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Search And Seizure : Lesson Plan
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Read more. Our services 2 History homework help Assignment writing help US history homework help Pay for coursework Pay for research paper History homework answers. Statistics Do my homework for me Math homework. Ready to get your homework done? In surveys of people with epilepsy, stress is the most commonly reported seizure trigger. Exposure to toxins or poisons such as lead or carbon monoxide, street drugs, or even excessively large doses of antidepressants or other prescribed medications also can trigger seizures.
Sleep deprivation is a powerful trigger of seizures. Sleep disorders are common among people with the epilepsies and appropriate treatment of co-existing sleep disorders can often lead to improved control of seizures. For some people, visual stimulation can trigger seizures in a condition known as photosensitive epilepsy.
Stimulation can include such things as flashing lights or moving patterns. However, there are many different types of seizures in each of these categories. In fact, doctors have described more than 30 different types of seizures. Focal seizures originate in just one part of the brain. About 60 percent of people with epilepsy have focal seizures. These seizures are frequently described by the area of the brain in which they originate. Many people are diagnosed with focal frontal lobe or medial temporal lobe seizures.
The person may experience sudden and unexplainable feelings of joy, anger, sadness, or nausea. He or she also may hear, smell, taste, see, or feel things that are not real and may have movements of just one part of the body, for example, just one hand.
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In other focal seizures, the person has a change in consciousness, which can produce a dreamlike experience. The person may display strange, repetitious behaviors such as blinks, twitches, mouth movements often like chewing or swallowing, or even walking in a circle. More complicated actions, which may seem purposeful, can also occur involuntarily.
Individuals may also continue activities they started before the seizure began, such as washing dishes in a repetitive, unproductive fashion. These seizures usually last just a minute or two. Auras are usually focal seizures without interruption of awareness e. The symptoms of focal seizures can easily be confused with other disorders. The strange behavior and sensations caused by focal seizures also can be mistaken for symptoms of narcolepsy, fainting, or even mental illness.
Several tests and careful monitoring may be needed to make the distinction between epilepsy and these other disorders. Generalized seizures are a result of abnormal neuronal activity that rapidly emerges on both sides of the brain. The many kinds of generalized seizures include:. Not all seizures can be easily defined as either focal or generalized. Some people have seizures that begin as focal seizures but then spread to the entire brain. Other people may have both types of seizures but with no clear pattern.
Some people recover immediately after a seizure, while others may take minutes to hours to feel as they did before the seizure. During this time, they may feel tired, sleepy, weak, or confused. Following focal seizures or seizures that started from a focus, there may be local symptoms related to the function of that focus.
If the focus is in the temporal lobe, post-ictal symptoms may include language or behavioral disturbances, even psychosis. After a seizure, some people may experience headache or pain in muscles that contracted. Just as there are many different kinds of seizures, there are many different kinds of epilepsy. For other syndromes, the cause is unknown.
Epilepsy syndromes are frequently described by their symptoms or by where in the brain they originate. These seizures almost always begin in childhood or adolescence and tend to run in families, suggesting that they may be at least partially due to genetic factors. Individuals may show purposeless movements during their seizures, such as a jerking arm or rapidly blinking eyes, while others may have no noticeable symptoms except for brief times when they appear to be staring off into space.
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Immediately after a seizure, the person can resume whatever he or she was doing. However, these seizures may occur so frequently in some cases up to or more a day that the person cannot concentrate in school or other situations. Childhood absence epilepsy usually stops when the child reaches puberty. It can affect the part of the brain that controls movement and involves seizures that can cause muscle weakness or abnormal, uncontrolled movement such as twisting, waving the arms or legs, eye deviation to one side, or grimacing, and are usually associates with some loss of awareness.
Seizures usually occur when the person is asleep but also may occur while awake. Temporal lobe epilepsy , or TLE, is the most common epilepsy syndrome with focal seizures. The seizure itself is a brief period of impaired consciousness which may appear as a staring spell, dream-like state, or repeated automatisms. TLE often begins in childhood or teenage years. Research has shown that repeated temporal lobe seizures are often associated with shrinkage and scarring sclerosis of the hippocampus.
The hippocampus is important for memory and learning. It is not clear whether localized asymptomatic seizure activity over years causes the hippocampal sclerosis. The seizures can be either focal or generalized. Symptoms may include unusual sensations, visual hallucinations, emotional changes, muscle contractions, convulsions, and a variety of other symptoms, depending on where in the brain the seizures originate. There are many other types of epilepsy that begin in infancy or childhood. Seizure onset is usually before age four years. This severe form of epilepsy can be very difficult to treat effectively.
Children with Dravet syndrome have seizures that start before age one and later in infancy develop into other seizure types. People with hypothalamic hamartoma have seizures that resemble laughing or crying. Such seizures frequently go unrecognized and are difficult to diagnose. While any seizure is cause for concern, having a seizure does not by itself mean a person has epilepsy. First seizures, febrile seizures, nonepileptic events, and eclampsia a life-threatening condition that can occur in pregnant women are examples of conditions involving seizures that may not be associated with epilepsy.
Many people have a single seizure at some point in their lives, and it can be provoked or unprovoked, meaning that they can occur with or without any obvious triggering factor. Unless the person has suffered brain damage or there is a family history of epilepsy or other neurological abnormalities, the majority of single seizures usually are not followed by additional seizures. Medical disorders which can provoke a seizure include low blood sugar, very high blood sugar in diabetics, disturbances in salt levels in the blood sodium, calcium, magnesium , eclampsia during or after pregnancy, impaired function of the kidneys, or impaired function of the liver.
Sleep deprivation, missing meals, or stress may serve as seizure triggers in susceptible people. Many people with a first seizure will never have a second seizure, and physicians often counsel against starting antiseizure drugs at this point. In some cases where additional epilepsy risk factors are present, drug treatment after the first seizure may help prevent future seizures.
Evidence suggests that it may be beneficial to begin antiseizure medication once a person has had a second unprovoked seizure, as the chance of future seizures increases significantly after this occurs. A person with a pre-existing brain problem, for example, a prior stroke or traumatic brain injury, will have a higher risk of experiencing a second seizure. In one study that followed individuals for an average of 8 years, 33 percent of people had a second seizure within 4 years after an initial seizure.
People who did not have a second seizure within that time remained seizure-free for the rest of the study. For people who did have a second seizure, the risk of a third seizure was about 73 percent by the end of 4 years. Among those with a third unprovoked seizure, the risk of a fourth was 76 percent. Not infrequently a child will have a seizure during the course of an illness with a high fever. These seizures are called febrile seizures.
Antiseizure medications following a febrile seizure are generally not warranted unless certain other conditions are present: a family history of epilepsy, signs of nervous system impairment prior to the seizure, or a relatively prolonged or complicated seizure.
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The risk of subsequent non-febrile seizures is low unless one of these factors is present. Results from a study funded by the National Institute of Neurological Disorders and Stroke NINDS suggested that certain findings using diagnostic imaging of the hippocampus may help identify which children with prolonged febrile seizures are subsequently at increased risk of developing epilepsy.
Researchers also have identified several different genes that influence the risks associated with febrile seizures in certain families. Studying these genes may lead to new understandings of how febrile seizures occur and perhaps point to ways of preventing them. An estimated 5 to 20 percent of people diagnosed with epilepsy actually have non-epileptic seizures NES , which outwardly resemble epileptic seizures, but are not associated with seizure-like electrical discharge in the brain.
Non-epileptic events may be referred to as psychogenic non-epileptic seizures or PNES, which do not respond to antiseizure drugs. Instead, PNES are often treated by cognitive behavioral therapy to decrease stress and improve self-awareness. A history of traumatic events is among the known risk factors for PNES. People with PNES should be evaluated for underlying psychiatric illness and treated appropriately. Two studies together showed a reduction in seizures and fewer coexisting symptoms following treatment with cognitive behavioral therapy.
Some people with epilepsy have psychogenic seizures in addition to their epileptic seizures. Other nonepileptic events may be caused by narcolepsy sudden attacks of sleep , Tourette syndrome repetitive involuntary movements called tics , cardiac arrhythmia irregular heart beat , and other medical conditions with symptoms that resemble seizures. Because symptoms of these disorders can look very much like epileptic seizures, they are often mistaken for epilepsy.
Although most people with epilepsy lead full, active lives, there is an increased risk of death or serious disability associated with epilepsy. There may be an increased risk of suicidal thoughts or actions related to some antiseizure medications that are also used to treat mania and bipolar disorder. Status epilepticus is a potentially life-threatening condition in which a person either has an abnormally prolonged seizure or does not fully regain consciousness between recurring seizures. Status epilepticus can be convulsive in which outward signs of a seizure are observed or nonconvulsive which has no outward signs and is diagnosed by an abnormal EEG.
Nonconvulsive status epilepticus may appear as a sustained episode of confusion, agitation, loss of consciousness, or even coma. Any seizure lasting longer than 5 minutes should be treated as though it was status epilepticus. There is some evidence that 5 minutes is sufficient to damage neurons and that seizures are unlikely to end on their own, making it necessary to seek medical care immediately. One study showed that 80 percent of people in status epilepticus who received medication within 30 minutes of seizure onset eventually stopped having seizures, whereas only 40 percent recovered if 2 hours had passed before they received medication.
The mortality rate can be as high as 20 percent if treatment is not initiated immediately. Researchers are trying to shorten the time it takes for antiseizure medications to be administered. A key challenge has been establishing an intravenous IV line to deliver injectable antiseizure drugs in a person having convulsions. An NINDS-funded study on status epilepticus found that when paramedics delivered the medication midazolam to the muscles using an autoinjector, similar to the EpiPen drug delivery system used to treat serious allergic reactions, seizures could be stopped significantly earlier compared to when paramedics took the time to give lorazepam intravenously.
For reasons that are poorly understood, people with epilepsy have an increased risk of dying suddenly for no discernible reason. Some studies suggest that each year approximately one case of SUDEP occurs for every 1, people with the epilepsies. For some, this risk can be higher, depending on several factors. SUDEP can occur at any age. Researchers are still unsure why SUDEP occurs, although some research points to abnormal heart and respiratory function due to gene abnormalities ones which cause epilepsy and also affect heart function. People with epilepsy may be able to reduce the risk of SUDEP by carefully taking all antiseizure medication as prescribed.
Not taking the prescribed dosage of medication on a regular basis may increase the risk of SUDEP in individuals with epilepsy, especially those who are taking more than one medication for their epilepsy. A number of tests are used to determine whether a person has a form of epilepsy and, if so, what kind of seizures the person has. This most common diagnostic test for epilepsy records electrical activity detected by electrodes placed on the scalp. Some people who are diagnosed with a specific syndrome may have abnormalities in brain activity, even when they are not experiencing a seizure.
However, some people continue to show normal electrical activity patterns even after they have experienced a seizure. These occur if the abnormal activity is generated deep in the brain where the EEG is unable to detect it. Many people who do not have epilepsy also show some unusual brain activity on an EEG. Ideally, EEGs should be performed while the person is drowsy as well as when he or she is awake because brain activity during sleep and drowsiness is often more revealing of activity resembling epilepsy.
Video monitoring may be used in conjunction with EEG to determine the nature of a person's seizures and to rule out other disorders such as psychogenic non-epileptic seizures, cardiac arrhythmia, or narcolepsy that may look like epilepsy. A magnetoencephalogram MEG detects the magnetic signals generated by neurons to help detect surface abnormalities in brain activity. MEG can be used in planning a surgical strategy to remove focal areas involved in seizures while minimizing interference with brain function. CT and MRI scans reveal structural abnormalities of the brain such as tumors and cysts, which may cause seizures.
SPECT single photon emission computed tomography is sometimes used to locate seizure foci in the brain. In a person admitted to the hospital for epilepsy monitoring, the SPECT blood flow tracer is injected within 30 seconds of a seizure, then the images of brain blood flow at the time of the seizure are compared with blood flow images taken in between seizures.
The seizure onset area shows a high blood flow region on the scan.
PET scans can be used to identify brain regions with lower than normal metabolism, a feature of the epileptic focus after the seizure has stopped. Taking a detailed medical history, including symptoms and duration of the seizures, is still one of the best methods available to determine what kind of seizures a person has had and to determine any form of epilepsy. The medical history should include details about any past illnesses or other symptoms a person may have had, as well as any family history of seizures. Since people who have suffered a seizure often do not remember what happened, caregiver or other accounts of seizures are vital to this evaluation.
The person who experienced the seizure is asked about any warning experiences. The observers will be asked to provide a detailed description of events in the timeline they occurred. Blood samples may be taken to screen for metabolic or genetic disorders that may be associated with the seizures.
Fourth Amendment; Search and Seizure
They also may be used to check for underlying health conditions such as infections, lead poisoning, anemia, and diabetes that may be causing or triggering the seizures. In the emergency department it is standard procedure to screen for exposure to recreational drugs in anyone with a first seizure. Tests devised to measure motor abilities, behavior, and intellectual ability are often used as a way to determine how epilepsy is affecting an individual.
These tests also can provide clues about what kind of epilepsy the person has. At this time there are no medications or other therapies that have been shown to prevent epilepsy. In some cases, the risk factors that lead to epilepsy can be modified. Good prenatal care, including treatment of high blood pressure and infections during pregnancy, may prevent brain injury in the developing fetus that may lead to epilepsy and other neurological problems later.
Treating cardiovascular disease, high blood pressure, and other disorders that can affect the brain during adulthood and aging also may prevent some cases of epilepsy. Prevention or early treatment of infections such as meningitis in high-risk populations may also prevent cases of epilepsy. Also, the wearing of seatbelts and bicycle helmets, and correctly securing children in car seats, may avert some cases of epilepsy associated with head trauma.
Accurate diagnosis of the type of epilepsy a person has is crucial for finding an effective treatment.
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