EPILEPSY SKOTNEVSKAYA A.A. 2.4.13 OVERVIEW Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness. Vocabulary: Seizures – припадки Behavior – поведение Seizure symptoms can vary widely. Some people with Sensations – ощущения epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two seizures without a known trigger (unprovoked seizures) that happen at least 24 hours apart are generally required for an epilepsy diagnosis. Awareness – осознание Vary widely – широко варьироваться Stare blankly – смотреть тупо Repeatedly twitch – многократно дергаться SIGNS AND SYMPTOMS Characteristics of seizures vary and depend on where in the brain the disturbance first starts, and how far it spreads. Temporary symptoms occur, such as loss of awareness or consciousness, and disturbances of movement, sensation (including vision, hearing and taste), mood, or other cognitive functions. Depend on – зависит Disturbance – нарушение Temporary symptoms occur – возникают временные симптомы Consciousness – сознание Movement – движение People with epilepsy tend to have more physical problems (such as fractures and bruising from injuries related to seizures), as well as higher rates of psychological conditions, including anxiety and depression. Similarly, the risk of premature death in people with epilepsy is up to three times higher than in the general population, with the highest rates of premature mortality found in low- and middle-income countries and in rural areas. A great proportion of the causes of death related to epilepsy, especially in low- and middle-income countries are potentially preventable, such as falls, drowning, burns and prolonged seizures.A great proportion of the causes of death related to epilepsy, especially in low- and middle-income countries are potentially preventable, such as falls, drowning, burns and prolonged seizures. Tend to have – как правило, имеют Fractures – переломы Bruising – синяк Injures – травма Higher rates – высокие показатели Premature death – преждевременная смерть Mortality found - обнаружена CAUSES Epilepsy is not contagious. Although many underlying disease mechanisms can lead to epilepsy, the cause of the disease is still unknown in about 50% of cases globally. The causes of epilepsy are divided into the following categories: structural, genetic, infectious, metabolic, immune and unknown. Examples include: brain damage from prenatal or perinatal causes (e.g. a loss of oxygen or trauma during birth, low birth weight); congenital abnormalities or genetic conditions with associated brain malformations; Although – несмотря на Underlying – лежащий в основе Lead – привести Congenital abnormalities – генетические аномалии Associated – сопутствующие Brain malformations – пороки развития головного мозга Severe – тяжелая форма a severe head injury; Stкoke – инсульт a stroke that restricts the amount of oxygen to the brain; Restricts – ограничивает an infection of the brain such as meningitis, encephalitis or Amount – количество neurocysticercosis, certain genetic syndromes; and a brain tumour. TYPES OF EPILEPSY GENERALIZED SEIZURES Overview A generalized seizure starts when all areas of the brain are affected by an abnormal electrical impulse. There are different types of generalized seizures, including: Absence seizures (petit mal seizures) Myoclonic seizures Clonic seizures Tonic seizures Tonic-clonic seizures (grand mal seizures) Atonic seizures (drop attacks) In some cases, the seizure may begin as a partial, or focal, seizure. These seizures may affect only part of the body. Then they may progress to a generalized seizure, which affects the whole body. Patients experiencing a generalized seizure will often lose consciousnes Absence seizures (petit mal seizures) – малые припадки Blank out – терять сознание, отключиться Absence seizure - blank out or stare into space for a few seconds. Myoclonic seizures - brief shock-like jerks of a muscle or group of muscles. Clonic seizures - sustained rhythmical jerking Tonic-clonic seizures (grand mal seizures) - auses violent muscle contractions and loss of consciousness Atonic seizures (drop attacks) - sudden loss of muscle strength Stare into space – уходить в себя, выпадать из реальности brief shock-like jerks – короткие шоковые конвульсии sustained rhythmical jerking – устойчивые (постоянные) ритмичные конвульсии Auses – вызывает Violent muscle contractions – сильные мышечные сокращения sudden loss of muscle strength – внезапная потеря мышечной силы GENERAL SYMPTOMS Symptoms of a generalized seizure can vary depending on the type of seizure. Symptoms may include: Stiff muscles Loss of consciousness A cry or groan Jerking of the arms or legs Stiff muscles – зажатые мышцы Loss of bladder or bowel control loss of bladder or bowel control - потеря контроля Limited or even stopped breathing Blue lips Loss of muscle tone Sudden collapse Most generalized seizures typically last between one to three minutes. Tonic-clonic seizures can last up to five minutes and may need emergency medical attention/ над мочевым пузырем или кишечником FOCAL SEIZURE When an epileptic seizure starts in one side of the brain, it’s called a focal onset seizure or a focal seizure. Both terms mean the same thing. Until recently these seizures were called partial seizures. FOCAL EPILEPSY SEIZURES COME IN FOUR CATEGORIES Focal aware seizures - the person is conscious (aware and alert) and will usually know that something is happening and will remember the seizure afterwards. Some people find their focal aware seizures hard to put into words. During the seizure they may feel ‘strange’ but not able to describe the feeling afterwards. This may be upsetting or frustrating for them. Focal impaired awareness seizures - affect a bigger part of one hemisphere (side) of the brain than focal aware seizures. The person's consciousness is affected and they may be confused. They might be able to hear you, but not fully understand what you say or be able to respond to you. Focal aware seizures- фокальные судороги в сознании Focal impaired awareness seizures - очаговые приступы нарушения сознания Hemisphere – полушарие Focal motor seizures - will affect muscle activity, causing jerking movements of a foot, the face, an arm or another part of the body. Physicians can diagnose which side of the brain is affected by observing which side of the body experiences symptoms, since the left brain controls the right side of the body and the right brain controls the left. Focal non-motor seizures - can cause changes in any one of the senses. Generally, a person experiencing a Focal Onset Non-Motor Seizure remains alert and able to interact, and these types of seizures generally last seconds to less than two minutes. Focal motor seizures – фокальные моторные припадки Interact – взаимодействовать TREATMENT Seizures can be controlled. Up to 70% of people living with epilepsy could become seizure free with appropriate use of antiseizure medicines. Treatments include: medicines called anti-epileptic drugs (AEDs) surgery to remove a small part of the brain that's causing the seizures a procedure to put a small electrical device inside the body that can help control seizures a special diet (ketogenic diet) that can help control seizures