癲癇症_羊吊_ Epilepsy

							          癲癇症(羊吊) Epilepsy

反覆發作之全身或肢体抽搐，同時可伴有意識的喪失
sudden excessive discharge in the brain
分類

     Grandmal 大發作

     Petitmal 失神小發作

     Infantile spasm 嬰兒痙攣症

     Myoclonic seizure 肌陣攣
原因
Congenital malformation of the brain 先天性腦
                                 發育不全

Perinatal asphyxia 圍產期腦缺氧

CNS infection 腦炎，腦膜炎

Trauma

Idiopathic 原因不明
         Incidence of epilepsy


• New cases identified each year:
  120 cases per 100,000 population
• Highest in first decade of life
檢驗

Blood electrolytes

Electroencephalogram (EEG) 腦電圖

Computerized tomography CT scan 電腦掃描

MRI 核磁共振
Treatment

 Anticonvulsant 抗癲癇葯物

 Avoid strong flashing light

 Psychological counseling
    Side effects of anticonvulsant
•    bone marrow dpression
•   hepatotoxity
•   gum hypertrophy
•   hirsutism
•   ataxia
•   irritability and overactivity
•   drowsiness
Management during convulsion


1. Lateral position, protect the patient from
  injury

2. iv or per rectum anticonvulsant
Lateral position, protect the
    patient from injury
          Febrile convulsion


• Occurs in children 6 months to 6 years old
• Hereditary factors
• Normal intelligence
       Management of fever
• Antipyretics
• Luke warm water bath
• Plenty fluid intake
           Sleepingwalking
• Wander during deep sleep
• Most often occurs in children 4 to15 years
  old
• No known cause, normal EEG
• Usually starts 1 to 2 hours after going to
  sleep and may walk around for 5 to 20 min.
• Spontaneous improvement in adolescent
  age
Appearance during sleepwalking
•   Cannot be awakened during sleepwalking
•   Eyes are open, but staring blankly
•   Not as well coordinated as when awake
•   May perform semipurposeful acts such as
    dressing and undressing
               Night Terrors
•   Often hereditary
•   Usually not caused by psychological stress
•   Normal EEG during attack
•   Exhaustion can trigger night terrors
•   Usually occur in children under 8 years old
•   In the morning, the child cannot remember
    what happened
              Management
• Gently lead the patient back to bed
• Protect the patient from accident
• Help the patient to avoid exhaustion during
  the day
• Try prompt awakenings to prevent
  sleepwalking
Epilepsy  mental retardation
Mental retardation

Classification: mild    IQ 50 - 70

               moderate IQ 49 ~ 35

               severe   IQ < 35
Causes:

Prenatal: chromosome abnormalities,
           congenital metabolic defects
           malformation of the brain,
           intrauterine infection……..
Perinatal: trauma, hypoxia
Postnatal: meningitis, encephalitis, lead
           poisoning, trauma…...
Early detection and early intensive
       training is important
Delay in development is suspected if the
 baby cannot

• smile at 2 months

• walk at 18 months

• say single words at 18 months