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What Is Epilepsy?

Epilepsy is a disorder of the brain's electrical system.

 Abnormal electrical impulses cause brief changes in movement, behavior, sensation, or awareness.

These interruptions, known as seizures, may last from a few seconds to a few minutes.

 People who have had two or more seizures are considered to have epilepsy.

 

 

Epilepsy Symptoms

Epilepsy is best known for causing convulsions.

But seizures can trigger a wide range of symptoms, from staring to falling to fumbling with clothes. Doctors divide seizures into several types depending on how the brain is affected. Each type has a distinct set of symptoms.

 

Absence Seizures

Absence seizures are often described as staring spells.

The person stops what he or she is doing and stares vacantly for a few seconds, then continues as if nothing happened

.This type of seizure is more common in children and usually starts between the ages of 4 and 12. Some children experience up to 100 absence seizures in a day.

 

Generalized Tonic Clonic Seizures

Generalized tonic clonic seizures (formerly known as grand mal seizures) are the most easily recognized.

They usually begin with a stiffening of the arms and legs, following by jerking motions.

The convulsions last up to 3 minutes, after which the person may be tired and confused.

This type of seizure involves abnormal electrical activity involving both sides of the brain.

 

 

 

Partial Seizures

In partial seizures, just one side of the brain is affected. Simple partial seizures may cause jerking motions or hallucinations, but the person often remains aware of what is happening.

During complex partial seizures, people may wander, mumble, smack their lips, or fumble with their clothes.

They appear to be conscious to observers, but are actually unaware of what they are doing.

 

Causes of Epilepsy

Epilepsy may result from anything that disrupts the brain's natural circuitry, such as:

• Severe head injury
• Brain infection or disease
• Stroke
• Oxygen deprivation
In nearly two-thirds of people with epilepsy, a specific cause is never found.

 

Epilepsy in Children

Children who are diagnosed with epilepsy may outgrow the condition in a few years.

 In the meantime, many kids are able to prevent seizures by taking regular medication.

 If drugs fail to keep seizures under control, other precautions may be needed. A well-informed school staff can help a child with epilepsy safely participate in most activities.

 

Diagnosis: EEG

To diagnose epilepsy a doctor will review the description of an individual's seizures, along with a medical history and physical exam.

 An EEG (electroencephalogram) can confirm the diagnosis and offer more information about the seizures. This painless procedure records the brain's electrical activity as wavy lines.

 The pattern changes during a seizure and may reveal which part of the brain is prone to seizures. Results may help guide treatment.

 

Diagnosis: Brain Scan

Detailed images of the brain from CT or MRI scans can help doctors rule out tumors or blood clots as a possible cause of seizures.

 This information is essential in planning surgery to treat epilepsy.

 

Epilepsy Complications

Most people with epilepsy live a normal lifespan and rarely suffer injuries from their seizures. Patients who tend to fall during seizures may need a special helmet to protect the head.

Some types of seizures may increase the risk of sudden, unexplained death in epilepsy (SUDEP), but this is extremely uncommon.

The best way to avoid complications is to find a treatment that controls seizures and stick to it.

 

Epilepsy Safety Precautions

Because seizures often strike without warning, certain activities are dangerous for people with epilepsy.

Losing consciousness while swimming or even taking a bath could be life-threatening.

The same goes for many extreme sports, such as mountain climbing.

Most states require a person with epilepsy to be seizure-free for a certain time before driving a car.

 

Treatment: Medication

 

Anti-seizure drugs are the most common treatment for epilepsy.

If medication is not successful at first, your doctor may adjust the dosage or switch to a different drug.

 About two-thirds of people with epilepsy become seizure-free by taking their medication regularly..

 

Treatment: Ketogenic Diet

When followed carefully, a ketogenic diet can eliminate or nearly eliminate seizures in a third of children with epilepsy who try it.

The diet is very high in fat and low in carbs, a combination that makes the body burn fat instead of sugar. This creates changes in the brain that reduce or eliminate seizures.

 It's a very strict diet that is created by a dietitian and monitored by a medical team. It may be recommended when medications fail or cause unacceptable side effects.

 

 

Treatment: VNS

VNS stands for vagus nerve stimulation, a treatment that is sometimes called a "pacemaker for the brain.

" It uses a small surgically implanted device to send electrical pulses to the brain. The pulses travel via the vagus nerve, a large nerve in the neck

. VNS is an option for people who don't do well with medication.

 

 

 

Treatment: Surgery

In people who have partial seizures, surgery can sometimes offer a cure. First, the medical team must determine that the seizures consistently begin in a single area of the brain. If so, removing this area may stop the seizures for good or make them easier to manage with medication.

 Surgery may also be done to treat an underlying condition that's causing seizures, such as a brain tumor.

 

 

First Aid for Seizures

If you see someone having a seizure, take the following steps:

• Time the seizure with your watch.
• Clear the area of anything hard or sharp.
• Loosen anything at the neck that may impair breathing.
• Turn the person onto his or her side.
• Put something soft beneath the head.
• Do not place anything inside the mouth.

Call 911 if a seizure lasts more than 5 minutes, recurs, or the person is pregnant, injured, or diabetic.

 

Treatment for Status Seizures

Prolonged or recurring seizures may be a condition called status epilepticus.

 This can have serious complications and requires emergency treatment.

 To bring the seizures to an end quickly, hospitals typically administer a sequence of drugs by IV and supplemental oxygen.

 

 

Epilepsy and Pregnancy

In most cases, it is safe for women with epilepsy to become pregnant and start a family.

More than 90% of babies born to women with epilepsy are healthy. However, it's best to consult your doctor before getting pregnant. It may be necessary to adjust your anti-seizure medication.

 Some drugs appear to be less risky during pregnancy than others.

 

 

 

Seizure Dogs

Some dogs appear to sense a person's seizure before it begins, providing an early warning system. But more research is needed before seizure alert dogs are widely used.

 In the meantime, many dogs can be trained to behave a certain way during a seizure.

For example, the dog can lie next to the person to help prevent injury. In the case of a child, a dog may be trained to alert the parents during a seizure.

 

 

 

Epilepsy Research

Researchers continue to pursue new therapies for epilepsy with two important goals.

The first is to increase the number of people who can fully control their seizures.

The second is to reduce the side effects of treatment.

Some researchers are also studying implantable devices that could alert patients when a seizure is about to occur.

 

 

Living With Epilepsy

People with epilepsy can enjoy full, active lives. Most are able to live seizure-free by taking medication on schedule.

 For the remainder, there are many resources for coping with uncontrolled seizures.

A specialist can help create strategies for reducing the impact seizures have on your life.

 The American Academy of Neurology and the Epilepsy Foundation provide listings of neurologists who specialize in epilepsy.

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Eclampsia Diagnosis

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If you experience any of the above symptoms call your doctor immediately and expect to come to the office or hospital. If you have your own blood pressure device at home, report this reading to your health care professional. However, do not substitute your home blood pressure reading for a doctor visit.

Be sure to review all of your signs, symptoms, and concerns with your health care professional. Your health care professional should check your blood pressure, weight, and urine at every office visit.

If your health care professional suspects that you have preeclampsia, he or she will order blood tests to check your platelet count,liver function, and kidney function. They will also check a urine sample in the office or possibly order a 24-hour urine collection to check for protein in the urine. The results of these blood tests should be available within 24 hours (if sent out), or within several hours if performed at a hospital.

The well-being of your baby should be checked by placing you on a fetal monitor. Further tests may include non-stress testing, biophysical profile (ultrasound), and an ultrasound to measure the growth of the baby (if it has not been done within the previous 2-3 weeks).

Ancillary studies may include ultrasound and CT or MRI scan of the head to help include or exclude diagnoses.

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CT Scan (CAT Scan, Computerized Axial Tomography)

CT Scan Introduction

History

CT, or CAT scans, are special X-ray tests that produce cross-sectional images of the body using X-rays and a computer. CT scans are also referred to as computerized axial tomography. CT was developed independently by a British engineer named Sir Godfrey Hounsfield and Dr. Alan Cormack. It has become a mainstay for diagnosing medical diseases. For their work, Hounsfield and Cormack were jointly awarded the Nobel Prize in 1979.

CT scanners first began to be installed in 1974. Currently, approximately 6,000 scanners are in use in the United States. Because of advances in computer technology, CT scanners have vastly improved patient comfort because they are now much faster than in the past. These improvements have also led to higher-resolution images, which improve the capabilities of the test to assist the doctor in making a diagnosis. For example, the CT scan can help doctors to visualize small nodules or tumors, which they cannot see with a plain film X-ray.

 

 

Picture of CT scan machine.

Introduction

• CT scan images allow the doctor to look at the inside of the body just as one would look at the inside of a loaf of bread by slicing it. This type of special X-ray, in a sense, takes "pictures" of slices of the body so doctors can look right at the area of interest. CT scans are frequently used to evaluate the brain, neck, spine, chest, abdomen, pelvis, and sinuses.
• CT has become a commonly performed procedure. Scanners are found not only in hospital X-ray departments, but also in outpatient offices.
• CT has revolutionized medicine because it allows doctors to see diseases that, in the past, could often only be found at surgery or at autopsy. CT is noninvasive, safe, and well-tolerated. It provides a highly detailed look at many different parts of the body.
• If one looks at a standard X-ray image or radiograph (such as a chest X-ray), it appears as if they are looking through the body. CT and MRI are similar to each other, but provide a much different view of the body than an X-ray does. CT and MRI produce cross-sectional images that appear to open the body up, allowing the doctor to look at it from the inside. MRI uses a magnetic field and radio waves to produce images, while CT uses X-rays to produce images. Plain X-rays are an inexpensive, quick test and are accurate at diagnosing things such as pneumonia, arthritis, and fractures. CT and MRI better to evaluate soft tissues such as the brain, liver, and abdominal organs, as well as to visualize subtle abnormalities that may not be apparent on regular X-ray tests.
• People often have CT scans to further evaluate an abnormality seen on another test such as an X-ray or an ultrasound. They may also have a CT to check for specific symptoms such as pain or dizziness. People with cancer may have a CT to evaluate the spread of disease.
• A head or brain CT is used to evaluate the various structures of the brain to look for a mass, stroke, area of bleeding, or blood vessel abnormality. It is also sometimes used to look at the skull.
• A neck CT checks the soft tissues of the neck and is frequently used to study a lump or mass in the neck or to look for enlarged lymph nodes or glands.
• CT of the chest is frequently used to further study an abnormality on a plain chest X-ray. It is also often used to look for enlarged lymph nodes.
• Abdominal and pelvic CT looks at the abdominal and pelvic organs (such as the liver, spleen, kidneys, pancreas, and adrenal glands) and the gastrointestinal tract. These studies are often ordered to check for a cause of pain and sometimes to follow up on an abnormality seen on another test such as an ultrasound.
• A sinus CT exam is used to both diagnose sinus disease and to detect a narrowing or obstruction in the sinus drainage pathway.
• A spine CT test is most commonly used to detect a herniated disc or narrowing of the spinal canal (spinal stenosis) in people with neck, arm, back, and/or leg pain. It is also used to detect a fracture or break in the spine.

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Magnetic Resonance Imaging (MRI)

MRI Introduction

History of MRI

Working independently, Felix Bloch of Stanford University and Edward Purcell of Harvard University made the first successful nuclear magnetic resonance experiment to study chemical compounds in 1946. Dr Bloch and Dr Purcell were awarded the Nobel Prize for Physics in 1952. In the early 1980s, the first "human" magnetic resonance imaging (MRI) scanners became available, producing images of the inside of the body. Current MRI scanners produce highly detailed two-dimensional and three-dimensional images of the human anatomy.

Introduction

• An MRI is similar to a computerized topography (CT) scanner in that it produces cross-sectional images of the body. Looking at images of the body in cross section can be compared to looking at the inside of a loaf of bread by slicing it. Unlike a CT scan, MRI does not use X-rays. Instead, it uses a strong magnetic field and radio waves to produce very clear and detailed computerized images of the inside of the body. MRI is commonly used to examine the brain, spine, joints, abdomen, and pelvis. A special kind of MRI exam, called magnetic resonance angiography (MRA), examines the blood vessels.
• An MRI of the brain produces very detailed pictures of the brain and is commonly used to study people with such problems as headaches, seizures, weakness, hearing loss, and blurry vision. It can also be used to further evaluate an abnormality seen on a CT scan. During a brain MRI, a special device called a head coil is placed around the person's head to help produce very detailed pictures of the brain. The head coil does not touch the person, and the person can see through large gaps in the coil.
• Spine MRI is most commonly used to look for a herniated disk or narrowing of the spinal canal (spinal stenosis) in people with neck, arm, back, and/or leg pain. It is also the best test to use to look for a recurrent disk herniation in a person with a history of prior back surgery.
• Bone and joint MRI can be used to check virtually all of the bones, joints, and soft tissues. MRI can be used to identify injured tendons, ligaments, muscles, cartilage, and bones. It can also be used to look for infections and masses.
• MRI of the abdomen is most frequently used to look more specifically at an abnormality seen on another test, such as an ultrasound or a CT scan. The exam is usually tailored to look at just the liver, pancreas, or adrenal glands.
• For women, pelvic MRI provides a detailed look at the ovaries and uterus and is often used to follow up an abnormality seen on ultrasound. It is also used to evaluate the spread of cancer of the uterus. For men, pelvic MRI is sometimes used to check those diagnosed with prostate cancer. Pelvic MRI is also used to look at the bones and muscles of the pelvis.
• Magnetic resonance angiography (MRA) depicts the blood vessels. The blood vessels in the neck (carotid and vertebral arteries) and brain are frequently studied by MRA to look for areas of constriction (narrowing) or dilatation (widening). In the abdomen, the arteries supplying blood to the kidneys are also frequently examined using this technique.

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Ultrasound

Ultrasound Overview

Ultrasound (also termed sonography, ultrasonography, and Doppler study) is a non-invasive diagnostic medical technique that uses high frequency sound waves to produce images of the internal structures of the body. These sound waves are not detectable by human hearing.

Using ultrasonography, a technician or doctor moves a device called a transducer (probe) over part of your body. The transducer emits sound waves which bounce off the internal tissues, and creates images from the waves that bounce back. Different densities of tissues, fluid, and air inside the body produce different images that can be interpreted by a physician, typically a radiologist (a physician who specializes in imaging technologies). Many studies are done by a trained technologist (sonographer) and then interpreted by a radiologist.

Ultrasound Uses

Ultrasound can be used as a diagnostic or screening tool to confirm medical disorders or to assist in performing medical procedures. It is also used as a therapeutic tool in treating musculoskeletal problems, renal stones (kidney stones), and gallstones.

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Liver Blood Tests

Liver Blood Test Overview

 

In general, liver blood tests are used to detect an injury or an inflammation to the liver. These tests

 are commonly ordered and performed in many situations, such as in routine health screening, evaluation of abdominal pain, or suspectedliver disease. The liver blood tests are typically done as a part of the comprehensive metabolic panel which also includes electrolyte levels and kidney function.

The main values measured in liver blood tests are the aminotransferases (alanine aminotransferase or ALT and aspartate aminotransferase or AST). The other measurements include alkaline phosphatase, albumin, and bilirubin. It is important to note that these tests are commonly referred to as "liver function tests", but this term is misleading as the aminotransferases and alkaline phosphatase do not reflect the function of the liver. Strictly speaking, the true liver function tests (LFT's) include albumin, bilirubin, blood coagulation panel, and glucose.

More specifically, AST, ALT, and alkaline phosphatase are called the liver enzymes and they typically are used to detect damage or injury to the liver (not its function) and they will be covered in this article.

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Abdominal pain felt by adults

Digestive Disease Myths Pictures

Appendicitis & Appendectomy Pictures

 

Abdominal Pain in Adults Overview

Abdominal pain can range in intensity from a mild stomach ache to severe acute pain. The pain is often nonspecific and can be caused by a variety of conditions. Many organs are found within the abdominal cavity. Sometimes the pain is directly related to a specific organ such as the bladder or ovary, while other times it is more diffuse or non-specific.. Usually, abdominal pain originates in the digestive system. For example, the pain can be caused by appendicitis, diarrheal cramping, or food poisoning.

The type and location of pain may help the physician find the cause. The intensity and duration of pain must also be considered when making a diagnosis. A few general characteristics of abdominal pain are as follows:

• Character of Pain: Abdominal pain can be sharp, dull, stabbing, cramp-like, knifelike, twisting, or piercing. Many other types of pain are possible.
• Duration of Pain: Abdominal pain can be brief, lasting for a few minutes, or it may persist for several hours and longer. Sometimes abdominal pain comes on strongly for a while and then lessens in intensity for a while.
• Triggering Events: The pain may be worsened or relieved by certain events, such as worse after meals, better with a bowel movement, better after vomiting, or worse when lying down.

Abdominal pain can make a person want to stay in one place and not move a muscle. Or the pain can make them so restless they want to pace around trying to find "just the right position."

The health care professional will try to pinpoint the area of the abdomen where the pain originates when determining the cause of abdominal pain. This is done by combining questions such as - "When you first had the pain, where did you feel it?" - with examination of the abdomen. Softly pressing on certain areas to elicit the pain and perhaps palpating other areas to examine the size and exact location of an organ are other parts of the physical examination.

When this is combined with general questions about the pain such as "Is the pain dull or sharp?" "How long have you had the pain?" and questions about your state of health - "Did you have to vomit?" - the health care professional can narrow down the possible causes of the pain.

Once the questions and physical exam are completed, the health care professional will either give the patient a diagnosis and advise on follow-up recommendations or order blood tests, and possibly X-rays andimaging studies to further help identify why the patient is in pain.

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