SEIZURE
A seizure (“fit”; epilepsy) represents vigorous involuntary muscle activity and altered consciousness associated with abnormal electrical discharges within the brain. It may be caused by a number of underlying disorders, which include structural abnormalities of the brain (scars, birth defects), injury, tumor, infection, bleeding (stroke), uncontrolled hypertension, lack of oxygen, abnormal blood chemistries (calcium, sodium, glucose), and “recreational” drug abuse (including drug or alcohol withdrawal).
Most seizures have been grouped into various classifications, which include the following types:
Partial. This seizure is initiated in a focal, or “restricted,” part of the outermost layer (cortex) of the brain. Consciousness may (complex seizure) or may not (simple seizure) be impaired.
Generalized. This seizure involves the cortex of the brain in a symmetrical and synchronous manner, and may lead to “automatic,” “absent,” or profoundly agitated behavior patterns.
Grand mal (“big illness”). In this type of generalized seizure disorder, the victim classically becomes unconscious and has violent repetitive muscle activity with tongue biting, grunting, eye deviation to one side, difficulty breathing, and occasional loss of bladder or bowel control. Following the seizure, the victim will be confused or combative for a time (10 to 60 minutes) as he slowly returns to normal. He may sleep for a while after a seizure.
Status epilepticus. This is defined as prolongation of the seizure activity for a period that exceeds 1 to 2 minutes, or as multiple seizures without a return of normal consciousness between fits. Status epilepticus is a true medical emergency.
Petit mal (“little illness”). This is an “absence” attack generally seen in a child; in it, he seems to be daydreaming, distracted, or confused. It is not associated with violent, abnormal physical behavior.
Psychomotor (temporal lobe). This is an episode of patterned abnormal behavior, such as lip smacking, olfactory hallucinations, vulgar speech, or repetitive movements such as arm waving. The origin of the electrical activity is thought to reside in the temporal lobe of the brain.
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