to prevent pregnancy should discuss this with their doctors, who may be able to prescribe a different kind of antiepileptic medication or suggest other ways of avoiding an unplanned pregnancy.

      How Do Seizure Disorders Affect The Body

      How Partial Seizures are Affected by Their Location in the ...

      Seizures, also known as epilepsy, involve a malfunction of the natural electrical activity in the brain. In people with epilepsy, the electrical impulses that the brain’s nerve cells use to communicate are disrupted periodically. During this disruption, the neurons become overactive and try to send too many electrochemical impulses in too short a time the result of this disruption in the neurons’ activity is a seizure. This neurological disorder can affect the body in a variety of ways, depending on the location of the seizure in the brain. There are more than 30 different kinds of seizure, but they fall into two general categories based on how they affect the brain. Focal seizures, which are also called partial seizures, are limited to one part of the brain. There are a variety of symptoms of focal seizures, but physical manifestations can include nausea and involuntary repetitive movements. Generalized seizures affect a larger portion of the brain. They also include a variety of symptoms, often more severe in nature than those associated with focal seizures. Examples include muscle stiffness, jerks or twitches, falls, and loss of consciousness.

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      C Behavioral Effects Involving Hippocampal Mr And Gr

      While the action of corticosteroid in hippocampus is thus involved in HPA regulation, further fine tuning of the HPA response to stress occurs by its behavioral effect. The hormone does not necessarily cause a behavioral change, but rather influences information processing and thereby affects the likelihood that a particular stimulus elicits an appropriate behavioral response. Moreover, through coordinate MR- and GR-mediated actions in higher brain areas, e.g., neocortical regions, and limbic areas such as hippocampus, septum, and amygdala, the corticosteroid hormone affects learning and memory processes. Accordingly, when the effect of corticosteroid on information processing and cognitive function facilitates behavioral adaptation to stress, the associated HPA response is more readily extinguished. Therefore, when one studies the modulation of behavioral responses by corticosteroids, the time and duration of the hormone action, as well as its context, need to be considered.

      Figure 9.Open in new tab

      What If The Medications Do Not Work

      Anti-seizure medicines usually work. But sometimes they cant stop your seizures. If you still have seizures after trying medicine, your doctor may send you to a comprehensive epilepsy center. At the center, you will see special seizure doctors called epileptologists or neurologists who specialize in epilepsy. These doctors may do brain wave tests and take a video of you during one of your seizures to help figure out whats causing them. This information may help your doctor decide what medicine will work best. It may also help the doctor figure out if other types of treatment will help with the seizures you are having.

      To find a center near you, you can visit the websites of the Epilepsy Foundation and the American Epilepsy Society

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      Inflammatory Pathways And Epileptogenesis

      How might inflammatory signaling upstream of neurodegeneration increase excitability and subsequent synchronicity? Immune responses in the brain are initiated, maintained and terminated by soluble effector proteins known as cytokines. Although a strong correlation between seizures and elevated inflammatory cytokines or their mRNA transcripts has been reported , emerging experimental evidence indicates that inflammatory cytokines can in turn alter neuronal excitability and synchronicity by modulating receptor function and expression . For example, the pro-inflammatory cytokine TNF- has also been shown to promote the recruitment of AMPA receptors to postsynaptic membranes. Interestingly, the recruited receptors preferentially lack the GluR2 subunit and consequently the calcium conductance underlying EPSPs is increased. Additionally, TNF- causes endocytosis of GABAA receptors from the cellular surface, decreasing inhibitory synaptic strength . Taken together these findings demonstrate that TNF can have a profound impact on circuit homeostasis in a manner that can provoke the pathogenesis of seizures.

      Know Your Studyselected Groups Or Population Based

      How Partial Seizures are Affected by Their Location in the Brain

      The advantage of studying a selected group of patients is that each individual can be carefully evaluated, perhaps using the latest imaging or neurophysiological techniques. The disadvantage is that patients who attend specialised clinics or hospitals tend to have relatively severe seizure problems and a worse outlook. By studying unselected groups of children or adults, population based studies have given a more optimistic view of outcome. This paper will refer particularly to three large population based studies:

      • The National Collaborative Perinatal Project which enrolled approximately 54000 pregnant American women between 1959 and 1966 and followed up their children until 7 years of age.

      • The system of medical records linkage of the Rochester Epidemiology Project which was used to identify residents of Rochester, Minnesota, USA, who had seizures.

      • The Child Health and Education Study , a birth cohort study, which enrolled over 16000 neonatal survivors born in the United Kingdom in one week in April 1970 and followed them for 10 years.

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      Rapid And Delayed Corticosteroid Effects On Neuronal Activity

      Exposure of brain cells to stress hormones will result in altered neuronal activity, after binding of the hormone to its receptor. The effect of monoamines and peptides is determined by the location of the terminals from which they are released in combination with the regional and subcellular distribution of the various receptor subtypes to which they bind as well as downstream signaling pathways . Almost without exception, this involves G-protein-coupled receptors, which upon binding of the ligand mediate actions that develop within minutes and generally are short lasting, due to dissociation of the ligand from the receptor or other processes like internalization . Still, secondary long-lasting actions frequently occur for example through the involvement of CREB .

      Fourth, in addition to the slow, delayed effects of corticosterone, rapid actions have also been described. Early studies in the seventies and eighties already suggested that corticosterone can change cellular function within minutes . This was firmly proven by a series of experiments performed in the Tasker lab . In parvocellular neurons of the paraventricular nucleus of the hypothalamus , corticosterone and dexamethasone were shown to decrease the release probability of glutamate-containing vesicles, via retrograde signaling involving the cannabinoid receptor-1. More recently, the involvement of GR rather than MR in these rapid corticosteroid actions was demonstrated, using conditional GR deletion .

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      V Implications For Age

      Imbalance in drive and feedback can develop under various conditions at different stages in life. Within a population, some individuals are more likely to develop a deficit in HPA regulation than others, differences that are presumably linked to their genotype. Environmental and experience-related factors, some originating in early life, can also add to HPA imbalance, as can psychosocial conditions . Once manifest, HPA dysfunction constitutes an added risk factor for many disorders associated with chronic stress, aging, and neurodegeneration, and/or with disturbances in cognition, mood, and affect.

      When To Get Medical Help

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      See a GP if you think you might have had a seizure for the first time.

      This does not mean you have epilepsy, as a seizure can have several causes and sometimes theyre just a one-off, but you should see a doctor to find out why it happened.

      • is having a seizure for the first time
      • has a seizure that lasts more than 5 minutes
      • has lots of seizures in a row
      • has breathing problems or has seriously injured themselves

      Treatment can help most people with epilepsy have fewer seizures or stop having seizures completely.

      Treatments include:

      • medicines called anti-epileptic drugs these are the main treatment
      • surgery to remove a small part of the brain thats causing the seizures
      • a procedure to put a small electrical device inside the body that can help control seizures
      • a special diet that can help control seizures

      Some people need treatment for life. But you might be able to stop treatment if your seizures disappear over time.

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