One of the great medical conditions that are characterized by episodes of uncontrolled electrical activity in the brain is called seizure. They are the result of sudden, usually brief excessive electrical discharges in a group of brain cells. Epilepsy is one of the disorders characterized by recurrent unprovoked seizures.
Seizures can be classified based on the observation (both clinical and (EEG) rather than the underlying patho -physiology or anatomy.
- Focal seizures (partial seizures): also called simple partial seizures. In this type of seizures consciousness is not impaired. This type of seizure is occurred with motor signs, sensory symptoms autonomic symptoms or signs and with psychic symptoms. This major category include sub categories such as :
- Complex partial seizures: consciousness is impaired in this type of seizure. It have simple partial onset followed by impairment of consciousness.
- Partial seizures evolving to secondarily generalized seizures : this include sub types such as :
- Simple partial seizures evolving to generalized seizure
- Complex partial seizure evolving to generalized seizures
- Simple partial seizures evolving to complex partial seizures evolving to generalized seizures
- Generalized seizures : it contain sub types such as:
- Absence seizure : This can be again categorized into typical absence seizures and atypical absence seizures
- Myoclonic seizures
- Clonic seizures
- Tonic seizures
- Tonic – clonic seizures
- Atonic seizures
- Unclassified epileptic seizures: this is categorised in terms of their origin within the brain seizures may be described as either partial or generalized.
Some seizure disorders are hereditary but others are caused by birth defects or environmental hazards, such as lead poisoning.
Nerve cells (neurons) in the brain create, send and receive electrical impulses which allow the brain’s nerve cells to communicate. Anything that disrupts these communication pathways can lead to seizures. Some of the causes are:
- High fever, which can be associated with an infection such as meningitis.
- Lack of sleep
- Low blood sodium (hypernatremia) which can happen with diuretic therapy.
- Medications, such as certain pain relievers, antidepressants or smoking cessation therapies, that lower the seizure threshold
- Head trauma that causes an area of bleeding in the brain
- Brain tumour
- Illegal or recreational drugs such as amphetamines or cocaine.
- Alcohol abuse, during times of withdrawal or extreme intoxication
Signs and symptoms can range from mild to severe and vary depending on the type of seizers. Major signs and symptoms are:
- Temporary confusion
- A staring spell
- Un controllable jerking movements of the arms and legs
- Loss of consciousness or awareness
- Cognitive or emotional symptoms, such as fear, anxiety etc..
Treatment can be medical and therapeutical
- Medical treatments:
FAD- licensed antiepileptic drugs
Vagus nerve stimulation
Investigational therapies it include deep brain stimulation and responsive neuro stimulation
Treatment is usually by medication, although in difficult causes a special diet or brain surgery may be tried.
Occupational therapy for epilepsy or seizure disorder:
- Occupational therapy is aimed at empowering individuals with epilepsy to maximise their independence throughout activities of daily living
- For people with seizure, safety is one of the most important conditions.
- Occupational therapists are able to advise individuals on how to create a safe environment.
- They can provide advice and implement risk assessment, safety equipment and tele care aids
Other interventions in which occupational therapist may implement include:
- Coping and self-management skills: these can help individuals to deal with social and psychological stress of seizures.
- Techniques to improve fine motor skills including writing, buttoning cloths, picking up small objects etc…
- Modify work and home environments.
- Provision of wheelchairs if appropriate.
- Can provide protective helmets or pad areas of their environment to minimize injury during seizures.
Occupational therapy is highly beneficial for helping individuals with epilepsy to carry out their everyday activities as independent and safety as possible.