Epilepsy
*It is not a disease but it is a symptom of disease. *A seizure is a transient disturbance of cerebral function caused by abnormal neuronal discharge. *Epilepsy is the tendency to have recurrent seizure due to chronic underlying cause.Epidemiology
*Epilepsy is a common cause of disturbed level of consciousness. *Incidence of epilepsy is 45/100000. *Prevalence of epilepsy is 0,5%. *The life time probability of a seizure is approximately 3%.Classification
*Essential for diagnostic approach,selection therapy,providing information about prognosis. *It is based on clinical features and EEG findings. *Partial seizures subdivided into;simple,complex,with secondary generalization.Classification
*Primary generalized epilepsy subdivided into;tonic-clonic,tonic,absence,atonic and myoclonic seizures. *Unclassified include;neonatal seizures,infantile seizures and epilepsy syndromes.Seizure Dx
*The circumstances of the attack.*Whether injury or incontinence has occurred.*The occurrence of aura +/- post –ictal todd’s paresis.Clinical Dx
History *Details of events from a witness. *Birth details and historyof febrile convulsion. *Previous trauma or intracranial infections. *Family history of epilepsy or neurological disorders.
Clinical Dx
*History of alcohol ingestion or drug abuse. Examination *Skin;signs of neurofibromatosis or tuberous sclerosis. *Blood pressure ;if any postural drop. *Pulse;if irregular consider emboli or arrythemia.Clinical Dx
*heart murmer ;emboli,valve disease,or atrial myxoma. *Liver & spleen;alcohol,and lymphoma. *Limb asymmetry;in cerebral palsy. *cranial bruits;in AVM and in atheroma. *Anosmia; in subfrontal meningioma.Clinical Dx
*Optic disc; papilloedema in mass lesion. *Visual field abnormality;in mass lesion. *Limb asymmetry;in mass lesion. *Planter asymmetry;in mass lesion. *Reflex asymmetry;in mass lesion.Etiology
Primary neurological disease *febrile convulsion. *idiopathic epilepsy. *head injury. *stroke or AVM. *mass lesion.Etiology
*meningitis or encephalitis. *HIV encephalopathy. Systemic diseases *hypoglycemia. *hyponatremia. *hyperosmolar states.Etiology
*hypocalcemia. *uremia. *hepatic encephalopathy. *drug overdose or withdrawal. *hypertensive encephalopathy or eclampsia. *global cerebral ischemia or hyperthermia.