Part II Epilepsy

Types of seizures

I-Partial seizures (seizures beginning local)

1-simple partial seizures-(the person is conscious and not impaired).  With motor symptoms, autonomic symptoms and even psychic symptoms.

2.)-Complex partial seizures-(the person is with impairment of consciousness)

II-Generalized seizures-(bilaterally symmetrical and without local onset).

3.) Tonic clonic seizures – Grand Mal


The history of the person is the most valuable component of the workup of that individual with possible epilepsy.

The routine diagnostic tooling to see if someone has this disease is a EEG which is the major diagnostic test.  EEG takes short samples of brain wave activity with 26 wires to the scalp recording amplified brain waves from the superficial regions of the brain by means of scalp electrodes.

Laboratory studies are done to rule out various causes for seizures.  Routine blood and urine studies are often done for baseline information.  Electrolytes and blood chemistries will be evaluated to identify possible metabolic causes for seizures.

Neuropsychological testing may be done in the evaluation of persons presenting with seizures.  The purpose of neuropsychological testing is to determine if there is brain dysfunction and to determine if the pattern of change in brain function is indicative of a destructive lesion.  Neuropsychological testing involves evaluation of cognitive functions and personality and emotional traits.

Medical Management

The major medical treatment for epilepsy is antiepileptic medications.  Epileptic seizures can be controlled in 50 to 95% of cases with this form of treatment depending on seizure type and compliance of the individual taking their medications.

Those taking medications for epilepsy know if a single first line  drug is not effective a second first lin drug is added but the noneffective drug is tapered off while the second first line drug is given.  Know during this time frame there is a risk for seizure activity so practice safety (ex. do not drive).

In some cases there is surgery:  those with intractable seizures is the epileptic focus may be possible.  In some cases partial complex seizures are the common seizure treated by surgery.  The focus of this seizure type has often been found in the anterior temporal and inferior frontal regions of the brain cortex.

There are other treatments as well.

Care during a Seizure

The care of a person in a seizure should focus primarily on maintaining a safe environment.  The seizure that has greatest risk for causing injury and even fatality is the generalized tonic/clonic (grand mal), although there is a potential for injury with any seizure that involves alteration of consciousness.

The 2 major goals for care during a seizure are protection from injury and prevention of aspiration.  The person’s head should be cradled if on the floor to prevent banging of the head.  At no time should the person be restraint when having a seizure.  The person should be turned to their side to allow the tongue to fall away from the airway and allow drainage of the excessive saliva that accumulates to drain out of the mouth during the seizure.  You should stay with the person till the seizure stops and note the behavior mentally and physically the person exhibits while having the seizure and how long it lasts.  Immediately call 911 (especially if this is the first seizure the person ever had) or call the neurologist of the individual to have the him or her be evaluated ASAP.

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