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Epilepsy. By Kat, Phoebe & Krupa. What is it. Episodic spontaneous seizures resulting from paroxysmal uncontrolled discharge of neurons within the CNS Its caused by a dysbalance between the excitatory and inhibitory systems. Neurotransmitters. GABA – main inhibitory neurotransmitter
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Epilepsy By Kat, Phoebe & Krupa
What is it • Episodic spontaneous seizures resulting from paroxysmal uncontrolled discharge of neurons within the CNS • Its caused by a dysbalance between the excitatory and inhibitory systems
Neurotransmitters • GABA – main inhibitory neurotransmitter • Most highly concentrated in substantianigra and globuspallidus • Glutamate – precursor of GABA • Therefore a lack of glutamate leads to a lack of GABA which results in epilepsy
What causes epilepsy • Stimuli are not always necessary • But they can be: • Endogenous • Exogenous They can be due to infection, hormonal dysbalance, visual or auditory stimuli, visual stimuli (photosensitive epilepsy)
Seizure type • Generalized - bilateral A seizure whose initial semiology indicatesmore than minimal involvement of both cerebral hemispheres. Can be grand mal or petit mal • Focal-unilateral A seizure whose initial semiology indicates activates only part of one cerebral hemisphere.
Course of seizure • Prodrome= mood or behavioural change preceding the attack • Aura = symptoms just before the attacks (specific sensation) • Attack = seizure • Postictal period = time immediately after the attack – confusion, disorientation, automatic behaviour
Petit Mal – usually in children 1. Absentia petit mal (<30secs) • Sudden loss of consciousness- break of activity • EEG – spike round wave 2. Myoclonic petit mal – puberty • Sudden cramp of upper limbs • No loss of consciousness 3. Akinetic – no movements • pre-school age • Sudden flexors cramp • Short unconsciousness
Grand Mal –deep unconsciousness • Tonic phase (fall) • General spasm of muscles • stop of respiration – cyanosis • Mydriasis– no light reaction • Clonic Phase • About 2mins • Symmetrical cramps • Post-Paroxysmal Phase • Unconsciousness • Respiratory difficulties • Amnesia, confusion, aggressiveness
Status Epilepticus • Serious complication • 5-10% ends in death • Uninterrupted grand mal seizures • Constant unconsciousness • Heart, lung failure and brain oedema occur
references • Pathophysiology – basic overview for medical students, by Kuba and Kubova • Department of Neurology -MUDr. Helena Hojdíková • www.wikipedia.com