1. Fereshteh Ashtari MD Professor of Neurology I sfahan University of Medical Sciences

2.  بروز علائم و حالات پاروکسیسمال و ناگهانی در اثرفعالیت الکتریکی غیر طبیعی و زیاد نرونهای مغز.  علائمی که در اثر تشنج ایجاد می شود بر اساس محل بروز دیسشارژ متفاوت است.  این علائم بطور ناگهانی ایجاد شده و بطور کوتاه باعث بروز اختلال هوشیاری یا اختلالات حرکتی و یا حسی در بیمار می گردد.  اگر تشنج جزء حرکتی داشته باشد بنام Convulse خوانده می شود.

3.  شرایطی که در ان فرد دچار حملات تشنج متناوب می گردد.  یک بار تشنج و یا تکرار تشنج در شرایط خاصی که قابل پیشگیری است صرع خوانده نمی شود.

5.  Epilepsy: two or more unprovoked seizure.  Incidence : 0.3-0.5%.  Prevalence: 0.5-1%

9.  birth trauma  congenital (present at birth) problems  fever  metabolic or chemical imbalances in the body

10.  alcohol or drugs  head trauma  infection  unknown reasons

11.  staring  jerking movements of the arms and legs  stiffening of the body  loss of consciousness  breathing problems or breathing stops  loss of bowel or bladder control  falling suddenly for no apparent reason  not responding to noise or words for brief periods  appearing confused or in a haze  sleepiness and irritable upon waking in the morning  periods of rapid eye blinking and staring

12.  Activation by sleep deprivation, photic stimulation, and/or hyperventilation  Normal : do not exclude the possibility of epilepsy.

16.  Partial (focal):the seizure activity is restricted to discrete areas of the cerebral cortex. usually associated with structural abnormalities of the brain.  Generalized : involve diffuse regions of the brain simultaneously.  Result from cellular biochemical or structural abnormalities that have a more widspread distribution.

17.  Partial seizure:  simple: consciousness is fully preserved during the seizure.  Complex: consciousness is impaired.  the symptomatology is more complex and the seizure is termed complex partial seizure.

18.  Simple partial seizure  Complex partial seizure  Secondary generalized seizure

19.  Simple partial seizure:  motor,  sensory,  autonomic  or psychic symptoms without alteration in consciousness.

20.  Complex partial seizure:  Frequently begin with an aura  Ictal phase : often sudden behavioral arrest or motionless stare whitch marks the onset of the period of amnesia.  Accompanied by automatisms( involuntary automatic behaviors that have a wide range manifestations such as chewing, lip smacking, swallowing,...)  Secondary generalized seizure

21.  Aura  Ictal : automatism, GMS  Postictal  15-30 y

22.  Arise from both cerebral hemispheres simultaneously.  Absence  Primary tonic clonic seizure  Myoclonic epilepsy

23.  Sudden, brief laps of consciousness without loss of postural control  seconds  No postictal confusion  Begin in childhood(4-8)  May recurs hundreds times  EEG is characterized

24.  2-15 s  5-15 y  After awaking  Exacerbate by hyperventilation,exersise  Simple, complex

26.  Begin abruptly without warning  No aura  Initial phase is tonic contraction of muscles ( ictal cry, contraction of jaw and tongue biting, apnea  Clonic phase  Post ictal

27.  STAGES:  Perodormal  Aura  Tonic  Clonic  postictall

28.  Atonic seizure: sudden loss of postural muscles lasting 1-2 sec  Consciousness briefly impaired but usually no post ictal confusion

29.  Sudden and brief muscle contraction  One part of body or entire the body.  Sudden jerking movement

31.  Disorders in which epilepsy is predominant features and there is sufficient evidences to suggest common underlying mechanisms'.  Juvenile myoclonic epilepsy  Lennox-Gastaut syndrom  Mesial temporal lobe epilepsy syndrome

32.  4-7 momth  Clinical findings?  With brain anomalies,metabolic errors disease and tuberous sclerosis,

33.  unknown cause  early adolescence  bilateral myoclonic jerks In the morning after awakening and can be provoked by sleep deprivation. . Many patients also experience generalized tonic- clonic seizures, and up to one-third have absence seizures.  The condition is otherwise benign,  There is often a family history of epilepsy, and genetic linkage studies suggest a polygenic cause.

34.  Drop attack  1s  6-7 years of old

35.  Tonic, clonic, tonic clonic, absence, atonic  1-10 more in 3-5 yearls of old  Primary  Secondary  Hemiplegia, paraplegia,hydrocephalus, microcephalus in 20%