Epilepsy

Epilepsy is a brain disorder characterized by convulsive seizures or loss of consciousness or

both.
Convulsion and Convulsive Seizure
Convulsion refers to uncontrolled involuntary muscular contractions. Convulsive seizure
means sudden attack of uncontrolled involuntary muscular contractions. It occurs due to
paroxysmal(sudden and usually recurring periodically) uncontrolled discharge of impulses from
neurons of brain, particularly cerebral cortex.
Epileptic
Patient affected by epilepsy is called epileptic. The person with epilepsy remains normal in
between seizures. Epileptic attack develops only when excitability of the neuron is increased,
causing excessive neuronal discharge.
TYPES OF EPILEPSY
Epilepsy is divided into two categories:
1. Generalized epilepsy
2. Localized epilepsy.
GENERALIZED EPILEPSY
Generalized epilepsy is the type of epilepsy that occurs due to excessive discharge of impulses
from all parts of the brain. It is also called general onset seizure or general onset epilepsy.
Generalized epilepsy is subdivided into three types:
1. Grand mal 2. Petit mal 3. Psychomotor epilepsy.
GRAND MAL
Grand mal is characterized by sudden loss of consciousness, followed by convulsion. Just
before the onset of convulsions, the person feels the warning sensation in the form of some
hallucination. It is called epileptic aura. Convulsions occur in two stages:
a. Tonic stage b. Clonic stage.
Tonic Stage
Initially, seizure is characterized by tonic contraction sof muscle leading to spasm. Spasm causes
twisting facial features, flexion of arm and extension of lower limbs.
Clonic Stage
Clonic convulsions develop after the tonic stage. This stage is characterized by violent jerky
movements of limbs and face due to alternate severe contraction and relaxation of muscles.
At the end of attack, alternative tonic and clonic convulsions are seen. During the entire period
of seizure, tongue may be bitten.
Electroencephalogram (EEG) shows fast waves with a frequency of 15 to 30 per second during
tonic stage. Slow and large waves appear during clonic phase. After the attack, slow waves are
recorded for some time. In between seizures, EEG shows delta waves in all types of epileptics.
Causes of Grand Mal
Cause of grand mal epilepsy is the excess neural activity in all parts of brain. Cause for stoppage
of attack is neuronal fatigue. Factors which accelerate the neural activity resulting in grand mal
epilepsy are:
i. Strong emotional stimuli ii. Hyperventilation and alkalosis iii. Effects of some drugs
iv. Uncontrolled high fever v. Loud noises or bright light
vi. Traumatic lesions in any part of brain
PETIT MAL
In this type of epilepsy, the person becomes unconscious suddenly without any warning. The
unconsciousness lasts for a very short period of 3 to 30 seconds. Convulsions do not occur.
However, the muscles of face show twitchlike contractions and there is blinking of eyes.
Afterwards, the person recovers automatically and becomes normal. Frequency of attack may be
once in many months or many attacks may appear in rapid series. It usually occurs in late
childhood and disappears completely at the age of 30 or above. EEG recording shows slow and
large waves during the attack. Each wave is followed by a sharp spike. This
type of waves appear from recording over any part of the cerebral cortex indicating the
involvement of whole brain. Delta waves appear in between the seizures.
Causes of Petit Mal
Cause of petit mal is not known. It occurs in conditions like head injury, stroke, brain tumor and
brain infection.
PSYCHOMOTOR EPILEPSY
Psychomotor epilepsy is characterized bye motional outbursts such as abnormal rage, sudden
anxiety, fear or discomfort. There is amnesia or a confused mental state for some period. Some
persons have the tendency to attack others bodily or rub their own face vigorously. In most cases,
the persons are not aware of their activities. Some persons are very well aware of the actions, but
still the abnormal actions cannot be controlled.
EEG recordings show low frequency rectangular waves, ranging between 2 and 4 per second.
Causes of Psychomotor Epilepsy
Causes of psychomotor epilepsy are the abnormalities in temporal lobe and tumor in
hypothalamus and other regions of limbic system like amygdala and hippocampus.
LOCALIZED EPILEPSY
Epilepsy that occurs because of excessive discharge of impulses from one part of brain is
called localized epilepsy. It is otherwise known as localor focal epilepsy or local seizure.It
involves only a localized area of cerebral cortex or the deeper parts of cerebellum, which
are affected by tumor, abscess or vascular defects. The abnormality starts from a particular area
and spreads to adjacent areas, developing slowspreading muscular contractions. Contractions
usually start in the mouth region and spread down towards the legs. This type of seizure is also
known as jacksonian epilepsy.
Causes of Localized Epilepsy
Localized epilepsy is caused by brain tumor.