Neuro anatomy/Seizures

Divisions of the Brain

Layers of the brain and path of CSF

Upper and lower motor neurons of the pyramidal and extrapyramidal tracts

Limbic system

Diencephalon

Neuron or nerve cell (dendrite and axon)

Action Potential/Conduction of impulses

Electrical and chemical synapse

SEIZURES

Uncontrolled electrical discharge of neurons (depolarization) Possible cause:

Defect in the production of the

neurotransmitter GABA Defect in membrane itself thus allowing alterations in the potassium and calcium channels

CAUSE

75% have no known cause: idiopathic Infarction, drugs, fever, dehydration, acidosis, bleeding, tumor etc Familial? Some people have a predisposition for low seizure thresholds

Types of Seizures

Partial: begin in one specific region of the cortex, may spread and become generalized Generalized (30%): bilateral synchronous discharge in the brain. Involves the whole brain all at once

GENERALIZED SEIZURES
No warning

Loss of consciousness
Myoclonic

Absence
Tonic Atonic Tonic-clonic (grand mal)

TYPES of Generalized Seizures

Absence: brief loss of awareness, staring, may involve some involuntary muscle movement
More common in children Can have up to 100 per day

Myoclonic: rapid contraction of muscles

More common after sleeping thru the night May not always involve total loss of

awareness (only generalized seizure where this is true)

Tonic: stiffening of extremities Atonic: Total sudden loss of consciousness and muscle tone
Also known as drop attacks

Tonic/clonic: grand mal seizure

PARTIAL SEIZURES

SIMPLE
No loss of consciousness Rarely last longer than one minute Examples of symptoms:

deja vu Nausea Seeing something from the corner of the eye Dizziness Aphasiz

If motor activity is involved it may spread (march) to adjacent body parts. This is a Jacksonian seizure

COMPLEX

Some alteration in consciousness, unaware Aura may occur Lasts longer than one minute Repetitive muscle movements may be involved Individual does not remember the incident
May progress to total body involvement and

become Generalized seizures

Consequences to the body of seizure activity

May stop breathing If muscle contractions are involved much energy can be used (250% increase in ATP usage) Increased Lactic acid production Oxygen consumption can decrease by as much as 60%

STATUS EPILEPTICUS

Recurrent tonic-clonic seizures without full return to consciousness Emergency situation which requires hospitalization and aggressive drug treatment to stop the seizures