Convulsive disorders | Symptoms & Causes | Diagnosis
 


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Convulsive disorders

What is Convulsive disorders?

Convulsive disorders (Epilepsy) are a group of brain disorders characterized by a tendency for recurrent seizures (convulsions), over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. When a person has two or more unprovoked seizures, they are considered to have epilepsy. A single seizure that does not happen again is not epilepsy.

Convulsions in small children : In infants between the ages of one month and one year convulsions are usually, associated with fever. If there is no fever, epilepsy should be considered, which is more prolonged and requires long term treatment, as compared to convulsions associated with fever which usually, stops by 5-6 years.

Cause

Convulsions are the result of abnormal electrical activity in the brain. The specific cause is often not clear. Convulsions can be caused by specific chemicals in the blood, as well as infections like meningitis or encephalitis. A common cause in children is febrile seizures. Other possibilities include celiac disease, head trauma, stroke or lack of oxygen to the brain. Sometimes the convulsion can be caused by genetic defects or brain tumors. Convulsions can also occur when the blood sugar is too low and deficiency of vitamin B6 (pyridoxine). In Nigeria, malaria is a very important cause of convulsions among children under 5 years of age.

Diagnosis & Tests

After a seizure, your doctor will thoroughly review your symptoms and medical history. Your doctor may order several tests to determine the cause of your seizure and evaluate how likely it is that you'll have another one.

Tests may include:

  • A neurological exam. Your doctor may test your behavior, motor abilities and mental function to determine if you have a problem with your brain and nervous system.
  • Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions, blood sugar levels or electrolyte imbalances.
  • Lumbar puncture. If your doctor suspects an infection as the cause of a seizure, you may need to have a sample of cerebrospinal fluid removed for testing.
  • An electroencephalogram (EEG). In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain, which shows up as wavy lines on an EEG recording. The EEG may reveal a pattern that tells doctors whether a seizure is likely to occur again. EEG testing may also help your doctor exclude other conditions that mimic epilepsy as a reason for your seizure. Depending on the details of your seizures, this test may be done as an outpatient in the clinic, overnight at home with an ambulatory device or over a few nights in the hospital.
  • Computerized tomography (CT). A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might cause a seizure, such as tumors, bleeding and cysts.
  • Magnetic resonance imaging (MRI). An MRI scan uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could lead to seizures.
  • Positron emission tomography (PET). A PET scan uses a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities.
  • Single-photon emission computerized tomography (SPECT). A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain that happens during a seizure. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. This test is usually done in a hospital with overnight EEG recording.

Prevention & Risk Factors

  • Get plenty of sleep each night

Treatments & Therapies

Not everyone who has one seizure will have another one, and because a seizure can be an isolated incident, your doctor may not decide to start treatment until you've had more than one.

The optimal goal in seizure treatment is to find the best possible therapy to stop seizures, with the fewest side effects.
Medication
Treatment for seizures often involves the use of anti-seizure medications. Several options exist for anti-seizure medications. The goal is to find the medicine that works best for you and that causes the fewest side effects. In some cases, your doctor might recommend more than one medication.

Finding the right medication and dosage can be complex. Your doctor will consider your condition, your frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won't interact with them.