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ICD-9-CM CODE

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  • 345.9 Epilepsy

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ICD-10-CM CODE

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  • G40.909 Epilepsy, epileptic, epilepsia (attack) (cerebral) (convulsion) (fit) (seizure)

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PREFERRED PRACTICE PATTERNS

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  • 5A: Primary Prevention/Risk Reduction for Loss of Balance and Falling1

  • 5C: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System—congenital origin or acquired in infancy or childhood2

  • 5D: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System—acquired in adolescence or adulthood3

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PATIENT PRESENTATION

A physical therapist is evaluating a 15-year-old boy with a history of epilepsy since the age of 12. The boy suffered a medial collateral ligament tear during the last epileptic seizure 2 weeks ago. During the interview, the boy states that he has heard exercise will help him not have epileptic episodes. The physical therapist explains the interaction between exercise and epilepsy and proceeds to develop a plan of care to address the knee instability and exercise tolerance.

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KEY FEATURES

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Description
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  • Chronic disorder of various causes characterized by recurrent seizures

  • Seizures result from sudden and excessive electrical discharge of large groups of neurons.

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Essentials of Diagnosis
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  • Diagnosis requires that the individual experience seizures, but not all seizures are indicative of epilepsy.

  • Epilepsy can be caused by any major category of serious disease or human disorder.

  • Approximately 1% of cases result from genetic disease

  • People with idiopathic or primary epilepsies share the following features:

    • Variable family history

    • Generalized spike-wave abnormality on electroencephalogram (EEG)

    • Onset in childhood or adolescence

  • Development of epilepsy in an individual who suffers brain injury is influenced by family history and premorbid and postmorbid EEG abnormalities.

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General Considerations
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  • Third most common serious neurologic disease in the elderly, following stroke and dementia.

  • Depression commonly occurs in people with epilepsy.

    • Suggested that the hippocampus, implicated in both mood disorders and seizures, is likely link between depression and epilepsy.

  • Events that may trigger seizure in people with epilepsy include

    • Stress

    • Poor nutrition

    • Missed medication

    • Skipping meals

    • Flickering lights

    • Illness

    • Fever and allergies

    • Lack of sleep

    • Strong emotions

    • Heat and humidity

  • Fear of seizure may cause self-restriction of activities resulting in deconditioning, reduced balance strategy, loss of muscle strength, and endurance.

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FIGURE 87-1

Distribution of the main types of epilepsy by age. Apparent is the overrepresentation of absence and myoclonic seizures in childhood and of complex partial seizures in older individuals. (Adapted from Hauser WA, Annegers JF: Epidemiology of epilepsy. In: Laidlaw JP, Richens A, Chadwick D, eds. Textbook of Epilepsy, 4th ed. New York, NY: Churchill Livingstone; 1992: 23–45 and Engel J Jr, Pedley TA. Epilepsy: A Comprehensive Textbook. Philadelphia, PA: Davis, 1998.)

Graphic Jump Location
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FIGURE 87-2

Relations among cortical ...

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