Jul 16
In complex partial seizures, as with absence seizures, the child stops, stares, and is unaware of his environment. But here, in addition, there is often a period of confusion after the child stops staring. Also, during the spell, he may get up and wander around the room, pick at his clothes, and fail to respond [...] [...more]
Posted: under Epilepsy.
In complex partial seizures, as with absence seizures, the child stops, stares, and is unaware of his environment. But here, in addition, there is often a period of confusion after the child stops staring. Also, during the spell, he may get up and wander around the room, pick at his clothes, and fail to respond appropriately. These “peculiar” episodes are likely to be misunderstood by the other children in the classroom and by his teacher. As with absence spells, it is important that the teacher understands what is happening. The teacher needs to realize that if your child is wandering around and someone tries to restrain him, the child may lash out or even become highly agitated. Providing gentle guidance and supervision at such times is far better than trying to make him sit down. The teacher needs to be able to be comforting and reassuring both to the student, who is not aware of what is happening, and to the other children, who may be confused by the behavior. It is important that the teacher alert you to changes in your child’s performance. You can then alert your doctor.As with other recurrent seizures, your child needs to understand what is happening during these episodes when he is not aware. He may remember the beginning of the seizure, when he felt the aura (for example, fear, rising feeling in the stomach), and he may be vaguely aware of people responding to his behavior during and after the seizure. Or he may only be aware that something happened and that now things are different from what they were a few seconds or minutes ago. Since these spells usually follow a pattern, let him know what has been going on so that he will be less upset and confused. If he does have an aura, point out that it can be a useful warning. Encourage him to pay attention so that he can avoid harmful situations.*185\208\8*
Apr 11
Evaluation of a child who has no fever depends on many factors: the age of the child, the type of seizure, how soon after the seizure the child is seen, and whether the child has returned to normal. The frequency of various causes of seizures changes with the age of the patient. After taking a [...] [...more]
Posted: under Epilepsy.
Evaluation of a child who has no fever depends on many factors: the age of the child, the type of seizure, how soon after the seizure the child is seen, and whether the child has returned to normal. The frequency of various causes of seizures changes with the age of the patient. After taking a careful history, the physician will look for general physical abnormalities. Abnormalities of the heart’s rhythm or rate may lead to a lack of oxygen to the brain, other heart disease to strokes and seizures. Lung problems can cause brain infection. High blood pressure can cause seizures, as can acute or chronic kidney disease. Some birthmarks provide evidence of problems in the brain that may cause seizures, so your physician will look carefully at your child’s skin. Brain tumors and cancer are rare causes of seizures in children. Your doctor will also want to concentrate on the child’s neurologic function and on your child’s development to detect any new neurologic abnormality that might suggest a stroke, infection, or tumor requiring treatment; to verify that there is no abnormality; or to document old neurologic abnormalities for comparison with future examinations.
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Jan 18
At one time, seizures were classified into two types: big and small— in French, grand and petit. Since seizures were bad—mal in French— they were classified as “grand mal” and “petit mal,” terms still, unfortunately, used by many patients and by many physicians—unfortunately because they are imprecise. Many types of seizures are “big and bad,” [...] [...more]
Posted: under Epilepsy.
At one time, seizures were classified into two types: big and small— in French, grand and petit. Since seizures were bad—mal in French— they were classified as “grand mal” and “petit mal,” terms still, unfortunately, used by many patients and by many physicians—unfortunately because they are imprecise. Many types of seizures are “big and bad,” causing a patient to fall to the ground and shake. Johnny’s seizure and William’s seizure caused each child respectively to fall down and shake, and thus, in the old days, both would have been called grand mal seizures. We know they are different because William’s seizure had a partial, or focal, beginning.
The term “grand mal” (big and bad) means different things to different people. Some people consider a seizure “big” that another, with worse seizures, might consider “small.” If one person has a spell in which he just stops and stares, as Mary did, while another, like William, has a spell in which he stares, smacks his lips, and is confused, and a third, such as Trina, has jerking of the face—are these little spells all “petit mal”? They are different types of seizures, coming from different parts of the brain, with different implications of causation, requiring different evaluation, requiring different medications, and probably having differing outcomes. Thus, the terms grand mal and petit mal are now seldom used in classifying seizures.
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Dec 12
The alteration of function or behavior that occurs in a seizure will depend on the magnitude and type of the disruption or disorganization and on the “community” of the brain in which it occurs. Local disruptions of brain function are called “partial” seizures because only part of the brain is involved. Since each area of [...] [...more]
Posted: under Epilepsy.
The alteration of function or behavior that occurs in a seizure will depend on the magnitude and type of the disruption or disorganization and on the “community” of the brain in which it occurs. Local disruptions of brain function are called “partial” seizures because only part of the brain is involved. Since each area of the brain has a different function, the manifestations of an electrical disruption or seizure will differ, depending on which area of the brain is involved. When a partial seizure affects one area of the brain, the manifestations may be twitching of the thumb, hand, or face. If it affects another, there may be a tingling sensation, a peculiar smell, an unusual taste. In other areas, the seizure may lead to changes in behavior—staring or alterations of awareness. All such seizures are caused by local (contained) disruption of normal electrical activity.
But, as in a society, so a seizure or demonstration may not remain confined to a local region. Depending on its intensity and on the threshold of the brain, the disturbance or seizure may become sufficiently severe to involve a large part of the brain or, indeed, the whole brain and become a generalized seizure.
Just as we do not understand exactly why demonstrations begin, spread, and end in a society, we also do not yet completely understand the factors that maintain the seizure focus in the brain or the interactions with the “crowd” of surrounding neurons. How does excitement, lack of sleep, or a fever alter the threshold of the surrounding cells? What genetic and environmental factors influence the “threshold” ? If we understood the multiple factors and interactions that cause disruptions in the brain, and the factors that cause these disruptions to stop, we could probably prevent seizures from occurring altogether. But we do not.
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