1. An overview
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2. 
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3. 
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4. Normal brain function requires

an
orderly, organized, coordinate
d discharge of electrical
impulses.
Electrical impulses enable the

brain to communicate with the
spinal cord, nerves, and
muscles as well as within itself.
Seizures may result when the

brain's electrical activity is
disrupted.
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5. Classified as involving parts of the brain

Involving a small part of the brain: Focal

Involving the whole part of the brain: Generalized

Focal Seizures can be simple or complex

Also classified in terms of body affected

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6. Whole body affected : Generalized

Small part or side of the body affected: Focal

Symptom may vary depending on what parts of brain

are involved.
Some Seizures may hard to notice as they consist of

staring spells
May cause loss of awareness and shaking of body
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7. A sudden, involuntary, time-limited alteration in

behavior, motor activity, autonomic
function, consciousness, or sensation, accompanied by an
abnormal electrical discharge in the brain.
Seizure (medicine), sudden attack or spasm, as in epilepsy

or a similar disorder. Seizures differ with the type of
condition and may consist of loss of
consciousness, convulsive jerking of parts of the
body, emotional explosions, or periods of mental
confusion.
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8. An electroencephalogram (an EEG) is a

recording of the brain's electrical activity.
The procedure is simple and painless.
About 20 small adhesive electrodes are
placed on the scalp, and the brain's activity
is recorded under normal conditions. Then
the person is exposed to various stimuli,
such as bright or flashing lights, to try to
provoke a seizure. During a seizure,
electrical activity in the brain accelerates,
producing a jagged wave pattern. Such
recordings of brain waves help identify a
seizure disorder. Different types of seizures
have different wave patterns.
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9. Primary generalized seizure:
A.
 Begins with a widespread electrical discharge
 Involves both sides of the brain at once
 Hereditary factors are important
Partial Seizure:
B.
 Begins with an electrical discharge in one limited area of the
brain
 Related to head injury, brain infection, stroke, or tumor
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10. Types of Primary generalized seizure
1. Absence seizures:
▪ Brief episodes of staring
▪ Absence seizures are considered complex absence
seizures
▪ Include a change in muscle activity
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11. ▪ Most common movement are eye blinks
▪ Complex absence seizures are often more than 10
seconds long
▪ Usually begin between ages 4 and 14
▪ no warning before a seizure, and the person is
completely alert immediately afterward
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12. ▪ Other movements include slight tasting movements of
the mouth, hand movements such as rubbing the fingers
together ,etc
▪ Children who get them usually have normal development
and intelligence
▪ 70% of cases, absence seizures stop by age 18
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13. 2. Atypical absence seizure:
▪ Atypical (a-TIP-i-kul) means unusual or not typical
▪ Person will stare but often is somewhat responsive
▪ Eye blinking or slight jerking movements of the lips may
occur
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14. ▪ Hard to distinguish from the person's usual behavior,
especially in those with cognitive impairment
▪ Generally begins at the age of 6
▪ Most of the children affected have below-average
intelligence
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15. ▪ Other types of seizures that are difficult to control
▪ Seizures usually continue till adulthood
▪ Daydreaming and inattentiveness can mimic these
seizures
▪ Diagnosis can be difficult if the behavior during seizures is
similar to the child's usual behavior
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16. 3. Monoclonic seizures:
▪ Very brief jerks, last only for 2 to 3 sec
▪ seizures usually cause abnormal movements on both
sides of the body at the same time
▪ Myoquot; means muscle and quot;clonusquot; (KLOH-nus) means
rapidly alternating contraction and relaxation
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17. ▪ Seizures usually begin in childhood, but the seizures can
occur at any age
▪ Seizures occur in reflex epilepsies, triggered by flashing
lights or other things in the environment
▪ Syndromes usually can be diagnosed on the basis of the
medical history and often EEG patterns
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18. 4. Atonic Seizures:
▪ Atonicquot; (a-TON-ik) means quot;without tone
▪ In an atonic seizure, muscles suddenly lose strength
▪ Eyelids may droop, the head may nod, and the person
may drop things and often falls to the ground
▪ Also known as quot;drop attacksquot; or quot;drop seizures
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19. ▪ The person usually remains conscious
▪ Another name for this type of seizure is “akinetic”
▪ (A-kin-ET-ik), which means quot;without movement“
▪ Seizures often begin in childhood
▪ Often last into adulthood
▪ People with atonic seizures are injured when they fall
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20. ▪ Seizures may cause people to fall when they're standing
often have tonic seizures rather than atonic seizures
▪ Syndromes usually can be diagnosed on the basis of the
medical history and often EEG patterns
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21. 5. Tonic Seizures:
▪ Usually last less than 20 sec
▪ In such seizures, the tone is greatly increased and the
body, arms, or legs make sudden stiffening movements
▪ Consciousness is usually preserved
▪ Seizures most often occur during sleep
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22. ▪ Usually involve all or most of the brain, affecting both
sides of the body
▪ Common in people who have the epilepsy syndrome
called Lennox-Gastaut syndrome
▪ Seizures in Lennox-Gastaut syndrome may become more
difficult to control over time
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23. 6. Clonic seizures:
▪ Seizures consist of rhythmic jerking movements of the
arms and legs
▪ Length vary according to the case
▪ Clonusquot; (KLOH-nus) means rapidly alternating
contraction and relaxation of a muscle
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24. ▪ Movements cannot be stopped by restraining or
repositioning the arms or legs
▪ These seizures are rarely found
▪ Common are tonic-clonic seizures, in which the jerking is
preceded by stiffening (the quot;tonicquot; part)
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25. ▪ Sometimes tonic-clonic seizures start with jerking alone
▪ These are called clonic-tonic-clonic seizures
▪ Occur at various ages, including in newborns
▪ Brief and infrequent clonic seizures in infants usually
disappear within very short period
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26. ▪ Occasionally quot;jitterinessquot; in a young infant can be
mistaken for a clonic seizure
▪ Children with neurological impairments with repetitive
movements that could be mistaken for clonic seizures
▪ The EEG pattern will change during a seizure, so video-
EEG is very useful for diagnosis
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27. 7. Tonic-clonic seizures:
▪ Normally last for 2 to 3 min
▪ More than 5 min calls for immediate medical help
▪ Seizure that lasts more than 30 minutes indicate
convulsion
▪ Person loses consciousness and falls to the floor
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28. ▪ Tongue or cheek may be bitten, so bloody saliva may
come from the mouth
▪ Person may turn a bit blue in the face
▪ After the tonic phase comes the clonic phase
▪ Arms and usually the legs begin to jerk rapidly and
rhythmically
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29. ▪ Bending and relaxing at the elbows, hips, and knees
▪ After a few minutes, the jerking slows and stops
▪ Bladder or bowel control sometimes is lost as the body
relaxes
▪ Consciousness returns slowly, and the person may be
drowsy, confused, agitated, or depressed
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30. ▪ They affect both children and adults
▪ Children who have had a single tonic-clonic seizure, the
risk that they will have more seizures
▪ Some children will outgrow their epilepsy
▪ Tonic-clonic seizures can be controlled by seizure
medicines
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31. ▪ Patients who are seizure-free for a year or two while
taking seizure medicine will stay seizure-free
▪ Medicine can be stopped gradually
▪ Patients with no epilepsy wave in EEG can stay free with
any medication
▪ People who faint sometimes may develop tonic or clonic
seizure
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32. Types of Partial seizures
1. Simple partial seizures:
▪ Different from person to person, depending on the part
of the brain where they begin
▪ One thing they all have in common is that the person
remains alert and can remember what happens
▪ Usually last for less than 2 min
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33. ▪ Doctors often divide simple partial seizures into
categories depending on the type of symptoms the
person experiences
i. Motor seizures
ii. Sensory seizures
iii. Autonomic seizures
iv. Psychic seizures
▪ Anyone can get these seizures
▪ People who have had a head injury, brain
infection, stroke, or brain tumor likely to get them
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34. ▪ These seizures often can be controlled by seizure
medicines
▪ Medical disorders such as, stomach disorders or a
pinched nerve can cause some similar symptoms
▪ Some symptoms (such as déja vu) are experienced by
almost everyone at some time
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35. 2. Complex Partial Seizures:
▪ Usually last between 30 seconds and 2 minutes
▪ Afterward, the person may be tired or confused for
about 15 minutes and may not be fully normal for hours
▪ Seizures usually start in a small area of the temporal lobe
or frontal lobe of the brain
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36. ▪ Quickly involve other areas of the brain that affect
alertness and awareness
▪ These seizures (usually ones beginning in the temporal
lobe) start with a simple partial seizure
▪ Also called an aura, this warning seizure often includes
an odd feeling in the stomach
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37. ▪ Person loses awareness and stares blankly
▪ Most people move their mouth, pick at the air or their
clothing, or perform other purposeless actions
▪ These movements are called quot;automatismsquot;
▪ Less often, people may repeat words or phrases, laugh,
scream, or cry
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38. ▪ Some people do things during these seizures that can be
dangerous or embarrassing
▪ People need to take precautions in advance
▪ Complex partial seizures starting in the frontal lobe tend
to be shorter than the ones from the temporal lobe
▪ Some complex partial seizures turn into secondarily
generalized seizures
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39. ▪ people who have had a head injury, brain
infection, stroke, or brain tumor are more likely to get
seizures
▪ If medication is not effective, some can be eliminated by
epilepsy surgery
▪ Complex partial seizures sometimes resemble
daydreaming or absence sezuires
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40. Secondarily generalized seizures:
3.
▪ Start in one limited area of the brain
▪ Can also spread throughout the brain becoming
generalized
▪ Convulsive phase of these seizures usually lasts no more
than a few minutes
▪ Preceding partial seizure is usually not very long
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41. ▪ Happen when a burst of electrical activity in a limited
area (the partial seizure) spreads throughout the brain
▪ Seizures occur in more than 30% of people with partial
epilepsy
▪ Can affect people of all ages who have partial seizures
▪ Seizures of this kind can be controlled with medication
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42. ▪ Seizures of this kind can be controlled with medication
▪ If not controlled with medication, surgery is another
option
▪ Easily diagnosed through EEG or MRI tests
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43. 7%
7%
34% Simple partial
15% Other generalized
Partial unknown
Absence
17%
Myoclonic
20%
Unclassified
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44. Change in consciousness, so that you can't remember

some period of time
Change in emotion, like unexplainable

fear, panic, joy, or laughter
Change in sensation of the skin, usually spreading

over the arm, leg, or trunk
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45. Changes in vision, including flashing lights, or (rarely)

hallucinations (seeing things that aren't there)
Loss of muscle control and falling, often very suddenly

Muscle movement such as twitching that might

spread up an arm or leg
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46. Muscle movement such as twitching that might

spread up an arm or leg
Muscle tension/tightening that causes twisting of the

body, head, arms or leg
Tasting a bitter or metallic flavor

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47. Beginning State:

 This stage can be said as warning or aura
 Sometimes an individual may not be aware of such aura
 In middle stage this aura is followed by other symptoms
 It may be considered as simple partial seizure
Middle State:

 People have aura in beginning, the aura may convert into
convulsion
 For those who don’t have aura, the seizure may continue as
complex partial seizure
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48. End state:

 This state represents a transition from seizure back to
normal state
 Also referred as the “Post-ictal period”
 Signifies recovery period of brain
 May last from a second to minutes to hours
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49.  If a person has a convulsion, the level of awareness gradually
improves during the post-ictal period, much like a person
waking up from anesthesia after an operation
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50.  Emotional
Early seizure symptoms:

▪ Fear/Panic
 Sensory/ thoughts
▪ Pleasant feeling
▪ Déjà vu
 Physical
▪ Jamais vu
▪
▪ Dizziness
Smell
▪ Headache
▪ Sound
▪ Lightheadedness
▪ Taste
▪ Nausea
▪ Visual loss or blurring
▪ Numbness
▪ Racing thoughts
 No Warnings
▪ Stomach feelings
▪ ▪ Sometimes seizures come with
Strange feelings
▪ no warnings
Tingling feeling
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51.  Emotional:
Middle Seizure Symptoms :

▪ Fear/Panic
 Sensory/ thoughts
▪ Black out
 Physical:
▪ Confusion
▪ Chewing movements
▪ Deafness/Sounds
▪ Convulsion
▪ Electric Shock Feeling
▪ Eyes rolling up
▪ Loss of consciousness
▪ Falling down
▪ Smell
▪ Foot stomping
▪ Spacing out
▪ Hand waving
▪ Out of body experience
▪ Inability to move
▪ Visual loss or blurring
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52. • Incontinence
▪ Staring
▪ Stiffening
▪ Swallowing
▪ Sweating
▪ Teeth clenching/grind
▪ Tongue biting
▪ Tremors
▪ Twitching movement
▪ Breathing difficulty
▪ Heart racing
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53.  Physical
Post-ical state:

▪ Bruising
 Thought
▪ Difficulty talking
▪ Memory loss
▪ Injuries
▪ Writing Difficulty ▪ Sleeping
▪ Exhaustion
 Emotional
▪ Headache
▪ Confusion ▪ Nausea
▪ Depression and Sadness ▪ Pain
▪ ▪
Fear Thirst
▪ ▪
Frustration Weakness
▪
▪ Urge to
Shame/ Embarrassment
urinate/defecate
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54. Causes Examples
•Heatstroke
High fever
•Infections
•Abscess
Brain infections
•AIDS
•Malaria
•Meningitis
•Rabies
•Syphilis
•Tetanus
•Toxoplasmosis
•Viral encephalitis
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55. Causes Examples
•High blood levels of sugar or sodium
Metabolic disorders
•Kidney or liver failure
•Low blood levels of sugar, calcium,
magnesium, or sodium
•Underactive parathyroid gland
•Vitamin B6 deficiency (in newborns)
•Abnormal heart rhythms
Inadequate oxygen supply to the brain
•Carbon monoxide poisoning
•Near drowning
•Near suffocation
•Stroke
•Vasculiti
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56. Causes Examples
•Brain tumor
Structural damage to the brain
•Head injury
•Hydrocephalus
•Intracranial hemorrhage
•Stroke
•Birth defect
Abnormalities present or occurring at
•Hereditary metabolic disorders, such as
birth
Tay-Sachs disease or phenylketonuria
•Injury during birth
•Eclampsia
luid accumulation in the brain (cerebral
•Hypertensive encephalopathy
edema)
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57. Drug Use Possible side-effects
Acetazolamide Absence seizures when Kidney stones and
other anticonvulsants are chemical imbalance in
ineffective blood
Carbamazepine Generalized seizures A low white blood cell
Partial seizures count (granulocytopenia),
production of too few
blood cells (aplastic
anemia, which can be fatal
disorder), a low platelet
count (thrombocytopenia),
digestive upset, inability to
articulate words, lethargy,
dizziness, and visual
disturbances
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58. Drugs Uses Possible side-effects
Clonazepam Atonic seizures Atypical Drowsiness, abnormal
absence seizures behavior, loss of
Infantile spasms coordination, and lost
Myo clonic seizures effectiveness of the drug
after 1 to 6 months
Divalproex Absence seizures Nausea, vomiting,
Febrile seizures abdominal pain, diarrhea,
Generalized tonic-clonic temporary drowsiness,
seizures dizziness, shaking
Infantile spasms (tremor), reversible hair
Juvenile myoclonic loss, weight gain, and liver
epilepsy damage
Myoclonic seizures
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59. Drugs Uses Possible side-effects
Ethosuximide Absence seizures Nausea, lethargy,
dizziness, a low white
blood cell count and a low
red blood cell count
Felbamate Atypical absence seizures, Headache, fatigue, liver
Partial seizures failure, and, rarely, aplastic
anemia (which can be
fatal)
Fosphenytoin Status Epilepticus Loss of coordination,
drowsiness, headache,
rash, and tingling
sensations
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60. Drugs Uses Possible side-effects
Gabapentin Partial seizures Drowsiness, dizziness,
weight gain, and headache
In children, aggressive
behavior, mood swings,
and hyperactivity
Lamotrigine Generalized seizures Nausea, vomiting,
Partial seizures indigestion, headache,
drowsiness, dizziness,
insomnia, fatigue, loss of
coordination, double
vision, tremor, rash, and
abnormal menstrual
periods
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61. Drugs Uses Possible side-effects
Levetiracetam Juvenile myoclonic Dizziness, weakness,
epilepsy fatigue, loss of
Myoclonic seizures coordination, changes in
Partial seizures mood and behavior, and
increased risk of infection
Oxcarbazepine Partial seizures Headache, abdominal
pain, double vision,
drowsiness, dizziness,
fatigue, nausea, low
sodium levels in the blood,
and a low white blood cell
count
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62. Drugs Uses Possible side-effects
Topiramate Atypical absence seizures Confusion, reduced
Partial seizures concentration, difficulty
Primarily generalized finding words, fatigue, loss
tonic-clonic seizures of appetite and weight,
numbness or tingling,
reduced sweating, and
kidney stones
Valproate Absence seizures Nausea, vomiting,
Febrile seizures abdominal pain, diarrhea,
Generalized tonic-clonic weight gain, reversible hair
seizures loss, temporary
Infantile spasms drowsiness, shaking
Juvenile myoclonic (tremor), and, rarely, liver
epilepsy damage
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63. Stay with the person until recovery or you have

professional medical help
Monitor pulse ,rate of breathing, and blood pressure

Do not give the person anything by mouth until

convulsions have stopped and the person is fully
awake and alert
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64. Do not move the person unless he or she is in danger

or near something hazardous
Do not place anything including your fingers between

the person’s teeth. You can break person’s teeth, if
you do so.
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65. The doctor will perform a physical examination and ask
questions to help understand the cause of the seizures,
such as:
Are there any risk factors ( such as recent head

injury)?
Did it occur or start on one side of the body?

Did the person remain awake and aware during

seizure?
How long the seizure last?

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66. How often do the seizures happen?

Was there any aura of the seizures?

Were there any other symptoms present (visual

changes, abnormal smells)?
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67. The following tests may be performed:
Blood tests

Ct scan or MRI of the brain

 EEG
 Lumbar puncture
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68. People with uncontrolled seizures should not drive.

Drinking should be avoided

Medicines should be taken regularly

Avoid activities such as climbing to high

places, biking, and swimming
Use of sharp instruments such as knife should be avoided

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69. Seizure is life threatening disease

No specific way to prevent seizures

But it is curable if instruction are followed

Good habits may help to control seizures

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70. Sleep deprivation, and poor diet must be avoided

Good sleep habits, stress reduction, proper

exercise, and sound nutrition may help
Use helmets to avoid head injury

Have faith in yourself, and seizure is curable!!

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