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Encyclopedia > Seizure
Seizure
Classification & external resources
ICD-10 G40., I64., P90., R56.
DiseasesDB 19011
eMedicine neuro/694  neuro/415

A seizure is a temporary abnormal electro-physiologic phenomenon of the brain, resulting in abnormal synchronization of electrical neuronal activity. It can manifest as an alteration in mental state, tonic or clonic movements, convulsions, and various other psychic symptoms (such as déjà vu or jamais vu). It is caused by a temporary abnormal electrical activity of a group of brain cells. The medical syndrome of recurrent, unprovoked seizures is termed epilepsy, but some seizures may occur in people who do not have epilepsy. It has been suggested that Reflex anoxic seizures be merged into this article or section. ... Search and seizure is a legal procedure used in many common law whereby police or other authorities and their agents, who suspect that a crime has been committed, do a search of a persons property and confiscate any relevant evidence to the crime. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... // I00-I99 - Diseases of the circulatory system (I00-I02) Acute rheumatic fever (I00) Rheumatic fever without mention of heart involvement (I01) Rheumatic fever with heart involvement (I02) Rheumatic chorea (I05-I09) Chronic rheumatic heart diseases (I05) Rheumatic mitral valve diseases (I050) Mitral stenosis (I051) Rheumatic mitral insufficiency (I06) Rheumatic aortic... // P00-P96 - Certain conditions originating in the perinatal period (P00-P04) Fetus and newborn affected by maternal factors and by complications of pregnancy, labour and delivery (P00) Fetus and newborn affected by maternal conditions that may be unrelated to present pregnancy (P01) Fetus and newborn affected by maternal complications of... // R00-R99 - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R09) Symptoms and signs involving the circulatory and respiratory systems (R00) Abnormalities of heart beat (R000) Tachycardia, unspecified (R001) Bradycardia, unspecified (R002) Palpitations (R008) Other and unspecified abnormalities of heart beat (R01) Cardiac murmurs and other... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... For other uses, see Brain (disambiguation). ... Drawing by Santiago Ramón y Cajal of neurons in the pigeon cerebellum. ... MENTAL STATE Listening to music by the North Carolina band Something For You can send a person or, in some extreme cases, another animal posessing ears into a strange mental state in which a pleasurable sense is sent to the ears. ... Tonic in physiology refers to a muscle which is predominantly toned. ... Clonus may also refer to the 1979 film Parts: The Clonus Horror. ... For other uses, see Déjà vu (disambiguation). ... In psychology, the term jamais vu (from the French, meaning never seen) is used to describe any familiar situation which is not recognized by the observer. ... For other uses, see Brain (disambiguation). ...


The treatment of epilepsy is a subspecialty of neurology; the study of seizures is part of neuroscience. Neurology is a branch of medicine dealing with disorders of the nervous system. ... Drawing of the cells in the chicken cerebellum by S. Ramón y Cajal Neuroscience is a field that is devoted to the scientific study of the nervous system. ...

Contents

Signs and symptoms

Seizures can cause involuntary changes in body movement or function, sensation, awareness, or behavior. A seizure can last from a few seconds to status epilepticus, a continuous seizure that will not stop without intervention. Seizure is often associated with a sudden and involuntary contraction of a group of muscles. However, a seizure can also be as subtle as marching numbness of a part of the body, a brief loss of memory, sparkling or flashes, sensing an unpleasant odor, a strange epigastric sensation or a sensation of fear. Therefore seizures are typically classified as motor, sensory, autonomic, emotional or cognitive. For other uses, see Memory (disambiguation). ... literally, an adjective which means of, relating to or characterised by the epigastrium. An abdominal pain or an abdominal viscus might be described as epigastric. The superior and inferior epigastric arteries are considered an important feature of the anterior abdominal wall. ... In vertebrates, motoneurons (also called motor neurons) are efferent neurons that originate in the spinal cord and synapse with muscle fibers to facilitate muscle contraction and with muscle spindles to modify proprioceptive sensitivity. ... The mechanism of the reflex arc Sensory neurons (neurones) are nerve cells within the nervous system responsible for converting external stimuli from the organisms environment into internal electrical motor reflex loops and several forms of involuntary behavior, including pain avoidance. ... This article or section is in need of attention from an expert on the subject. ... For other uses, see Emotion (disambiguation). ... Cognitive The scientific study of how people obtain, retrieve, store and manipulate information. ...


In some cases, the full onset of a seizure event is preceded by some of the sensations described above. These sensations can serve as a warning to the sufferer that a full tonic-clonic seizure is about to occur. These "warning sensations" are cumulatively called an aura.[1]


Symptoms experienced by a person during a seizure depend on where in the brain the disturbance in electrical activity occurs. Recent studies show that seizures happen in sleep more often than was thought. A person having a tonic-clonic seizure may cry out, lose consciousness and fall to the ground, and convulse, often violently. A person having a complex partial seizure may appear confused or dazed and will not be able to respond to questions or direction. Some people have seizures that are not noticeable to others. Sometimes, the only clue that a person is having an absence seizure is rapid blinking or a few seconds of staring into space. Complex partial seizures are epileptic attacks which involve a greater degree of impairment of consciousness than simple partial seizures. ... In medicine, there are many kinds of generalized seizures. ...


It is commonly thought among healthcare providers that many seizures, especially in children, are preceded by tachycardia that frequently persists throughout the seizure. This early increase in heart rate may supplement an aura as a physiological warning sign of an imminent seizure. This article or section does not cite any references or sources. ...


Types

Main article: Seizure types

Seizure types are organized according to whether the source of the seizure within the brain is localized (partial or focal onset seizures) or distributed (generalized seizures). Partial seizures are further divided on the extent to which consciousness is affected (simple partial seizures and complex partial seizures). If it is unaffected, then it is a simple partial seizure; otherwise it is a complex partial seizure. A partial seizure may spread within the brain - a process known as secondary generalisation. Generalized seizures are divided according to the effect on the body but all involve loss of consciousness. These include absence, myoclonic, clonic, tonic, tonic-clonic, and atonic seizures. The numerous epileptic seizure types are most commonly defined and grouped according to a scheme proposed by the International League Against Epilepsy (ILAE) in 1981. ... Focal seizures (also called partial seizures) are seizures which affect only a small part of the brain, and are split into two main categories; simple partial seizures and complex partial seizures A simple partial seizure will often be a precursor to a larger seizure such as a complex partial seizure... A complex partial seizure is an epileptic attack that involves a greater degree of impairment or alteration of consciousness/awareness and memory than a simple partial seizure. ... In medicine, there are many kinds of generalized seizures. ... Myoclonus is brief, involuntary twitching of a muscle or a group of muscles. ... Parts: The Clonus Horror Clonus (from the Greek for violent, confused motion) is a series of involuntary muscular contractions due to sudden stretching of the muscle. ... Tonic-clonic seizures (also known as Grand Mal Seizures, though this term is now discouraged and rarely used in a clinical setting) are a type of generalised seizure affecting the whole brain. ... Atonic seizures (also called drop seizures, drop attacks, or akinetic seizures), are a minor type of seizure. ...


Following standardization proposal published in 1970, out-dated terms such as "petit mal", "grand mal", "Jacksonian", "psychomotor", and "temporal-lobe seizure" have fallen into disuse.


Diagnosis

Determining whether a seizure occurred

Differentiating a seizure from other conditions such as syncope can be difficult. In addition, 5% of patients with a positive tilt table test may have seizure-like activity that seems to be due to cerebral hypoxia.[1] This article or section does not cite its references or sources. ... Cerebral hypoxia (the pathological condition is called hypoxic encephalopathy) is to a hypoxic condition in which there is a decrease of oxygen supply to the brain or parts of the brain despite adequate blood flow (compare with cerebral ischemia). ...


Physical examination

A small study found that finding a bite to the side of the tongue was very helpful when present[2]"

The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ... The specificity is a statistical measure of how well a binary classification test correctly identifies the negative cases, or those cases that do not meet the condition under study. ...

Serum prolactin level

Two meta-analyses have quantified the role of an elevated serum prolactin. The first meta-analysis found that[3]: "If a serum prolactin concentration is greater than three times the baseline when taken within one hour of syncope, then in the absence of test "modifiers": A meta-analysis is a statistical practice of combining the results of a number of studies. ...

  1. the patient is nine times more likely to have suffered a GTCS as compared with a pseudoseizure positive LR = 8.92 (95% CI (1.31 to 60.91)), SN = 0.62 (95% CI (0.40 to 0.83)), SP = 0.89 (95% CI (0.60 to 0.98))
  2. five times more likely to have suffered a GTCS as compared with non-convulsive syncope positive LR 4.60 (95% CI (1.25 to 16.90)), SN = 0.71 (95% CI (0.49 to 0.87)), SP = 0.85 (95% CI (0.55 to 0.98)). "

The second meta-analysis found:[4]

  1. "Elevated serum prolactin assay, when measured in the appropriate clinical setting at 10 to 20 minutes after a suspected event, is a useful adjunct for the differentiation of generalized tonic-clonic or complex partial seizure from psychogenic nonepileptic seizure among adults and older children (Level B)."
  2. "Serum prolactin assay does not distinguish epileptic seizures from syncope (Level B).
  3. "The use of serum PRL assay has not been established in the evaluation of status" epilepticus, repetitive seizures, and neonatal seizures (Level U)."

The serum prolactin level is less sensitive for detecting partial seizures.[5] The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ...


EEG

An isolated abnormal electrical activity recorded by an electroencephalography examination without a clinical presentation is called subclinical seizure. They may identify background epileptogenic activity, as well as help identify particular causes of seizures. “EEG” redirects here. ...


Investigation of underlying cause

Additional diagnostic methods include CT Scanning and MRI imaging or angiography. These may show structural lesions within the brain, but the majority of those with epilepsy show nothing unusual. CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ...


As seizures have a differential diagnosis, it is common for patients to be simultaneously investigated for cardiac and endocrine causes. Checking glucose levels, for example, is a mandatory action in the management of seizures as hypoglycemia may cause seizures, and failure to administer glucose would be harmful to the patient. Other causes typically considered are syncope and cardiac arrhythmias, and occasionally panic attacks and cataplexy. For more information, see non-epileptic seizures. This article does not cite any references or sources. ... Glucose (Glc), a monosaccharide (or simple sugar), is an important carbohydrate in biology. ... Hypoglycemia (hypoglycaemia in British English) is a medical term referring to a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. ... It has been suggested that Central Ischaemic Response be merged into this article or section. ... Cardiac arrhythmia is any of a group of conditions in which the electrical activity of the heart is irregular or is faster or slower than normal. ... Panic attacks are sudden, discrete periods of intense anxiety, fear and discomfort that are associated with a variety of somatic and cognitive symptoms[1]. The onset of these episodes is typically abrupt, and may have no obvious trigger. ... Cataplexy is a medical condition which often affects people who have narcolepsy, a disorder whose principal signs are EDS (Excessive Daytime Sleepiness), sleep attacks, and disturbed nighttime sleep. ... Non-epileptic seizures are paroxysmal events that mimic an epileptic seizure but do not have a primary neurological cause within the brain. ...


Management

The first aid for a seizure depends on the type of seizure occurring. Generalized seizures will cause the person to fall, which may result in injury. A tonic-clonic seizure results in violent movements that cannot and should not be suppressed. The person should never be restrained, nor should there be any attempt to put something in the mouth. Potentially sharp or dangerous objects should also be moved from the vicinity, so that the individual is not hurt. After the seizure if the person is not fully conscious and alert, they should be placed in the recovery position. A form of the recovery position. ...


It is not necessary to call an ambulance if the person is known to have epilepsy, if the seizure is shorter than five minutes and is typical for them, if it is not immediately followed by another seizure, and if the person is uninjured. Otherwise, or if in any doubt, medical assistance should be sought.


A seizure longer than five minutes is a medical emergency. Relatives and other caregivers of those known to have epilepsy often carry medicine such as rectal diazepam or buccal midazolam in order to rapidly end the seizure. There are several definitions of caregivers or carers. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche, is a drug which is a benzodiazepine derivative. ... Buccal mucosa is mucous membrane of the inside of the cheek. ... Midazolam (marketed under brand names Versed®, Hypnovel®, Dormicum® and Dormonid®, pronounced ) is a drug which is a benzodiazepine derivative. ...


Safety

A sudden fall can lead to broken bones and other injuries. Children who are affected by frequent drop seizures may wear helmets to protect the head during a fall.


The unusual behavior resulting from the chaotic brain activity of a seizure can be misinterpreted as an aggressive act. This may invoke a hostile response or police involvement, where there was no intention to cause harm or trouble. During a prolonged seizure, the person is defenseless and may become a victim of theft.


A seizure response dog can be trained to summon help or ensure personal safety when a seizure occurs. These are not suitable for everybody. Rarely, a dog may develop the ability to sense a seizure before it occurs.[6] Seizure response dogs are a special type of service dog, specifically trained to help someone who has epilepsy. ...


Seizures without epilepsy

Unprovoked seizures are often associated with epilepsy and related seizure disorders. Epilepsy (often referred to as a seizure disorder) is a chronic neurological condition characterized by recurrent unprovoked seizures. ...


Causes of provoked seizures include:

epileptics, especially those who are sensitive to its effects Some medications produce an increased risk of seizures and electroconvulsive therapy (ECT) deliberately sets out to induce a seizure for the treatment of major depression. Many seizures have unknown causes. Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ... ... Aminophylline is a drug combination that contains theophylline and ethylenediamine in 2:1 ratio. ... Cetacaine, a typical topical anesthetic Anesthesia or anaesthesia (see spelling differences), is the process of blocking the perception of pain and other sensations. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... An infection is the detrimental colonization of a host organism by a foreign species. ... Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. ... Meningitis is the inflammation of the protective membranes covering the central nervous system, known collectively as the meninges. ... This article needs additional references or sources for verification. ... A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature. ... Structure of the coenzyme adenosine triphosphate, a central intermediate in energy metabolism. ... Hypoglycemia is a medical term referring to a pathologic state produced and usually defined by a lower than normal amount of sugar (glucose) in the blood. ... Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply. ... Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, and slowed breathing, as well as slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... Grain alcohol redirects here. ... Barbiturates are drugs that acts as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ... For the death metal band, see Abscess (band). ... For malignant tumors specifically, see cancer. ... Electroconvulsive therapy (ECT), also known as electroshock, is a controversial psychiatric treatment in which seizures are induced with electricity for therapeutic effect. ...



Seizures which are provoked are not associated with epilepsy, and people who experience such seizures are normally not diagnosed with epilepsy. However, the seizures described above resemble those of epilepsy both outwardly, and on EEG testing. EEG can mean: Electroencephalography - the method and science of recording and interpreting traces of brain electrical activity as recorded from the skull surface or the device used to record such traces Emperor Entertainment Group - A Hong Kong entertainment company. ...


See also

Photosensitive epilepsy is a form of epilepsy in which seizures are triggered by visual stimuli that form patterns in time or space, such as flashing lights, bold, regular patterns, or regular moving patterns. ... // Introduction Psychogenic non-epileptic seizures are a manifestation or a form of conversion disorder. ... There are very few or no other articles that link to this one. ...

References

  1. ^ Passman R, Horvath G, Thomas J, et al (2003). "Clinical spectrum and prevalence of neurologic events provoked by tilt table testing". Arch. Intern. Med. 163 (16): 1945-8. doi:10.1001/archinte.163.16.1945. PMID 12963568. 
  2. ^ Benbadis SR, Wolgamuth BR, Goren H, Brener S, Fouad-Tarazi F (1995). "Value of tongue biting in the diagnosis of seizures". Arch. Intern. Med. 155 (21): 2346-9. PMID 7487261. 
  3. ^ Ahmad S, Beckett MW (2004). "Value of serum prolactin in the management of syncope". Emergency medicine journal : EMJ 21 (2): e3. PMID 14988379. 
  4. ^ Chen DK, So YT, Fisher RS (2005). "Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology". Neurology 65 (5): 668-75. doi:10.1212/01.wnl.0000178391.96957.d0. PMID 16157897. 
  5. ^ Shukla G, Bhatia M, Vivekanandhan S, et al (2004). "Serum prolactin levels for differentiation of nonepileptic versus true seizures: limited utility". Epilepsy & behavior : E&B 5 (4): 517-21. doi:10.1016/j.yebeh.2004.03.004. PMID 15256189. 
  6. ^ Dalziel D, Uthman B, Mcgorray S, Reep R (2003). "Seizure-alert dogs: a review and preliminary study". Seizure 12 (2): 115-20. PMID 12566236. 

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links

Look up Seizure in
Wiktionary, the free dictionary.
  • MEDLINEplus: Seizures
  • Epilepsy and seizure information for patients and health professionals : Epilepsy.com

  Results from FactBites:
 
Seizure - Wikipedia, the free encyclopedia (1288 words)
Seizures (or convulsions) are temporary abnormal electrophysiologic phenomena of the brain, resulting in abnormal synchronization of electrical neuronal activity.
However, a seizure can also be as subtle as marching numbness of a part of body, a brief loss of memory, sparkling of flashes, sensing an unpleasant odor, a strange epigastric sensation or a sensation of fear.
As seizures have a differential diagnosis, it is common for patients to be simultaneously investigated for cardiac and endocrine causes.
Febrile seizure - Wikipedia, the free encyclopedia (475 words)
A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature.
Febrile seizures represent the meeting point between a low seizure threshold (genetically and age determined) - some children have a greater tendency to have a seizure under certain circumstances - and a trigger: fever.
It is reassuring if the cause of seizure can indeed be determined to have been fever, as simple febrile seizures generally do not cause permanent brain injury; do not tend to recur frequently, as children tend to 'out-grow' them; and do not make the development of adult epilepsy significantly more likely.
  More results at FactBites »

 
 

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