What is Epilepsy?
Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. It’s also called a seizure disorder. When a person has two or more unprovoked seizures, they are considered to have epilepsy.
A seizure happens when a brief, strong surge of electrical activity affects part or all of the brain. One in 10 adults will have a seizure sometime during their life.
Seizures can last from a few seconds to a few minutes. They can have many symptoms, from convulsions and loss of consciousness to some that are not always recognized as seizures by the person experiencing them or by health care professionals: blank staring, lip smacking, or jerking movements of arms and legs.
Introduction
Seizures happen when the electrical system of the brain malfunctions. Instead of discharging electrical energy in a controlled manner, the brain cells keep firing. The result may be a surge of energy through the brain, causing unconsciousness and contractions of the muscles.
If only part of the brain is affected, it may cloud awareness, block normal communication, and produce a variety of undirected, uncontrolled, unorganized movements.
Most seizures last only a minute or two, although confusion afterwards may last longer. An epilepsy syndrome is defined by a collection of similar factors, such as type of seizure, when they developed in life, and response to treatment.
The Brain and Epilepsy
The human brain is the source of human epilepsy. Although the symptoms of a seizure may affect any part of the body, the electrical events that produce the symptoms occur in the brain. The location of that event, the extent of its reach with the tissue of the brain, and how long it lasts all have profound effects.
A child's brain contains billions of nerve cells. They communicate with each other through tiny electrical charges that fire on and off in random fashion. When some or all of these cells suddenly begin to fire together, a wave of electrical energy sweeps through the brain, causing a seizure.
Some people use the term "seizure disorder" instead of "epilepsy" to describe this condition. Both mean the same thing -- an underlying tendency to experience seizures.
Often Starts in Childhood
While epilepsy can begin at any time of life, fifty percent of all cases begin before the age of 25. Many start in early childhood.
One reason is that immature brains are more susceptible to seizures from any cause.
Seizure Triggers
Some people who have epilepsy have no special seizure triggers, while others are able to recognize things in their lives that do affect their seizures. Keep in mind, however, that just because two events happen around the same time doesn't mean that one is the cause of the other. Generally, the most frequent cause of an unexpected seizure is failure to take the medication as prescribed. That's the most common trigger of all. Other factors include ingesting substances, hormone fluctuations, stress, sleep patterns and photosensitivity.
Seizures interfere with the child's normal brain functions.They produce sudden changes in consciousness, movement, or sensation.
Having a single seizure does not mean a child has epilepsy -- epilepsy is the name for seizures that happen more than once without a known treatable cause, such as fever or low blood sugar.
Possible Causes
Pinpointing the cause of epilepsy is difficult at any age. In seven out of every ten cases, there is no known cause and they are labeled as having idiopathic epilepsy. "Idiopathic" is a latin word meaning "of unknown cause."
There are many possible causes in children. These include problems with brain development before birth; lack of oxygen during or following birth; a head injury that leaves scaring on the brain; unusual structures in the brain; tumors; a prolonged seizure with fever, or the after-effects of severe brain infections such as meningitis or encephalitis. When a cause can be identified, these children are labeled as having symptomatic epilepsy. The seizures are felt to be a symptom of the underlying brain injury.
Types of Seizures
There are many different types of seizures *explained later*. People may experience just one type or more than one. The kind of seizure a person has depends on which part and how much of the brain is affected by the electrical disturbance that produces seizures. Experts divide seizures into generalized seizures (absence, atonic, tonic-clonic, myoclonic), partial (simple and complex) seizures, nonepileptic seizures and status epilepticus.
When the electrical disturbance involves the whole brain, the seizure is called generalized. When only part of the brain is affected, it is called partial. If the electrical disturbance starts in one part of the brain and then spreads, it is called a partial seizure secondarily generalized.
Some children have just one type of seizure, others have two or more.
All the types of seizures Braeden has will be marked with an asterisk*
Generalized seizures
*Generalized tonic clonic (Grand Mal)* <Braeden's are heat induced either by over-exposure to heat or over-exertion as he can not regulate his internal body temperature>
Often called a convulsion, it starts with a sudden cry, fall, body stiffness followed by jerking movements as muscles tense, then relax, tense and relax. Breathing may be shallow or stop briefly. Skin may be bluish. Possible loss of bladder or bowel control as muscles relax. Usually lasts a minute or two, after which normal breathing returns. Child may be confused or tired afterwards and fall into a deep sleep. May complain of sore muscles or bitten tongue.
*Absense*
A blank stare, beginning and ending abruptly, lasting only a few seconds, often frequent, May be accompanied by rapid blinking, upward rolling of the eyes, chewing movements. Children may drop what they are holding. Out of touch during seizure, but they quickly return to full awareness once it stops. Often mistaken for daydreaming or inattention.
*Atonic (also called drop attack)*
A sudden loss of muscle tone makes the child collapse and fall. In some children all that happens is a sudden drop of the head. After a few seconds to a minute he or she recovers, regains consciousness. Drop attacks can cause injuries because of the force of the fall. Protective helmets may help, at least when the child is playing outside.
*Myoclonic*
Sudden, brief, involuntary muscle jerks, a bit like the kind everyone has when a foot or leg suddenly jerks in bed. May be mild and affect only part of the body, or be strong enough to throw the child abruptly to the floor. May occur as a single seizure or a cluster of seizures.
Partial Seizures
Simple partial Seizures affect movement, usually on one side of the body, but child stays aware of surroundings. May cause jerking movements that start in fingers, toes, or other parts of the body, eventually affecting the whole of one side. May progress to a generalized convulsion. Partial seizures affecting sensations may cause things to look, sound, taste, smell, or feel different. Effects can include stomach pain, nausesa, a rising feeling in the stomach, or sudden fear or anger.
*Complex partial*
Alters consciousness. Child won’t know what he’s doing or where he is during the seizure. Often starts with blank stare, followed by chewing, followed by repeated movements that seem out of place and mechanical. Child may seem dazed and mumble. May pick at clothes, pick up and put down objects, try to take clothes off. May run, appear afreaid. May struggle of flail at restraint. Same pattern of actions may happen with each seizure. Lasts only a minute or two, but child may remain frightened and confused for longer time afterwards. There’ll be no memory of what happened during the seizure.
Partial seizures can arise from any part of the brain. The symptoms that the child experiences will depend on the seizure location. *Most complex partial seizures arise from the brain’s temporal lobe and will have symptoms similar to those described above.
*If the seizures are coming from the frontal lobe, they may produce weakness or stiffness. They often occur in sleep and may include thrashing movements, fear, screaming, bicycling movements of the legs.
*Seizures arising from the occipital lobe are more likely to disturbances of vision, in which the child “sees” things that are not really there.
