Epilepsy dementia is functionally characterized via the ordinary recurrent immoderate electric powered discharge of cerebral beginning, and clinically characterized through loss of extra of motor, sensory or autonomic functions without or with alteration in awareness. Epilepsy may be number one wherein there may be no anatomically demonstrable abnormality of secondary whilst a nearby or diffuse lesion is present.
Classification of epilepsy: Epilepsies were categorised in several methods.
I. Primary generalized epilepsies: Tonic-clonic seizures (grand mal), Absence seizures (Petit mal), Myoclonic epilepsy, Infantile spasms, Atonic seizures.
II. Partial seizures: Simple- Motor, sensory (somatic, visual, auditory, olfactory), Affective. Complex- Temporal lobe or psychomotor seizure.
III. Partial seizure with secondary generalization.
Pathogenesis
The cortical neuron is abnormally excitable due to differentiation. The cytoplasmic mobile membrane of such cells has improved permeability rendering it liable to activation via hyperthermia, hypoxia, hypoglycemia and hyponatremia. Deficiency of the inhibitory neurotransmitter gamma-amino benzioc acid (GABA) and disturbance of nearby law of extracellular Potassium ions, Sodium ions, calcium ions or Magnesium ions are probable answerable for the membrane instability. This extraordinary electric discharge, if unchecked, spreads to the contralateral hemisphere throughout the interhemispheric pathways and also to the subcortical structures like basal ganglia and mind stem reticular nuclei, from wherein the excitatory hobby is fed back to the rest of the cortex. Most of the so-called idiopathic varieties of epilepsy do not have any demonstrable lesions within the mind. However, the secondary varieties of epilepsy can also have definable morbid lesions. These include areas of neuronal loss and gliosis (scars), hamatomas, tumors and vascular malformations. One primary medical function is the Grand Mal epilepsy.
Grand Mal epilepsy: The paroxysm happens in exclusive ranges sequentially. The ranges may be subdivided into the prodromal section, aura, tonic segment, clonic section and the postictal segment. The prodromal segment might also start several hours before the ictus (match). It includes several subjective phenomena like depressed or apathetic mood, irritability, indistinct belly cramps or other humorous sensations, which are without difficulty identified through the patient in many cases, stereotyped actions like rotation of the head or movement of the eyes, gripping sensation in the epigastriun or an unnatural sensation in some a part of the body occur just earlier than consciousness is misplaced. This is referred to as just before focus is lost. This is known as the “air of mystery” and it regularly indicates activation of the epileptic awareness in the brain. In many instances, there may be no air of mystery and the affected person receives the assault without any forewarning.
The tonic segment consists of beginning of mouth and eyes related to abduction of the hands observed through snapping closure of the jaws, frequently resulting in harm to the tongue and a cry because the entire musculature is going into spasm forcing air thru the closed vocal cords. The affected person turns into cyanosed and there may be voiding of Urine. This phase lasts for 10-15 secs. The tonic segment is followed via the clonic phase characterised with the aid of change from side to side actions of all the four limbs, sweating, frothing of the mouth and extra salivation. Urine and feces can be voided. The clonic segment lasts for 1-2 mins. This is followed via a deep comatose states which lasts for approximately 5 minutes. The pupils slowly start to react and the patient then resumes speech, but nevertheless remains stressed. If left undisturbed, he is going into sleep for several hours and regularly wakes up with extreme headache. This is the postictal section and the affected person does not don’t forget whatever that befell except the air of mystery.