EPILEPSY

EPILEPSY

DEFINITION

EPILEPSY is a recurrent paroxysmal cerebral dysrhythmia with abnormal paroxysmal neuronal discharge in the brain, with or without fit.

TYPES

1. Idiopathic. No. specific cause is present and no pathologic change is present.

2. Symptomatic or Secondary.

CAUSES OF SYMPTOMATIC OR SECONDARY EPILEPSY

General causes

Poisons

Alcohol, cocaine, cardiazole, picrotoxin, lead, organophosphorus compounds (insecticides) etc.

Metabolic Disturbances

Uraemia (Renal failure), cholaemia (Hepatic encephalopathy), ecclampsia, hypo and hyperglycaemia, porphyria, pyridoxine deficiency.

Cerebral Anoxia

Asphyxia, carbon monoxide and nitrous oxide poisoning, heart block.

Allergy

Asthma or related conditions.

Undetermined causes

Teething, fever, helminthic infestation.

Infection and infestations

Cerebral malaria, tetanus, AIDS.

Degenerative

Alzheimer’s disease.

Local causes

Vascular lesions

Cerebrovascular disease such as cerebral thrombosis, haemorrhage, cerebral embolism, hypertensive encephalopathy.

Trauma

Birth injury, head injury

Space occupying lesions

Cerebral tumours, abscess, subdural haematoma.

Inflammatory

Encephalitis, meningitis, general paralysis of insane, meningovascular syphilis etc.

Congenital

Tuberose sclerosis, congenital cerebral diplegia, gumma hydrocephalus.

Degenerative conditions

Pressure, dementias.

Classification of Idiopathic Epilepsy

Generalised seizure

(a) Grand mal epilepsy or major epilepsy or tonic clonic seizure.

(b) Status epilepticus

(c) Absence seizure (petit mal epilpsy)-Typical or Atypical.

(d) Myoclonic seizure.

(e) Tonic seizure.

(f) Akinetic seizure.

Partial seizure (Focal seizures)

(a) Simple (consciousness present).

(b) Complex (consciousness lost).

(c) Focal onset leading to tonic seizure.

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