Neurology Case Study: Generalized Versus Focal Seizure

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Neurology Case Study: Generalized Versus Focal Seizure

           The study of anatomical functions and biological disarrays of nerves and the nervous system becomes important for a neurologist and the entire healthcare structure. Neurology hence focuses on the study of neurological conditions involving the brain – which is the epicenter that gearshifts and adjusts all intended and spontaneous responses of the body through the nerve system. Seizure, therefore, is an occurrence that takes place when there is an abnormal electrical signal in any part of the brain which has transitory interference with the typical electrical function of the brain. A seizure occurs in two main different types: Generalized seizure which occurs when there are mutual abnormal electrical effects on either side of the brain. On the other hand, a focal seizure occurs when the electrical abnormality effect takes place on one side of the brain. This, paper, therefore, discusses both generalized and focal seizures with a focus on pathophysiology, examples, typical electroencephalogram that is associated with both seizures. Additionally, it concentrates on physical presentation and common medications used to treat each type of seizure.

Pathophysiology of Seizure

           Pathophysiology of seizure can be hypothesized to occur due to the falsification of a normal balance between excitation and inhibition within the brain. The imbalance can be due to changes that may occur at different stages of brain function which ranges from genetic and subcellular gesticulating torrents to neuronal trails (Stafstrom & Carmant, 2015). The alteration factors that cause seizures are either genetic or acquired. Genetic factors can cause seizures at any level of brain function from the circuit level to the receptor level which contains several subunits to anomalous iconic conduit purposes. Correspondingly, acquired cerebral affronts are thus able to alter the circuit function of the brain through mechanical modification of hippocampal circuitry due to prolonged febrile seizure of trauma of the head.  

           Additionally, developing brains are typically susceptible to seizures owing to the multiplicity of physiological reason due to the early development of the excitatory synaptic function of the brain before inhibitory synaptic function (Berkovic, 2015). This hence leads to supplemented excitation and generation of seizure rather than inhibition at an early stage. Therefore, this explains why young brains are susceptible to seizures with less structural damage as compared to the adult brain.

Example of Generalized and Focal Seizure

           Generalized seizure includes various conditions such as absence seizure which is also acknowledged as petit mal. It is characterized by an altered state of concussion with retained posture, mouth or face convulsion, and rapid eye blinks lasting for thirty seconds. It also considered by a lack of memory of any of such occurrences and individuals may continue with their engagements. Additionally, atonic or drop attacks seizure which is characterized by an unexpected loss of muscle tone making a person tumble their head. Another example of a generalized seizure is a generalized tonic-clonic seizure, which is also known as the grand mal seizure. It is characterized by five distinctive stages that involve contraction of the body, arms, legs, trembling, and a clonic period of both contraction and relaxation of the body muscles. Furthermore, a myoclonic seizure is a rapid movement and abrupt jerking of a group of muscles in a cluster (Center for Disease Control and Prevention (CDC), 2018). Moreover, infantile spam is another example of a generalized seizure that occurs in children before six months. A febrile seizure is a seizure that is more associated with fever which is more common in children.

           Focal or partial seizure includes examples like a simple focal seizure that has a range of symptoms based on that part of the brain that is affected. Normally, there is no concussion, however, the affected individual may experience sweating and nausea. Additionally, a complex focal seizure is an example of a focal seizure that is identified by abnormal behaviors like running or screaming. Notably, it affects the temporal lobe of the brain which is located at the part of the brain responsible for controlling the emotions and memory. 

Typical Electroencephalogram (EEG) Associated with General and Focal Seizure

           Electroencephalogram (EEG) is a procedural recording of the brain’s electrical activities. It can be used in the detection of – focal seizure – focal spikes and generalized seizure – diffuse bilateral spikes (Stafstrom & Carmant, 2015). The EEG normally includes wakefulness, drowsiness, and sleep since the occurrence abnormalities vary based on such a state of consciousness. During the EEG procedure, photic and hyperventilation stimulation to activate the entire process and hence increasing the harvest of Seizure activities. This normally takes three minutes. Moreover, photic stimulation activation may provoke paroxysmal epileptiform including general seizure for the susceptible people. Additionally, a video record of EEG monitored for hours or days increases the yield in diagnosis or aids in the differentiation of epileptic from nonepileptic events. However, the diagnosis of epilepsy is normally based on clinical formation and EEG is typical a confirmatory test. 

Physical Presentation of General and Focal Seizure

           A general seizure is physical presented by periodic eye blinking and staring, inability to respond to any word or noise for a short period, and episodic stiffening of the body due to seizure. Besides, it may also present physically as loss of consciousness and falling abruptly without and apparent cause, normally when associated with loss of consciousness. On the other hand, a focal seizure is physically presented by symptoms such as spontaneous contraction and relaxation of muscles respectively. It can also be identified typically by just one side of the body. Additionally, is characterized by sweating and nausea which can be physically be presented by patients (Ellis, 2017). More importantly, it normally involves dilated pupils, change in vision, blackouts, and prolonged hallucinations. 

Common Medication Use in Treatment of General and Focal Seizure

           A focal seizure can be treated using a multiplicity of medicine for a long duration of time basically to either prevent or reduce the frequency of its occurrence. A focal seizure can be treated using two common, specific, and effective drugs namely; Carbamazepine and lamotrigine are otherwise known as Lamictal. Other medicine include Valproate, oxcarbazepine, gabapentin, and topiramate. More importantly, medication requires close supervision by doctors while monitoring the side effects of the administered drugs.

           On the other hand, a generalized seizure can be treated using a variety of medications, unlike focal seizure. These medicines include Zonisamide, Rufinamide, Clobazam, and Lamotrigine. More importantly, such diseases can be prevented or reduced in the frequency of occurrence, like in focal seizure.