1. Lecturer: Dr Lucy Patston lpatston@unitec.ac.nz

2.  Thank you to the following 2013 Year Two students who devoted their time and effort to developing the following seminar topic:  Fiona Bilbrough  Some content may differ from that originally created by these students

3.  A recurrent episode of abnormal electrical impulses in the brain  Excessive cortical discharges are manifested by skeletal motor function, behaviour and consciousness  Different types of seizures but it is always due to bursts of electrical activity in the brain  Caused by a chemical imbalance responsible for the transmission of impulses  Seizures are classified based on the clinical symptoms and by electroencephalographic features  Short term memory can be affected

4. ‘Under the right circumstances anyone can have a seizure’ (Copstead, 2009)  It affects 1-2% of the population  1 in 50 people will have epilepsy at some point in their life  50-80% of people with epilepsy can control their symptoms either through lifestyle or medication  Can be due to: head injury, strokes, birth trauma, toxins, brain infection, brain diseases, genetic, drug abuse or it can be unknown ‘Epilepsy is the most common serious brain disorder worldwide. It has no age, racial, social class, national, or geographic boundaries’ Source: World Health Organisation (WHO)

5.  Symptoms are not constant  Length of time can vary between seizures  Type of seizure can sometimes change  Often people cannot recognise a seizure  Initial onset may not be predictable  If the seizure is a result of a structural change it may not develop for months / years  Genetics is a contributing factor but not necessarily a cause Retrieved from: www.epilepsycareandresearchfoundation.com/

6.  Forgetting to take medication  Stress  Lack of food / nutrients  Lack of sleep  Caffeine / Alcohol  Drug Abuse  Flickering light or changes in light  Even certain types of muscle weaknesses can cause a seizure  Often there is no real reason for a seizure

7.  A seizure occurs due to a change in membrane potential  Makes the neurons abnormally hyperactive or hypersensitive to changes in the environment  Abnormal neurons form an epileptogenic focus (where the seizures come from)  Neurons may recruit neurons in adjacent areas, also synaptically related areas in distant areas of the brain  Recruitment can also come from neurons in the opposite hemisphere How these abnormal neurons recruit will identify the type of seizure the person is having

8.  Partial  focal seizures where only part of the brain is involved; only one hemisphere is normally involved  General  where the whole brain is involved  Spreads to the thalamus and reticular activating systems Loss of consciousness

9. Retrieved from www.medicalook.com

10.  Atonic  Drop attack; complete loss of muscle tone  Clonic  Jerking of muscle groups  Tonic  Stiffening of muscle groups  Tonic-Clonic / Grand Mal  Loss of consciousness, followed by muscle rigidity, they then fall, then muscles will jerk,  They may give out a high pitch cry, eyes may roll and saliva production may increase, and bowel and bladder incontinence may occur  Status epilepticus  Series of seizures without any recovery between seizure episodes.  Can occur with any type of seizure – concern is with Grand Mal seizures  Irreversible brain damage and possible death from hypoxia, cardiac arrest

11.  Absence  Occurs normally in children  Children with poor academic performance  ‘Space cadets’  Staring spells that last 2-10 seconds  The individual is unaware of their surrounding environment  Usually motionless BUT not unusual for the person to continue walking or performing a motor task  Conversation – may miss a couple of words  10% of children with this will develop tonic – clonic seizures  Atypical Absence  Has a ‘myoclonic jerk at the start

12.  Simple partial ◦ No change in level of consciousness ◦ Symptoms may be motor, sensory, autonomic or a combination of the three ◦ In the form of numbness or tingling that moves around or jerking part of the body  Complex partial ◦ Loss or alteration of consciousness ◦ May become aggressive or display out of character episode ◦ After the seizure the person may feel very drowsy  Partial seizures that are secondarily generalised ◦ Begin as a simple partial seizure then progress to involve both hemispheres ◦ Progress to become a Grand Mal seizure

13.  It will depend on the individual  Electroencephalograms (EEGs) may be used between seizures with potential activation techniques  Initial studies may rule out any structural changes through computed tomography (CT) or magnetic resonance imaging (MRI)  Treatment during a seizure is protecting the individual from injury and ensuring the airway is open  If seizures are due to a tumour – removing it will help  Anticonvulsant medication is most often used as a prevention – if there has been no seizures for three years then it can be withdrawn  Avoiding the triggers  If medication does not work – surgical options can be considered e.g. vagal nerve stimulation with partial –onset seizures may help

14.  http://www.epilepsy.org.nz/ http://www.epilepsy.org.nz/  https://www.youtube.com/watch?v=2HFfx- V-yPI https://www.youtube.com/watch?v=2HFfx- V-yPI