With 65 million people worldwide suffering from it, epilepsy is a growing health concern. One in twenty-six people will be diagnosed with epilepsy in the United States at some point in their lives. Epilepsy affects people of any age and any background (TEF, 2013). Sixty percent of cases are of unknown cause. Seizures affect different parts of the brain and result from different factors such as genetic, symptomatic, or idiopathic. Seizures can express themselves as partial (involved in one side of the brain) or generalized (involved in both sides of the brain), and as absent (the person stares blankly for a few seconds), atonic (person falls to the ground with loss of consciousness), tonic (the patient becomes very rigid and may or may not lose consciousness and falls to the ground), myoclonic (repetitive jerky motion) and tonic-clonic (a series of muscle stiffening and loosening and the patient loses consciousness and the patient falls to the ground). Patients can display signs of more than one type of seizure occurring in different parts of the brain (Solomon et. al., 2012). The condition is named epilepsy when the seizures are recurrent without any definitive trigger such as fever (Burns et. al., 2009).
Seizures are a result of misfiring of the cortical neurons of the brain which can cause episodes of involuntary contraction of voluntary muscles (Burns et. al., 2009). This sudden, transient disturbance of brain function can also influence involuntary motor, sensory, autonomic, or psychic events in any combination with or without the loss of consciousness (Hay et. al., 2011).
Diagnosis is based on a good history. The patient may or may not remember the incident and bystanders may only recall a few details since viewing a seizure for the first time can be traumatic in itself for some people. The clinician needs to know information pertaining to what was happening before, during, and after the event. Videotaping the event is very useful (Hay et. al, 2011). Some patients may experience an “aura” (a simple partial absent seizure) before a full-blown seizure emerges. Aside from the incident, the clinician also needs to know if the patient has any other underlying conditions such as cardiovascular disease, renal disease, or diabetes and if the patient recently had an infection or head injury. Facts about the birth history of the patient need to be discussed, especially if there was any birth trauma, intrauterine bleeding, or intrauterine infection involved. The patient or patient’s family should also be asked about any family history of seizures, and if the patient has missed any milestones during development. Physical examination may include focal abnormalities, presence of seizure activity during the exam, hypertension, cardiovascular disorder, systemic disease, signs of head trauma, and transillumination of the skull in infants. Also, the patient may display neurocutaneous disease, café au lait...