“There are two main types of seizures: generalized and focal seizures.
These types describe where a seizure starts in the brain and how it may affect a person.
Call 911 if a seizure (of any type) lasts more than 5 minutes or if the person does not wake up fully between seizures.”
Centers for Disease Control and Prevention (https://www.cdc.gov/epilepsy/about/types-of-seizures.html)
Old Lists Below on Seizure Classification:
Most Updated List on Classifications of Seizures by the Epilepsy Foundation:
Types of seizures whether with a etiology or unknown:
I-Partial seizures (seizures beginning local)
1-simple partial seizures-(the person is conscious and not impaired). With motor symptoms, autonomic symptoms and even psychic symptoms.
2.)-Complex partial seizures-(the person is with impairment of consciousness)
II-Generalized seizures-(bilaterally symmetrical and without local onset).
3.) Tonic clonic seizures – Grand Mal
See Above the most updated,being 2017, on classifications of seizures list by the Epilepsy Foundation.
Treatment:
1-Epilepsy is sometimes referred to as a long-term condition, as people often live with it for many years, or for life. Although generally epilepsy cannot be ‘cured’, for most people, seizures can be ‘controlled’ (stopped) so that epilepsy has little or no impact on their lives. So treatment is often about managing seizures in the long-term.
Most people with epilepsy take anti-epileptic drugs (AEDs) to stop their seizures from happening. However, there are other treatment options for people whose seizures are not controlled by anti-epileptic drugs (AEDs).
2-The ketogenic diet is one treatment option for children with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and can often have positive effects on behaviour.
3-Vagus nerve stimulation therapy is a treatment for epilepsy that involves a stimulator (or ‘pulse generator’) which is connected, inside the body, to the left vagus nerve in the neck. The stimulator send regular, mild electrical stimulations through this nerve to help calm down the irregular electrical brain activity that leads to seizures.
There are several ways to treat epilepsy. How well each treatment works varies from one person to another. Vagus nerve stimulation therapy is a form of treatment for people with epilepsy whose seizures are not controlled with medication.
4-There are different kinds of epilepsy surgery. One kind of surgery involves removing a specific area of the brain which is thought to be causing the seizures. Another kind involves separating the part of the brain that is causing seizures from the rest of the brain.
Surgery may be possible for both adults and children, and might be considered if:
Whether you are suitable for surgery is something that you may like to talk about with your GP or neurologist. If you meet these criteria and are considered for surgery, you will need to have further tests before you can have the surgery.
If you are referred for surgery you will probably go to a specialist centre for tests. There are many different pre-surgical tests you might have before you can be given the go-ahead for surgery. This could include further MRI scans, an EEG (electroencephalogram) and video telemetry (an EEG while also being filmed). Other types of scans may also be done, which trace a chemical injected into the body. This can show detailed information about where seizures start in the brain.
Memory and psychological tests are also used to see how your memory and lifestyle might be affected after the surgery. These types of tests also help the doctors to see how you are likely to cope with the impact of having this type of surgery.
The tests will confirm whether:
The results from the pre-surgical tests will help you and your neurologist decide whether surgery is an option for you, and what the result of the surgery might be.
Your specialist will also talk with you about the possible risks and benefits of having surgery.
For many people the results show that surgery is not an option: the majority of people who are recommended for surgery, and have these tests carried out, are unable to have surgery.
Take the action and make your life one without seizures occurring putting your life on HOLD you need to TAKE CARE OF YOURSELF! That is all up to you, the patient diagnosed with it or questioning if they have seizures.
“Seizures are unpredictable. When a person has a seizure, it is usually not in a doctor’s office or other medical setting where health care providers can observe what is happening, so diagnosing seizures is a challenge. Accurate diagnosis depends on taking a careful medical history and using brain imaging and other tests to assess abnormal patterns of electrical activity in the brain. Proper diagnosis of seizures and epilepsy is essential for effective treatment. Diagnostic tests can help determine if and where a lesion in the brain is causing seizures. . In the majority of cases, there may be no cause that can be discovered for epilepsy or in some cases there are actual causes.”
John Hopkins Medicine (https://www.hopkinsmedicine.org/health/conditions-and-diseases/epilepsy)
Their epilepsy that is diagnosed with a IDIOPATHIC cause – meaning unknown cause and the patient could grow out of it in childhood in some cases (not all) depending on the type of seizure disorder and if the child doesn’t grow out of it the condition becomes chronic (for life).
Genetic influence (heredity). Some types of epilepsy run in families. In these instances, it’s likely that there’s a genetic influence. Researchers have linked some types of epilepsy to specific genes. But some people have genetic epilepsy that isn’t hereditary. Genetic changes can occur in a child without being passed down from a parent.For most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures.
Although heredity has been known since antiquity to cause epilepsy, the progress to date in identifying the genetic basis of epilepsy has been limited primarily to the discovery of single gene mutations that cause epilepsy in relatively rare families. For the more common types of epilepsy, heredity plays a subtler role, and it is thought that a combination of mutations in multiple genes likely determine an individual’s susceptibility to seizures, as well as the responsiveness to antiepileptic medications.
Epilepsy can be caused by genetic factors (inherited) or acquired (a etiology—cause) , although in most cases it arises in part from both. The neurology and neurological sciences of Stanford Epilepsy Center Dr. Robert S. Fischer Ph D. presents in the article Genetic Causes of Epilepsy.
He also presents in this article our genes are the instruction set for building the human body. Genes reside on chromosomes.
Going to the basics is every person has 46 chromosomes, carrying a total of about 30,000 genes. We get half our chromosomes from our mother and half from our father. While genes determine the structure of our body, they also control the excitability of our brain cells. Defective genes can make hyperexcitable brain cells, which are prone to seizures.
In recent years, several epilepsy conditions have been linked to mutations in genes, but the matter is complicated by the fact that different genes may be involved in different circumstances.
In general, the most common epilepsy conditions, including partial seizures, seem to be more acquired than genetic.
Gene testing will soon be able to identify predispositions to epilepsy, allowing doctors to help a patient get treatment and to assist with family counseling. One day, doctors may simply be able to swap a patient’s cheek, test his or her genes, and predict response to various epilepsy medicines, eliminating much of the trial and error in medication choice that goes on today. Eventually, we may even be able to repair or replace defective genes that predispose a person to epilepsy, a process called gene therapy.
Lastly, Dr. Robert Fischer Ph D presented in his article, that I found very interesting, the general population has about a 1% risk of developing epilepsy. Meanwhile, children of mothers with epilepsy have a 3 to 9% risk of inheriting this disease, while children of fathers have a 1.5 to 3% risk of inheritence. Still, the actual risk is upon the specific type of epilepsy. For example, partial seizures are less likely to run in families than are generalized seizures. In any event, with the usual forms of epilepsy, even if a parent does have the condition, there is more than a 90% chance that their child will not. So most epilepsies are acquired than inherited.
Clearly, genes determine a great deal of who we are, including our possible risk for epilepsy but slim versus a actual cause. But what happens to us in life and what we do is still the larger part of the risk for epilepsy.
A person given this diagnosis in the 1970’s, or before and even up to the early 1990’s was quiet about ever letting people know about this since in the 1970’s and back with lack of knowledge, information to the public and definitely technology versus now. Epilepsy is much more an accepted disease in the overall community compared to 20-25 years ago and back. Heck in the 1970’s and back these patients when having a seizure episode were characterized as “Freaks”. This was due to ignorance and lack of information to society/community but due to the past 20 to 25 years with the computer used more as a must in our lives with media, television and even our government they all have made it possible for society everywhere in the world to learn and understand diseases with acceptance in wanting to help those, particularly the US, but we still need a healthier America. It will take time to get there with the many multicultural lives that all live in the U.S. which practice differently on how important a healthy diet is with exercise balanced with rest. Also including stress well controlled is not always in America on their top priority list in living. Stress can even be a catalyst for a seizure but not the cause.
For a person diagnosed with or without a cause of epilepsy these steps in learning about the disease with higher technology and continuous research with medications over the years has allowed them to be able to live a completely healthy life doing the same things other people do without the disease but only if the patient is UNDER COMPLETE CONTROL which includes being COMPLIANT with your Rx; this does exist in America.
Compliant meaning taking their medications everyday as ordered by their neurologist with yearly or sooner follow-up visits with blood levels of the anti-seizure medications there on. This is the only way one with chronic epilepsy is guaranteed that living this way MAY stop the seizures from occurring (inactive epilepsy you can call it — meaning you’ll always have the disease but can put the seizure activity in a remission by medications preventing the seizure.)
Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including:
Head trauma/Degenerative Disease like Alzheimer’s or Creutfeldz-Jacob or Huntington’s Chorea or Multiple Sclerosis or Pick’s Disease. There is also tumors or genetic disease or Stroke or Infections or Febrile seizures.
Different epilepsies are due to many different underlying causes. The causes can be complex, and sometimes hard to identify. A person might start having seizures because they have one or more of the following.
Some researchers now believe that the chance of developing epilepsy is probably always genetic to some extent, in that any person who starts having seizures has always had some level of genetic likelihood to do so. This level can range from high to low and anywhere in between.
Even if seizures start after a brain injury or other structural change, this may be due to both the structural change and the person’s genetic tendency to seizures, combined. This makes sense if we consider that many people might have a similar brain injury, but not all of them develop epilepsy afterwards.
a.) Electrolyte Imbalance=In the blood having acidosis, heavy metal poisoning, Hypocalcemia (low Ca+) , Hypocapnea (low carbon dioxide), Hypoglycemia (low glucose), Hypoxia (low oxygen), Sodium-Potassium imbalance, and than Systemic diseases (liver, renal failure, etc…). Then their is also toxemia of pregnancy, and water intoxication.
b.) Infections like meningitis, encephalitis, brain abcess. Structural changes due to genetic conditions such as tuberous sclerosis, or neurofibromatosis, which can cause growths affecting the brain.
Tuberous sclerosis – a genetic condition that causes growths in organs including the brain. Tuberous sclerosis can cause epilepsy.
Neurofibromatosis – a genetic condition that causes benign tumours to grow on the covering of nerves. Neurofibromatosis can cause epilepsy.
c.) Withdrawal of sedative-hypnotic drugs=Alcohol, Antiepileptic drugs, Barbiturates, Benzodiazepines.
d.) Iatrogenic drug overdose=Theopylline, Penicillin.
The purpose for intial visits is for the Neurologist to determine if the patient is having a seizure or something else and to determine what diagnotic tooling tests to start with to help the doctor to find out the problem. Apart from the description of the seizure, there are other things that can help to explain why your seizures have happened. Your medical history and any other medical conditions will also be considered as part of your diagnosis.
If you have a seizure you may not remember what has happened. It can be helpful to have a description of what happened from someone who saw your seizure, to pass on to your GP or specialist.
For F/U (follow up) visits is for the neurologist to see how well your seizures are under control by taking drug blood levels of the anti seizure medication your taking to make sure the medication is in a therapeutic drug level and if not he or she will make dose changes in the med(s) your on. Possible do a EEG (electroencephalogram); the only test to decipher if you have spikes in your brain waves indicating you had a seizure determining from which lobe of the brain is having the seizures (a 26 lead to wires on the brain, which is painless). Go to the expert for keeping you on the right track. Its just like based on the principle why a person gets a check up on there car by seeing the mechanic (the car’s doctor) who fixes it. The expert, the Neurologist, fix your seizures or get them under control.
When the seizure occurs there is a decrease in oxygen since the brain isn’t capable to send messages during the seizure. The problem it too much electrical stimulation is happening in the brain causing the type of seizure to come on. If the seizure continues to repeat one right after another the person is in status epilepticus and if the seizures do not stop the person can lead to a neuronal death; like John Travolta’s son who died of this for example.
The term seizure disorder may refer to any number of conditions that result in such a paroxysmal electrical discharge. These conditions could be metabolic or structural in nature.
For example, if a metabolic condition this could be “Canavan disease” which is primarily a disease of demyelination. Your myelin sheath that protects and insulates the nerves is being destroyed and can cause a seizure as one of the symptoms.
*Another example being metabolic is thought to be caused by brain acetate deficiency resulting from a defect of N–acetylaspartic acid (NAA) catabolism (meaning breakdown is occurring). Accumulation of NAA, a compound thought to be responsible for maintaining cerebral fluid balance, can lead to cerebral edema and neurological injury, like a seizure as one symptoms of the disease.
*Sometimes there is a known cause and than there is just idiopathic, unknown cause for the epilepsy which if starts in childhood can resolve by the child growing out it, like in petite mal seizures but other times that is not the case and goes into motor/focal or grand mal that is permanent so the individual needs Rx for life.
Remember, not all seizures are due to epilepsy. Other conditions that can look like epilepsy include fainting, or very low blood sugar in some people being treated for diabetes.
Remember, etiology (the cause) of Epilepsy can be generally a sign of underlying pathology involving the brain–knowing the cause. To find this out diagnostic tooling be a neurologist who specializes in epilepsy is the best resource to go to. The epilepsy may be the first sign of a nervous system disease (ex. Brain tumor), or it may be a sign of a systemic or metabolic derangement. Where the treatment may be able to resolve the seizure symptom completely where this wasn’t a seizure disorder or epilepsy but just a symptom due to another disorder that may be 100% cured, like a operable tumor removed surgically from the brain.
Check out Part II tomorrow!
“Lung cancer diagnosis often starts with an imaging test to look at the lungs. If you have symptoms that worry you, a healthcare professional might start with an X-ray. If you smoke or used to smoke, you might have an imaging test to look for signs of lung cancer before you develop symptoms. People with an increased risk of lung cancer may consider yearly lung cancer screening using low-dose CT scans. Lung cancer screening is generally offered to people 50 and older who smoked heavily for many years. Screening also is offered to people who have quit smoking in the past 15 years. Discuss your lung cancer risk with your healthcare professional. Together you can decide whether lung cancer screening is right for you. Treatment for lung cancer usually begins with surgery to remove the cancer. If the cancer is very large or has spread to other parts of the body, surgery may not be possible. Treatment might start with medicine and radiation instead. Your healthcare team considers many factors when creating a treatment plan.”
MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627)
For many people, the first sign that they may have lung cancer is the appearance of a suspicious spot on a chest x-ray or a CT scan. But an image alone is not enough to tell you whether you have cancer and, if so, what type of cancer it is.
Most people who come to us for a lung cancer diagnosis first meet with a surgeon. He or she will work with pathologists, radiologists, and other lung cancer specialists to determine the specific type of lung cancer you have and how advanced it is. These findings help your disease management team develop the most successful treatment plan for you.
The first step is for your doctor to get a tissue sample using one of several biopsy methods. Then a pathologist — a type of doctor who specializes in diagnosing disease —who focuses on lung cancer studies the tissue under a microscope to determine whether you have lung cancer and, if so, what type. He or she will be able to tell this by looking closely at the cancer cells’ shape and other features.
Knowing which type of lung cancer you have will help your doctors to stage the tumor accurately and to begin identifying the best treatment approach. Understanding what type of cancer you have is also important because each type responds differently to certain chemotherapy drugs.
Several organizations recommend people with an increased risk of lung cancer consider annual computerized tomography (CT) scans to look for lung cancer. If you’re 55 or older and smoke or used to smoke, talk with your doctor about the benefits and risks of lung cancer screening.
If there’s reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. In order to diagnose lung cancer, your doctor may recommend:
“There are many cancers that affect the lungs, but we usually use the term “lung cancer” for two main kinds: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It accounts for over 80% of lung cancer cases. Common types include adenocarcinoma and squamous cell carcinoma. Adenosquamous carcinoma and sarcomatoid carcinoma are two less common types of NSCLC. Small cell lung cancer (SCLC) grows more quickly and is harder to treat than NSCLC. It’s often found as a relatively small lung tumor that’s already spread to other parts of your body. Specific types of SCLC include small cell carcinoma (also called oat cell carcinoma) and combined small cell carcinoma. Cancer is usually staged based on the size of the initial tumor, how far or deep into the surrounding tissue it goes, and whether it’s spread to lymph nodes or other organs. Each type of cancer has its own guidelines for staging but ranges from stage 0 to stage 5.”
Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/4375-lung-cancer)
Understanding if and where lung cancer has spread (the stage) is important to determining what options are available for treatment. Imaging tests, biopsies and laboratory tests help to determine staging.
Non-small cell lung cancer is one of several cancers staged using the TNM system. The cancer is staged according to the size of the tumor (T), the extent to which the cancer has spread to the lymph nodes (N), and the extent to which the cancer has spread beyond the lymph nodes, or metastasis (M).
The TNM staging system:
How big is the tumor? Where is it located? Has it spread to nearby tissue?
| TX | The primary tumor cannot be assessed, or the presence of a tumor was only proven by the finding of cancer cells in sputum or bronchial washings but not seen in imaging tests or bronchoscopy. |
| T0 | No evidence of a primary tumor. |
| Tis | “In situ” – cancer is only in the area where the tumor started and has not spread to nearby tissues. |
| T1 | The tumor is less than 3 cm (just slightly over 1 inch), has not spread to the membranes that surround the lungs (visceral pleura), and does not affect the air tunes (bronchi) that brand out on either side from the windpipe (trachea). |
| T1a | The tumor is less than 2 cm. |
| T1b | The tumor is larger than 2 cm but less than 3 cm. |
| T2 | The tumor is larger than 3 cm but less than 7 cm or involves the main air tubes (bronchus) that brand out from the windpipe (trachea) or the membranes that surround the lungs (visceral pleura). The tumor may partially block the airways but has not caused the entire lung to collapse (atelectasis) or to develop pneumonia). |
| T2a | The tumor is larger than 3 cm but less than or equal to 5 cm. |
| T2b | The tumor is larger than 5 cm but less than or equal to 7 cm. |
| T3 | The tumor is more than 7 cm or touches an area near the lung (such as the chest wall or diaphragm, or sac surrounding the heart (pericardium) or has grown into the main air tubes (bronchus) that brand out from the windpipe (trachea) but not the area where the windpipe divides or has caused one lunch to collapse (atelectasis) or pneumonia in an entire lung or there is a separate tumor(s) in the same lobe. |
| T4 | The tumor is of any size and has spread to the area between the lungs (mediastinum), heart, trachea, esophagus, backbone or the place where the windpipe (trachea) branches or there is a separate tumor(s) in a different lobe of the same lung. |
Has the cancer spread to the lymph nodes in and around the lungs? For more information on the lymph system and lymph nodes, see Lymph System
| NX | Regional lymph nodes cannot be assessed. |
| N0 | No cancer found in lymph nodes. |
| N1 | Cancer has spread to lymph nodes within the lung or to the area where the air pipes (bronchus) that branch out from the windpipe enter the lung, but only on the same side of the lung as the tumor (ipsilateral). |
| N2 | Cancer has spread to lymph nodes near where the windpipe (trachea) branches into the left and right air tubes (bronchi) or near the area in the center of the lung (mediastinum) but only on the same side of the lung as the tumor. |
| N3 | Cancer has spread to lymph nodes found on the opposite side of the lung as the tumor (contralateral) or lymph nodes in the neck. |
Has the cancer spread to other parts of the body?
| MX | Cancer spread cannot be assessed |
| M0 | Cancer has not spread. |
| M1 | Cancer has spread. |
| M1a | Cancer has spread: separate tumor(s) in a lobe in the opposite lung from the primary tumor (contralateral), or malignant nodules in the membrane that surround the lung (pleura) or malignant excess fluid (effusion) in the pleura or membrane that surround the hear (pericardium). |
| M1b | Cancer has spread to distant part of the body such as brain, kidney, bone. |
After the Tumor (T), Lymph Nodes (N) and Metastasis (M) have been determined, the cancer is then staged accordingly:
| Overall Stage | T | N | M |
|---|---|---|---|
| Stage 0 | Tis (in situ) | N0 | M0 |
| Stage IA | T1a, b | N0 | M0 |
| Stage IB | T2a | N0 | M0 |
| Stage IIA | T1a, b T2a T2b |
N1 N1 N0 |
M0 M0 M0 |
| Stage IIB | T2b T3 |
N1 N0 |
M0 M0 |
| Stage IIIA | T1, T2 T3 T4 |
N2, N1 N2, N0 N1 |
M0 M0 M0 |
| Stage IIIB | T4 Any T |
N2 N3 |
M0 M0 |
| Stage IV | Any T | Any N | M1a, b |
Small cell lung cancer is most often staged as either limited-stage or extensive-stage.
Limited-Stage
Indicates that the cancer has not spread beyond one lung and the lymph nodes near that lung.
Extensive-Stage
The cancer is in both lungs or has spread to other areas of the body.
International Association for the Study of Lung Cancer. Goldstraw P, ed. Staging Handbook in Thoracic Oncology. Orange Park: Editorial Rx Press; 2009.