Types of seizures

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

Diagnosis

The history of the person is the most valuable component of the workup of that individual with possible epilepsy.

The routine diagnostic tooling to see if someone has this disease is a EEG which is the major diagnostic test.  EEG takes short samples of brain wave activity with 26 wires to the scalp recording amplified brain waves from the superficial regions of the brain by means of scalp electrodes.

Laboratory studies are done to rule out various causes for seizures.  Routine blood and urine studies are often done for baseline information.  Electrolytes and blood chemistries will be evaluated to identify possible metabolic causes for seizures.

Neuropsychological testing may be done in the evaluation of persons presenting with seizures.  The purpose of neuropsychological testing is to determine if there is brain dysfunction and to determine if the pattern of change in brain function is indicative of a destructive lesion.  Neuropsychological testing involves evaluation of cognitive functions and personality and emotional traits.

Medical Management

The major medical treatment for epilepsy is antiepileptic medications.  Epileptic seizures can be controlled in 50 to 95% of cases with this form of treatment depending on seizure type and compliance of the individual taking their medications.

Those taking medications for epilepsy know if a single first line  drug is not effective a second first lin drug is added but the noneffective drug is tapered off while the second first line drug is given.  Know during this time frame there is a risk for seizure activity so practice safety (ex. do not drive).

In some cases there is surgery:  those with intractable seizures is the epileptic focus may be possible.  In some cases partial complex seizures are the common seizure treated by surgery.  The focus of this seizure type has often been found in the anterior temporal and inferior frontal regions of the brain cortex.

There are other treatments as well.

Care during a Seizure

The care of a person in a seizure should focus primarily on maintaining a safe environment.  The seizure that has greatest risk for causing injury and even fatality is the generalized tonic/clonic (grand mal), although there is a potential for injury with any seizure that involves alteration of consciousness.

The 2 major goals for care during a seizure are protection from injury and prevention of aspiration.  The person’s head should be cradled if on the floor to prevent banging of the head.  At no time should the person be restraint when having a seizure.  The person should be turned to their side to allow the tongue to fall away from the airway and allow drainage of the excessive saliva that accumulates to drain out of the mouth during the seizure.  You should stay with the person till the seizure stops and note the behavior mentally and physically the person exhibits while having the seizure and how long it lasts.  Immediately call 911 (especially if this is the first seizure the person ever had) or call the neurologist of the individual to have the him or her be evaluated ASAP.

“-65 MILLION: Number of people around the world who have epilepsy.

-3.4 MILLION: Number of people in the United States who have epilepsy.

-1 IN 26 people in the United States will develop epilepsy at some point in their lifetime.”

Epilepsy Foundation

Most people with epilepsy are otherwise healthy; as long as it is controlled like most other diseases.  A seizure is a physical manifestation of paroxysmal and abnormal electrical firing of neurons in the brain.  Think of it as numerous voltage (hyperexcitability of neurons) going throughout the brain meaning brain waves going in all directions with the brain saying its too much activity causing the brain to go into a seizure.

When the seizure occurs there is a decrease in oxygen since the brain isn’t capable to send messages during the seizure.  If the seizure continues to repeat one right after another the person is in status epilepticus and if the seizures doesn’t stop the person can lead to a neuronal death;  like John Travolta’s son who died of this.

The term seizure disorder may refer to any number of conditions that result in such a paroxysmal electrical discharge.  These conditons could be metabolic or structural in nature.   Epilepsy is the term for those who have a second seizure that occurs spontaneously and without preceding metabolic or structural cause for the occurrence.  Epilepsy is a chronic disorder that requires antiepileptic drug therapy; usually thorough out life.

Etiology of Epilepsy is generally a sign of underlying pathology involving the brain.  It may be the first sign of nervous system disease (ex. Brain tumor), or it may be a sign of a systemic or metabolic derangement.

Metabolic and Systemic Causes of Seizures:

a.) Electrolyte Imbalance=Acidosis, heavy metal poisoning, Hypocalcemia, Hypocapnea, Hypoglycemia, Hypoxia, Sodium-Potassium imbalance, Systemic  diseases (liver, renal failure, etc…) Toxemia of pregnancy, and water intoxication.

b.) Infections like meningitis, encephalitis, brain abcess.

c.) Withdrawal of sedative-hypnotic drugs=Alcohol, Antiepileptic drugs, Barbiturates, Benzodiazepines.

d.) Iatrogenic drug overdose=Theopylline, Penicillin.

Other causes of epilepsy can be Trauma, Heredity.

“Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.  Coronaviruses are zoonotic, meaning they are transmitted between animals and people.  Detailed investigations found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans.”

World Health Organizations (WHO)

2019 Novel Coronavirus (2019-nCoV) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Early on, many of the patients in the outbreak in Wuhan, China reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. However, a growing number of patients reportedly have not had exposure to animal markets, indicating person-to-person spread is occurring. At this time, it’s unclear how easily or sustainably this virus is spreading between people.

Much is unknown about how 2019-nCoV, a new coronavirus, spreads. Current knowledge is largely based on what is known about similar coronaviruses. Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS, SARS, and now with 2019-nCoV.

Most often, spread from person-to-person happens among close contacts (about 6 feet). Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It’s currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.

Typically, with most respiratory viruses, people are thought to be most contagious when they are most symptomatic (the sickest).

It’s important to note that how easily a virus spreads person-to-person can vary. Some viruses are highly contagious (like measles), while other viruses are less so. There is much more to learn about the transmissibility, severity, and other features associated with 2019-nCoV and investigations are ongoing.

SYMPTOMS:

For confirmed 2019-nCoV infections, reported illnesses have ranged from people with little to no symptoms to people being severely ill and dying. Symptoms can include:

• Fever
• Cough
• Shortness of breath

CDC has developed a new laboratory test kit for use in testing patient specimens for 2019 novel coronavirus (2019-nCoV). The test kit is called the “Centers for Disease Control and Prevention (CDC) 2019-Novel Coronavirus (2019-nCoV) Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panel.” It is intended for use with the Applied Biosystems 7500 Fast DX Real-Time PCR Instrument with SDS 1.4 software. This test is intended for use with upper and lower respiratory specimens collected from persons who meet CDC criteria for 2019-nCoV testing. CDC’s test kit is intended for use by laboratories designated by CDC as qualified, and in the United States, certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity tests. The test kits also will be shipped to qualified international laboratories, such as World Health Organization (WHO) Global Influenza Surveillance Response System (GISRS) laboratories.

PREVENTION:

There is currently no vaccine to prevent 2019-nCoV infection. The best way to prevent infection is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:

• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

“Age-related macular degeneration (AMD) is a problem with your retina. It happens when a part of the retina called the macula is damaged. With AMD you lose your central vision. You cannot see fine details, whether you are looking at something close or far. But your peripheral (side) vision will still be normal.”

American Academy of Ophthalmology

Age-related macular degeneration (AMD) is a deterioration or breakdown of the eye’s macula. The macula is a small area in the retina — the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly.

The macula makes up only a small part of the retina, yet it is much more sensitive to detail than the rest of the retina (called the peripheral retina). The macula is what allows you to thread a needle, read small print, and read street signs. The peripheral retina gives you side (or peripheral) vision. If someone is standing off to one side of your vision, your peripheral retina helps you know that person is there by allowing you to see their general shape.

Many older people develop macular degeneration as part of the body’s natural aging process. There are different kinds of macular problems, but the most common is age-related macular degeneration.

Signs and symptoms of Macular Degenerative Disease:

With macular degeneration, you may have symptoms such as blurriness, dark areas or distortion in your central vision, and perhaps permanent loss of your central vision. It usually does not affect your side, or peripheral vision. For example, with advanced macular degeneration, you could see the outline of a clock, yet may not be able to see the hands of the clock to tell what time it is.

• Blurry distance and/or reading vision
• Need for increasingly bright light to see up close
• Colors appear less vivid or bright
• Hazy vision
• Difficulty seeing when going from bright light to low light (such as entering a dimly lit room from the bright outdoors)
• Trouble or inability to recognize people’s faces
• Blank or blurry spot in your central vision.

The Risks of Macular Degeneration:

The risk factors we can control=Modifiable Rish Factors:

1. Smoking: Current smokers have a two-to-three times higher risk for developing age-related macular degeneration than people have who never smoked.
2. Artificial fats: Usually labeled “partially-hydrogenated vegetable oils,” these artificial fats are pervasive in foods and particularly in low-fat bakery goods. Low-fat foods are good options if they’ve achieved their low-fat status through a process that physically removes the fat, as in skim milk or low-fat cottage cheese. Low-fat bakery goods are different, however. If you remove all or half the fat from a cake recipe, it won’t turn into a cake; thus, when cakes and bakery goods are labeled low-fat or no-fat, it means they contain artificial fats, or laboratory-produced chemicals. These chemicals are not food and our bodies can’t metabolize them.
3. Sunlight: It is the blue wavelengths from the sun that damage the macula, not the ultraviolet (UV) rays.
4. A diet high in processed, packaged foods and low in fresh vegetables: Vegetable oils are added in the packaging process. These oils are rich in omega-6 fatty acids, which promote inflammation.
5. Uncontrolled hypertension and high cholesterol: Research by the National Eye Institute indicates that persons with hypertension are 1.5 times more likely to develop wet macular degeneration than persons without hypertension.
6. Obesity: Being overweight doubles the risk of developing advanced macular degeneration.

The four risk factors we can’t control=Unmodifiable Risk Factors:

1. Advanced age: Although AMD may occur earlier, studies indicate that people over age 60 are at greater risk than those in younger age groups. For instance, a large study found that people in middle age have about a 2% risk of getting AMD, but this risk increased to nearly 30 percent in those over age 75.
2. Race: Whites are much more likely to lose vision from age-related macular degeneration than are Blacks or African-Americans.
3. A gene variant that regulates inflammation: While not all types of macular degeneration are hereditary, certain genes have been strongly associated with a person’s risk of age-related macular degeneration, and genetic predisposition may account for half the cases of age-related macular degeneration in this country.
4. Family history: Studies indicate that your chances of developing age-related macular degeneration are three to four times higher if you have a parent, child, or sibling with macular degeneration.

Treatment of Macular Degeneration:

People who develop significant age-related macular degeneration (AMD) typically compensate with large-print publications and magnifying lenses for everyday activities. In addition, evidence suggests that certain vitamins and antioxidants — vitamins C and E, beta-carotene, and zinc — may help reduce or delay the risk of severe vision loss. Ask your eye doctor about using nutritional supplements.

Treatment for Dry Macular Degeneration

Dry macular degeneration, the most common form of AMD, cannot be cured at this time, but patients with the condition should continue to remain under an ophthalmologist’s care to monitor both eyes. If the one eye is healthy, screening should still continue.

Treatment for Wet Macular Degeneration

A variety of treatments are available for wet AMD. Successful treatment may not restore normal vision, but it will improve sight and prevent central vision loss from worsening. While laser procedures can destroy the abnormal blood vessels, they also damage neighboring retinal tissue.

Medications, such as Eylea, Lucentis, and Macugen, have become the preferred treatment for acute wet macular degeneration, helping to prevent the growth of leaky blood vessels in your eye. Lucentis is given once every month, although some patients may need treatment only once every three months. Macugen is given every six weeks. Eylea is given once every two months after three once-monthly injections.

Laser photocoagulation destroys leaking blood vessels that have grown under the macula and halts the leakage. Laser therapy is helpful for about 10%-20% of people with wet macular degeneration. Some vision loss may occur, because this treatment creates scar tissue that is perceived as blind spots; however, even more vision would be lost if nothing is done at all. Up to half of patients who elect laser therapy may need repeat treatments.

Photodynamic therapy (PDT) uses a different, non-heat-generating laser to treat abnormal blood vessels. Visudyne is injected into the patient’s arm and flows through the vessels in the eye. Upon exposure to the laser, a chemical reaction occurs that seals off the leaky vessels. Since the dye is light sensitive, you must stay out of the sun or bright light for several days until the dye has passed from your system. Laser photocoagulation must be done before the abnormal blood vessels cause irreversible damage to the retina. More blood vessels could grow later on, so people who undergo this treatment also need to continue with regular follow-up appointments.

Vitamins. A large study performed by the National Eye Institute of the National Institutes of Health, called AREDS (Age-Related Eye Disease Study), showed that for certain individuals, vitamins C, E, beta-carotene, zinc and copper can decrease the risk of vision loss in patients with intermediate to advanced dry macular degeneration. In addition, there was a correlation between the hormone DHEA and the degree of macular degeneration. DHEA can be purchased over-the-counter.

“Nearly 80 percent of cardiac events can be prevented, cardiovascular diseases continue to be a woman’s greatest health threat. ”

goredforwomen.org

“Burn Awareness Week, observed the first full week in February, is a window of opportunity for organizations to mobilize burn, fire and life safety educators to unite in sharing a common burn awareness and prevention message in our communities.”

American Burn Association

“In the United States, almost one in four women dies from heart disease. Heart disease is the most common cause of death in American women.¹ Some types of heart problems are more common in women.”

WomensHealth.gov