Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 345.9 Epilepsy ++ G40.909 Epilepsy, epileptic, epilepsia (attack) (cerebral) (convulsion) (fit) (seizure) ++ 5A: Primary Prevention/Risk Reduction for Loss of Balance and Falling15C: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System – congenital origin or acquired in infancy or childhood25D: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System – acquired in adolescence or adulthood3 +++ Description ++ Chronic disorder of various causes characterized by recurrent seizures Seizures result from sudden and excessive electrical discharge of large groups of neurons +++ Essentials of Diagnosis ++ Diagnosis requires that the individual experience seizures, but not all seizures are indicative of epilepsyEpilepsy can be caused by any major category of serious disease or human disorderApproximately 1% of cases result from genetic diseasePeople with idiopathic or primary epilepsies share the following featuresVariable family historyGeneralized spike-wave abnormality on electroencephalogram (EEG)Onset in childhood or adolescenceDevelopment of epilepsy in an individual who suffers brain injury is influenced by family history and pre- and post-morbid EEG abnormalities +++ General Considerations ++ Third most common serious neurologic disease in the elderly, following stroke and dementiaDepression commonly occurs in people with epilepsySuggested that the hippocampus, implicated in both mood disorders and seizures, is likely link between depression and epilepsyEvents that may trigger seizure in people with epilepsy includeStressPoor nutritionMissed medicationSkipping mealsFlickering lightsIllnessFever and allergiesLack of sleepStrong emotionsHeat and humidityFear of seizure may cause self-restriction of activities resulting in deconditioning, reduced balance strategy, loss of muscle strength and endurance +++ Demographics ++ Affects approximately 45 million people worldwideHighest incidence in young children and elderly populations; 75% of cases have onset before age 20 yearsMen affected slightly more than women +++ Signs and Symptoms ++ Many people with epilepsy have no outward signs or symptoms except during seizureMost signs and symptoms related to medication use, such asAtaxiaNystagmusDizzinessConfusionSlurred speechNauseaVomitingFatigueLethargy +++ Functional Implications ++ Injury from fall at onset of seizures or collision with objects during the seizureAsphyxia if seizure occurs while eating, drinking, swimmingDeconditioning resulting in poor activity tolerance and increased fall risk +++ Possible Contributing Causes ++ StrokeIntracranial massTraumatic brain injurySubdural hematomaPneumoniaHypoxiaAlcohol abuseBrain abscessHigh doses of caffeine can trigger seizure in people with epilepsy +++ Differential Diagnosis ++ Transient ischemic attackHypoglycemiaOther seizure disorderSyncopeTransient cerebral anoxiaRecurrent cardiac arrhythmiaNonspecific dizziness or episodic vertigo +++ Imaging ++... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.