EPILEPSY

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Slide 1 :

SEMINAR ON BRAIN INFECTIONS & EPILEPSY BY ARUN I IMSc NURSING MED SURG DEPT PCON, Bengaluru 5/18/2011 ARUN PIRAVOM

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EPILEPTIC CRY: A CRY, OCCURING IN SOME SEIZURES, CAUSED BY A THORACIC AND ABDOMINAL SPASM, WHICH EXPEL AIR THROUGH THE NARROWED SPASTIC GLOTTIS. MYOCLONUS: SPASM OF A SINGLE MUSLE OR GROUP OF MUSCLES. 5/18/2011 ARUN PIRAVOM

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COND.. DYSKINESIA: IMPAIRED ABILITY TO EXECUTE VOLUNTARY MOVEMENT. SPASTICITY: MUSCULAR HYPERTONICITY WITH INCREASED RESISTANCE TO STRETCH OFTEN ASSOCIATED WITH WEAKNESS; INCREASED DEEP TENDON REFLEXES AND DIMINISHED SUPERFICIAL REFLEXES. 5/18/2011 ARUN PIRAVOM

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ANATOMY & PHYSIOLOGY 5/18/2011 ARUN PIRAVOM

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HUMAN BRAIN 5/18/2011 ARUN PIRAVOM

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BACTERIAL MENINGITIS DEFINITION MENINGITIS IS AN ACUTE INFLAMMATION OF THE MENINGEAL TISSUES SURROUNDING THE BRAIN AND THE SPINAL CORD 5/18/2011 ARUN PIRAVOM

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INIDENCE MENINGITIS USUALLY OCCURES IN THE FALL, WINTER OR EARLY SPRING AND IS OFTEN SECONDARY TO VIRAL RESPIRATORY DISEASE. OLDER ADULTS AND PERSONS WHO ARE DEBILITATED ARE MORE OFTEN AFFECTED THAN IS THE GENERAL POPULATION 5/18/2011 ARUN PIRAVOM

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ETIOLOGY BACTERIA NEISSERIA MENINGITIDIS, HAEMOPHILUS INFLUENZAE AND STREPTOCOCCUS PNEUMONIAE TOBACCO USE AND VIRAL UPPERRESPIRATORY INFECTION OTITIS MEDIA AND MASTOIDITIS PERSONS WITH IMMUNE SYSTEM DEFICIENCIES. 5/18/2011 ARUN PIRAVOM

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5/18/2011 ARUN PIRAVOM PATHOPHYSIOLOGY UNDERLYING CAUSES ORGANISMS ENTERS THE BLOOD STREAM INFLMMATION OF SUBARACHNOID SPACE AND PIA MATER INCREASED INTRACRANIAL PRESSURE CSF FLOWS IN SUBARACHNOID SPACE INCRESING THE CSF CELL COUNT

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5/18/2011 ARUN PIRAVOM

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CLINICAL MANIFESTATIONS HEADACHE FEVER NUCHAL RIGIDITY POSITIVE KERNIG’S SIGN POSITIVE BRUDZINKI’S SIGN PHOTOPHOBIA 5/18/2011 ARUN PIRAVOM

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KERNIG’S SIGN AND BRUDZINKI’S SIGN 5/18/2011 ARUN PIRAVOM

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5/18/2011 ARUN PIRAVOM

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CONTD… RASH AND SKIN LESIONS DISORIENTATION &MEMORY IMPAIRMENT LETHARGY, UNRESPONSIVENESS AND COMA SEIZURES AND INCREASED ICP 5/18/2011 ARUN PIRAVOM

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DIAGNOSTIC FINDINGS BACTERIAL CULTURE AND GRAM STAINING OF CSF CT SCAN MRI PET SCAN SKULL X RAY 5/18/2011 ARUN PIRAVOM

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PREVENTION ANTIMICROBIAL CHEMO PROPHYLAXIS VACCINATION 5/18/2011 ARUN PIRAVOM

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MANAGEMENT PENICILLIN VANCOMYCIN HYDROCHLORIDE DEXAMETHASONE PHENYTOIN 5/18/2011 ARUN PIRAVOM

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ENCEPHALITIS ENCEPHALITIS, AN ACUTE INFLAMMATION OF THE BRAIN 5/18/2011 ARUN PIRAVOM

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ETIOLOGY VIRUSES TICKS AND MOSQUITOE MEASLES, CHICKENPOX OR MUMPS 5/18/2011 ARUN PIRAVOM

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5/18/2011 ARUN PIRAVOM

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HERPES SIMPLEX VIRUS ENCEPHALITS ETIOLOGY HERPES SIMPLEX VIRUS 5/18/2011 ARUN PIRAVOM

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PATHOPHYSIOLOGY PRIMERY HSV-1 INFECTION OF THE BUCCAL MUCOSA OCCUR RETROGRADE SPREAD ALONG THE TRIGEMINAL NERVE TO THE BRAIN 5/18/2011 ARUN PIRAVOM

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CLINICAL MANIFESTATIONS INFLAMMATION AND NECROSIS IN THE TEMPORAL LOBE, FRONTAL LOBE AND LIMBIC SYSTEM FEVER, HEADACHE CONFUSION AND BEHAVIOURAL ABNORMALITIES 5/18/2011 ARUN PIRAVOM

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CONTD.. FOCAL SEIZURES, DYSPHASIA, HEMIPARESIS ALTERED LEVEL OF CONSCIOUSNESS 5/18/2011 ARUN PIRAVOM

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DIAGNOSTIC FINDINGS NEUROIMAGING STUDIES EEG CSF EXAMINATION MRI 5/18/2011 ARUN PIRAVOM

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MANAGEMENT ACYCLOVIR 5/18/2011 ARUN PIRAVOM

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ARTHROPOD BORNE VIRUS ENCEPHALITIS INCIDENCE: ARBOVIRUS INFECTION OCCURS IN SPECIFIC GEOGRAPHIC AREAS DURING THE SUMMER AND FALL 5/18/2011 ARUN PIRAVOM

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PATHOPHYSIOLOGY VIRAL REPLICATION OCURRS AT THE SITE OF MOSQUITO BITE VIREMIA ENUES VIRUS GAIN ACCESS TO THE CNS VIA CEREBRAL CAPILLARIES 5/18/2011 ARUN PIRAVOM

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SPREADS FROM NEURON TO NEURON AFFECTING CORTICAL GRAY MATTER, BRAIN STEM AND THALAMUS MENINGEAL EXUDATES INCREASED ICP 5/18/2011 ARUN PIRAVOM

Slide 30 :

CLINICAL MANIFESTATIONS LACROSSE ENCEPHALITIS MAY PRESENT WITH FOCAL NEUROLOGICAL SYMPTOMS AND SEIZURES ST.LOUIS ENCEPHALITIS: SIADH WITH HYPONATREMIA 5/18/2011 ARUN PIRAVOM

Slide 31 :

DIGNOSTIC STUDIES CT SCAN MRI CSF ANALYSIS 5/18/2011 ARUN PIRAVOM

Slide 32 :

MANAGEMENT NO SPECIFIC MEDICATION FOR ARBOVIRAL ENCEPHALITIS. IT IS AIMED AT CONTROLLING SEIZURES AND INCREASED ICP 5/18/2011 ARUN PIRAVOM

Slide 33 :

FUNGAL ENCEPHALITIS ETIOLOGY: CRYPTOCOCCUS NEOFORMANS, HISTOPLASMA CAPSULATUM, AND CANDIDA ALBICANS 5/18/2011 ARUN PIRAVOM

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PATHOPHYSIOLOGY THE FUNGAL SPORES ENTER THE BODY VIA BLOOD STREAM FUNGEMIA SPREADS TO CNS MENINGTIS FOLLOWED BY ENCEPHALITS AND BRAIN ABSCESS 5/18/2011 ARUN PIRAVOM

Slide 35 :

FUNGI MAY INFECT THE SPINAL CORD PRODUCING ABSCESS CAUSE SPINAL CORD COMPRESSION 5/18/2011 ARUN PIRAVOM

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CLINICAL MANIFESTATIONS FEVER MALAISE, HEADACHE NUCHAL RIGIDITY, LETHARGY MENTAL STATUS CHANGES ARTHRITIS OR CEREBRAL INFARCTION 5/18/2011 ARUN PIRAVOM

Slide 37 :

DIAGNOSTIC FINDINGS BLOOD TEST SEROLOGICAL TEST CSF ANALYSIS NEUROIMAGING MRI AND CT SCAN 5/18/2011 ARUN PIRAVOM

Slide 38 :

MANAGEMENT ANTI SEIZURE MEDICATIONS LUMBAR PUNCTURE OR SHUNTING OF CSF ANTIFUNGAL AGENTS 5/18/2011 ARUN PIRAVOM

Slide 39 :

BRAIN ABSCESS A BRAIN ABSCESS IS AN INFECTION IN THE BRAIN THAT IS ENCAPSULATED AND LOCALIZED TO ONE OR MORE AREAS INSIDE OF THE BRAIN. 5/18/2011 ARUN PIRAVOM

Slide 40 :

ETIOLOGY VIRUSES AND BACTERIA INFECTION CAN SPREAD THROUGH ANOTHER AREA OF INFECTION IN THE BODY BLOOD STREAM FROM THE LUNG OR CHEST AREA BRAIN THROUGH OPEN WOUND 5/18/2011 ARUN PIRAVOM

Slide 41 :

RISK FACTORS CONGENITAL HEART DISEASE MENINGITIS CHRONIC NIDDLE EAR AND SINUS INFECTIONS DENTAL OR JAW INFECTIOS INFECTIONS OF THE FACE OR SCALP HEAD INJURY TRACTION SHUNT 5/18/2011 ARUN PIRAVOM

Slide 42 :

CLINICAL MANIFESTATIONS IN BABIES AND YOUNGER CHILDREN FEVER FULL OR BULGING FONTANELLE SLEEPINESS OR LESS ALERT INCREASED IRRITABILITY HIGH PITCHED CRY POOR FEEDING PROJECTILE VOMITING SEIZUREA 5/18/2011 ARUN PIRAVOM

Slide 43 :

IN OLDER CHILDREN FEVER SEVER HEADACHE NAUSEA AND VOMITING CHANGE IN PERSONALITY AND BEHAVIOUR CHANGE IN SPEECH PROBLEM IN WALKING SPASTICITY SEIZURES 5/18/2011 ARUN PIRAVOM

Slide 44 :

DIAGNOSTIC STUDIES COMPLETE MEDICAL HISTORY MEASUREMENT OF THE HEAD CIRCUMFERENCE BLOOD TEST X RAY MRI CT SCAN SPUTUM CULTURE LUMBAR PUNCTURE 5/18/2011 ARUN PIRAVOM

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MANAGEMENT LOWERING THE INCREASED INTRACRANIAL PRESSURE INTRAVENOUS ANTIBIOTICS SURGICAL DRAINAGE OF THE ABSCESS 5/18/2011 ARUN PIRAVOM

Slide 46 :

SEMINAR ON EPILEPSY BY SHAHJAHAN BANU I1 MSc NURSING MED SURG DEPT 5/18/2011 ARUN PIRAVOM

Slide 47 :

TERMINOLOGIES SEIZURE: A PAROXYSMAL, UNCONTROLLED ELECTRICAL DISCHARGE OF NEURON IN THE BRAIN THAT INTERRUPT NORMAL FUNCTION. AURA: GENERALLY, A BRIEF SENSORY EXPERIENCE THAT OCCURS AT THE ONSET OF SOME SEIZURES. 5/18/2011 ARUN PIRAVOM

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Slide 49 :

Slide 50 :

ANATOMY & PHYSIOLOGY 5/18/2011 ARUN PIRAVOM

Slide 51 :

HUMAN BRAIN 5/18/2011 ARUN PIRAVOM

Slide 52 :

Definition EPILEPSY IS A CONDITION IN WHICH A PERSON HAS SPONTANEOUSLY RECURRING SEIZURES 5/18/2011 ARUN PIRAVOM

Slide 53 :

INCIDENCE IT IS HIGHER IN UNDERDEVELOPED COUNTRIES INCEDENCE RATE IS HIGH DURING FIRST YEAR OF LIFE, DECLINE THROUGH CHILDHOOD AND ADOLESCENCE AND RISE SHARPLY AGAIN AMONG ELDERLY 5/18/2011 ARUN PIRAVOM

Slide 54 :

ETIOLOGY FIRST 6 MONTHS OF LIFE SEVER BIRTH INJURY CONGENITAL DEFECTS INBORN ERROR OF METABOLISM BETWEEN 2 AND 20YRS BIRTH INJURY INFECTIONS TRAUMA AND GENETIC FACTORS 5/18/2011 ARUN PIRAVOM

Slide 55 :

CONTD.. BETWEEN 20 TO 30YRS STRUCTURAL LESIONS SUCH AS TRAUMA, BRAIN TUMORS OR VESCULAR DISEASE AFTER 50YRS CEREBROVASCULAR LESIONS METASTATIC BRAIN TUMORS IDIOPATHIC 5/18/2011 ARUN PIRAVOM

Slide 56 :

PATHOPHYSIOLOGY SEIZURES ACTIVITY DISCHARGES BLOCK NORMAL INHIBITION AND PERPETUTE A FEED BACK LOOP DISHARGES IN THE BRAIN STEM CAUSE MUSLE CONTRACTION AND LOSS OF CONSCIOUSNESS 5/18/2011 ARUN PIRAVOM

Slide 57 :

CLASSIFICATION OF SEIZURE DISORDERS GENERALIZED SEIZURES TONIC CLONIC ABSENCE MYOCLONIC TONIC ATONIC CLONIC 5/18/2011 ARUN PIRAVOM

Slide 58 :

CONTD.. PARTIAL SEIZURES SIMPLE PARTIAL COMPLEX PARTIAL PARTIAL SEIZURE IVOLVING TO SECONDARY GENERALIZED SEIZURES UNCLASSIFIED EPILEPTIC SEIZURES 5/18/2011 ARUN PIRAVOM

Slide 59 :

PHASES PRODROMAL PHASE AURAL PHASE ICTAL PHASE POST ICTAL PHASE 5/18/2011 ARUN PIRAVOM

Slide 60 :

CLINICAL MANIFESTATIONS GENERALIZED SEIZURES TONIC CLONIC LOSS OF CONSCIOUNESS FALLING TO THE GROUND STIFFENING OF THE BODY FOR 10-20SEC SUBSEQUENT JERKING OF THE EXTREMITIES CYNOSIS EXESSIVE SALIVATION TONGUE BITE OR CHEEK BITE INCONTINENCE MAY ACCOMPANY THE SEIZURE 5/18/2011 ARUN PIRAVOM

Slide 61 :

CONTD.. TYPICAL ABSENCE SEIZURES BRIEF STARING SPELL BRIEF LOSS OF CONSCIOUSNESS ATYPICAL ABSENCE SEIZURES STARING SPELL ACCOMPANIED BY OTHER SIGNS AND SYMPTOMS. 5/18/2011 ARUN PIRAVOM

Slide 62 :

CONTD.. MYOCLONIC SEIZURES CHHRACTERIZED BY A SUDDEN, EXESSIVE JERK OF THE BODY OR EXTREMITIES. TONIC SEIZURES SUDDEN ONSET OF MAINTAINED INCREASED TONE IN THE EXTENSOR MUSLES,PATIENTS OFTEN FALL. 5/18/2011 ARUN PIRAVOM

Slide 63 :

CONTD.. ATONIC SEIZURES IT INVOLVE EITHER A TONIC EPISODES OR A PAROXYSMAL LOSS OF MUSCLE TONE AND BEGIN SUDDENLY WITH PERSON FALLING TO THE GROUND 5/18/2011 ARUN PIRAVOM

Slide 64 :

CONTD.. CLONIC SEIZURES BEGINS WITH LOSS OF CONSCIOUSNESS SUDDEN LOSS OF MUSCLE TONE, FOLLOWED BY LIMB JERKING THAT MAY OR MAY NOT BE SYMMETRIC 5/18/2011 ARUN PIRAVOM

Slide 65 :

CONTD.. PARTIAL SEIZURES EX: IF THE DISCHRGING FOCUS IS LOCATED IN MEDIAL ASPECT OF THE POST CENTRAL GYRUS, PATIENT MAY EXPERIENCE PARASTHESIAS AND TINGLING OR NUMBNESS IN THE LEG ON THE SIDE OPPOSITE THE FOCUS. 5/18/2011 ARUN PIRAVOM

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5/18/2011 ARUN PIRAVOM

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CONTD.. IF THE DISCHARGING FOCUS IS LOCATED IN THE PART OF THE BRAIN, SENSORY, MOTOR, COGNITIVE OR EMOTIONAL MANIFESTATIONS MAY OCCUR. 5/18/2011 ARUN PIRAVOM

Slide 68 :

CONTD.. SIMPLE PARTIAL SEIZURES : LOSS OF CONSCIOUSNESS AND RARELY LAST LONGER THAN 1 MTS. THEY MAY INVOLVE MOTOR, SENSORY OR AUTONOMIC PHENOMINA.. 5/18/2011 ARUN PIRAVOM

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CONTD.. COMPLEX PARTIAL SEIZURES: THE LOCATION OF DISCHARGING FOCUS IS USUALLY IN THE TEMPORAL LOBE. 5/18/2011 ARUN PIRAVOM

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5/18/2011 ARUN PIRAVOM

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COMPLICATIONS PHYSICAL STATUS EPILEPTICUS IT IS A STATE OF CONTINUOUS SEIZURE ACTIVITY OR A CONDITION IN WHICH SEIZURES RECURE IN RAPID SUCCESSION WITHOUT RETURN TO CONCIOUSNESS BETWEEN SEIZURE. 5/18/2011 ARUN PIRAVOM

Slide 72 :

DIAGNOSTIC STUDIES HISTORY AND PHYSICAL EXAMINATION NEUROLOGICAL ASSESSMENT EEG CBC CT SCAN, MRI 5/18/2011 ARUN PIRAVOM

Slide 73 :

MANAGEMENT ANTISEIZURE DRUGS GENERALIZED TONIC CLONIC AND PARTIAL CARBAMAZEPINE PHENOBARBITAL ABSENCE, AKINETIC AND MYOCLINIC CLONAZEPAM ETHOSUXAMIDE 5/18/2011 ARUN PIRAVOM

Slide 74 :

SURGICAL MANAGEMENT LIMBIC RESECTION PRIMARILT ANTERIOR TEMPORAL LOBE RESECTION NEOCORTICAL RESECTION,INCLUDING EXTRA TEMPORAL RESECTION AND LESIONECTOMIES HEMPHERECTOMIES MULTI LOBAR RESECTIONS AND CARPUS COLLOSUM RESECTION 5/18/2011 ARUN PIRAVOM

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THANK YOU 5/18/2011 ARUN PIRAVOM

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