Does Type Of Epilepsy Play A Role
There are many different types of seizures, all with different characteristics. According to the National Institute of Neurological Disorders and Stroke, doctors have identified over 30 different types of seizures.
As such, research findings may not translate across different seizure types. For example, whats true for someone with temporal lobe epilepsy may not be true for an individual with a different type of epilepsy.
The effectiveness of medications may also play a role. For example, someone whose seizures can be managed using antiseizure medications may not experience the same effects as an individual with epilepsy whos body is resistant to medications.
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.
Diagnosis Of Seizure Disorders
A doctor’s evaluation
If the person has never had a seizure before, blood and other tests, imaging of the brain, and usually electroencephalography
If a seizure disorder has already been diagnosed, usually blood tests to measure levels of antiseizure drugs
The diagnosis of a seizure is based on symptoms and the observations of eyewitnesses. Symptoms that suggest a seizure include loss of consciousness, muscle spasms that shake the body, a bitten tongue, loss of bladder control, sudden confusion, and inability to pay attention. Doctors diagnose a seizure disorder when people have at least two unprovoked seizures that occur at different times.
People who lose consciousness, sometimes even when they lose muscle tone and muscles jerk, may not be having a seizure. A brief loss of consciousness is more likely to be fainting than a seizure.
People are usually evaluated in an emergency department. If a seizure disorder has already been diagnosed and people have completely recovered, they may be evaluated in a doctors office.
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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.;
The Effects Of Epilepsy On The Body
Epilepsy is a condition that causes seizures temporary glitches in the brains electrical activity. These electrical disruptions can cause a range of symptoms. Some people stare off into space, some make jerky movements, while others lose consciousness.
Doctors dont know what causes epilepsy. Genes, brain conditions like tumors or strokes, and head injuries may be involved in some cases. Because epilepsy is a brain disorder, it can affect many different systems throughout the body.
Epilepsy may stem from changes in the brains development, wiring, or chemicals. Doctors dont know exactly what causes it, but it can start after an illness or damage to the brain. The disease disrupts the activity of brain cells called neurons, which normally transmit messages in the form of electrical impulses. An interruption in these impulses leads to seizures.
There are many different kinds of epilepsy, and different types of seizures. Some seizures are harmless and barely noticeable. Others can be life-threatening. Because epilepsy disrupts brain activity, its effects can trickle down to affect just about every part of the body.
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What Are Some Of The Important Technical And Experimental
The challenges and controversies concerning how to evaluate whether neuronal death has occurred and how to quantify it are substantial. Even when one only considers a fraction of the methodological and protocol-related issues, the additional factors involving what, where, and when of neuronal death add further complexity to the potential analyses and interpretations. Additional disagreement surrounds the question What is a seizure? and the problem of what comprises an adequate animal model of acquired epilepsy.
Do Seizures Cause Brain Damage
The relationship between seizures and brain damage can be cyclical. On the one hand, seizures can lead to brain injury; on the other hand, a brain injury can result in seizures later on.;
Seizures Causing Brain Injury
Scientific evidence and research have long shown that prolonged seizures can kill brain cells and cause other damage. More recent research also suggests that smaller, recurring seizures can also contribute to nerve cell injury within the brain. This can be associated with cognitive decline and an erosion in the patients quality of life.;
Seizure-induced brain damage can be highly dependent on the age and developmental stage of the patient. Adult and juvenile brains are more susceptible to damage after seizures than are the brains of newborns and infants. Again, the damage and changes in brain functioning depend highly on the type of seizure or epilepsy involved.;
Brain Injury Leading to Seizures
Additionally, the type of brain injury can often dictate the likelihood that the victim will experience a post-traumatic seizure. Consider the following statistics:
To summarize, prolonged seizures can result in brain damage, while recurring seizures can also have adverse effects on brain functioning. In turn, traumatic brain injuries can also lead to various types of seizures, which may cause further damage.;
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What Do You Wish More People Knew About Epilepsy
Epilepsy is quite a common disorder. It affects about 1% of the population, or about 3 million people in the U.S. The first approach to treating it is to use medication, but about a third of those people still have seizures despite the best medical therapy.
Having epilepsy can be frustrating, especially for someone who feels like they’ve made no progress controlling it. But there’s a lot of support out there, and groups are constantly working on new treatments. Don’t be shy about reaching out to see what other options are available.
Rewiring Of Brain Circuitry
Recurrent seizures in the developing human brain is associated with adverse and widespread impairments of the growth and development of both the structure and the function of the brain. Besides killing cells, epileptic seizures adversely alter brain function in other ways as well. Memory deficits, behavioral modifications, and mood disorders can be triggered by these changes. The modifications in the brain and the birth of new cells can also cause further seizures., ;,
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Focal Seizure That Becomes Generalized
A focal seizure that becomes generalized begins with one part of the body and then spreads to the entire body. Unless you watch closely, it may look like the child has had a generalized seizure because the focal seizure may be so short that it is missed.
This type of seizure begins with nerve cells having extra discharges in one part of the brain. This then spreads and affects the whole brain. For a more detailed description of the various types of generalized seizures, refer to the Helping Hand:;Seizures: Generalized, HH-I-182.
What Is The Focus Of Recent Epilepsy Research
There are still some very big questions about epilepsy, including how it starts in the brain. For people who have seizures that continue despite the best medication that doctors provide, surgery is an option. The only way that surgery can be useful, though, is if we can identify the exact spot in the brain that’s causing the seizures. Our research has been focused on trying to pinpoint those spots and identify which areas are most likely to be involved in seizure activity.
“For people who have seizures that continue despite the best medication that doctors provide, surgery is an option.”
Kareem Zaghloul, M.D., Ph.D.
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When To Get Emergency Help
It is important to remember that seizures usually do not cause brain damage, unless they last for more than 30 to 60 minutes. However, you should call for emergency help if any of the following occurs:
- Your child has trouble breathing during the seizure and the child’s color changes.
- The seizure lasts more than 5 minutes, or if a cluster of seizures lasts more than 5 minutes.
- Your child chokes on secretions .
- Your child is injured during a fall or during the seizure and requires first aid .
- Have someone stay close to your child after the seizure. Within 30 minutes you should be able to get some response from him, such as opening his eyes, pushing you away or beginning to arouse. If you cannot get any response from your child within 30 minutes after the seizure, you should get emergency help. For more information on how to care for your child during a seizure, refer to the Helping Hand: Seizure Care, HH-I-61.
If you have any questions, please ask your childs doctor or nurse.
If you need to speak with someone after regular office hours, call the hospital operator at 722-2000 and ask to speak with the neurology physician on call.
Prognosis Of Seizure Disorders
With treatment, one third of people with epilepsy are free from seizures, and most become seizure-free shortly after starting treatment. In another third, seizures recur less than half as often as they did before treatment. If seizures are well-controlled with drugs, about 60 to 70% of people can eventually stop taking antiseizure drugs and remain seizure-free.
Epileptic seizures are considered resolved when people have been seizure-free for 10 years and have not taken antiseizure drugs for the last 5 years of that time period.
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Stimulation Of The Vagus Nerve
Electrical stimulation of the 10th cranial nerve can reduce the number of focal-onset seizures by more than one half in about 40% of people who have focal-onset seizures. This treatment is used when seizures continue despite use of antiseizure drugs and when surgery is not a possibility.
The vagus nerve is thought to have indirect connections to areas of the brain often involved in causing seizures.
For this procedure, a device that looks like a heart pacemaker is implanted under the left collarbone and is connected to the vagus nerve in the neck with a wire that runs under the skin. The device causes a small bulge under the skin. The operation is done on an outpatient basis and takes about 1 to 2 hours.
The device is programmed to periodically stimulate the vagus nerve. Also, people are given a magnet, which they can use to stimulate the vagus nerve when they sense that a seizure is about to begin. Vagus nerve stimulation is used in addition to antiseizure drugs.
Side effects of vagal nerve stimulation include hoarseness, cough, and deepening of the voice when the nerve is stimulated.
Aspects Of The Brain Affected By Different Brain Seizure
The emergence of a brain seizure can be down to several reasons, but determining the exact cause has proven to be challenging. At least half of all patients display idiopathic seizures meaning the cause is unknown. Nevertheless, depending on the age of the patient, determining the trigger of a brain seizure can be narrowed down.
Generally, genetics plays a large role whether someone will experience a seizure in their lives or not. Pinpointing the specific genes which are responsible for the symptoms though is a struggle. This diagnosis is mostly very vague as the relationship between the genes in the brain and the nature of seizures is poorly understood.
What is known on the other hand is a prevalence of about 3 out of 10 patients having a change in brain structure which leads to some sort of brain seizure. Mostly this is the case for children born with alterations in brain regions. ;For the elderly, incidence such as a stroke is usually the cause of developing recurrent seizures.
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Focal Seizures: What Happens
Focal seizures can start in one part of the brain and spread to other areas, causing symptoms that are mild or severe, depending on how much of the brain becomes involved.
At first, the person may notice minor symptoms, which is referred to as an aura. The person may have altered feelings or sense that something is about to happen . Some people experiencing an aura describe a rising sensation in the stomach similar to riding on a roller coaster.
As the seizure spreads across the brain, more symptoms appear. If the abnormal electrical activity involves a large area of the brain, the person may feel confused or dazed, or experience minor shaking, muscle stiffening, or fumbling or chewing motions. Focal seizures that cause altered awareness are called focal unaware seizures or complex partial seizures.
The electrical activity of the seizure can remain in one sensory or motor area of the brain, resulting in a focal aware seizure . The person is aware of what is happening, and may notice unusual sensations and movements.
Focal seizures can evolve into major events that spread to the entire brain and cause tonic-clonic seizures. These seizures are important to treat and prevent since they can cause respiratory problems and injuries.
How Can I Help Research On Epilepsy
There are many ways that people with epilepsy and their families can help with research on this disorder. Pregnant women with epilepsy who are taking antiepileptic drugs can help researchers learn how these drugs affect unborn children by participating in the Antiepileptic Drug Pregnancy Registry, which is maintained by the Genetics and Teratology Unit of Massachusetts General Hospital . People with epilepsy that may be hereditary can aid research by participating in the Epilepsy Gene Discovery Project, which is supported by the Epilepsy Foundation. This project helps to educate people with epilepsy about new genetic research on the disorder and enlists families with hereditary epilepsy for participation in gene research. People who enroll in this project are asked to create a family tree showing which people in their family have or have had epilepsy. Researchers then examine this information to determine if the epilepsy is in fact hereditary, and they may invite participants to enroll in genetic research studies. In many cases, identifying the gene defect responsible for epilepsy in an individual family leads researchers to new clues about how epilepsy develops. It also can provide opportunities for early diagnosis and genetic screening of individuals in the family.
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When To Get Medical Help
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 they’re 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.
- medicines called anti-epileptic drugs; these are the main treatment
- surgery to remove a small part of the brain that’s 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.
What Treatments Are Available
Medication Your doctor may prescribe a drug called an antiepileptic drug, or anticonvulsant, used to treat seizures. These drugs are taken every day, sometimes several times a day, for as long as needed. The drugs help control the seizures. There are over two dozen medications for seizures. Common anticonvulsants include Dilantin , Tegretol , Depakote , and phenobarbital. Several recent medications, such as Lamictal , Neurontin , Cerebyx , Keppra , and Felbatol , have been approved since 1993 for the treatment of seizure disorders. These drugs may be used alone or in combination with each other when seizures are difficult to control.
Your doctor may prescribe anticonvulsants briefly after you have had brain surgery, head trauma, or a cerebral hemorrhage. If you have no seizures, the dosage of the drug is usually tapered until it is stopped within a short time. However, that time period may vary, based on your condition and specific problem.
As with all drugs there are side effects and drug interactions. Most common side effects include fatigue, drowsiness, nausea, and blurred vision. Also, these drugs may reduce the effectiveness of birth control pills.
Surgery If medications do not control your seizures, then surgery in the portion of the brain responsible for your seizures may treat the condition. If this is the case, you should discuss this option with your doctor .