S

seizure disorders Abnormal discharge of electri-
cal activity in certain areas of the BRAINthat causes
various involuntary consequences. Most seizures
originate in areas of the cerebral cortex.
Seizure disorders may occur spontaneously
(without identifiable cause) or as a consequence
of damage to the brain such as TRAUMATIC BRAIN
INJURY(TBI) orCEREBRAL PALSY. Among the more
common forms of seizure disorders are

• epilepsy, in which seizures are recurrent and
  often frequent


• absence seizures, in which the person experi-
  ences very brief episodes of loss of conscious-
  ness though often is unaware they occur


• clonic–tonic seizures, in which the person loses
  consciousness and there is convulsive move-
  ment of the legs and arms


• focal seizures, in which the person may or may
  not lose consciousness and the seizure affects a
  specific and localized part of the body

Seizures generally end within a minute and do
not themselves harm injuries may occur if a per-
son falls or has a seizure in a hazardous location
such as a swimming pool. There is no reason to
intervene with a person who is having a seizure,
other than for safety. Some people, especially chil-
dren, may have seizures during FEVER. Such
seizures, called febrile seizures, do not indicate the
person has a seizure disorder.

Symptoms and Diagnostic Path

Seizure disorders run the gamut from causing
barely noticeable to disabling symptoms. The diag-
nostic path includes a thorough PERSONAL HEALTH
HISTORY, NEUROLOGIC EXAMINATION, ELECTROEN-

CEPHALOGRAM(EEG), and diagnostic imaging proce-

dures such as COMPUTED TOMOGRAPHY(CT) SCANor

MAGNETIC RESONANCE IMAGING(MRI). The EEG typi-

cally shows irregularities in electrical activity even

when the person is not having seizures. Because

sleep deprivation makes the brain more sensitive

to electrical activity, the neurologist may request

the person remain awake for 24 hours before the

EEG. These procedures are generally conclusive

for diagnosing seizure disorders.

Treatment Options and Outlook

Antiseizure medications are the mainstay of treat-

ment for seizure disorders. Often a person may

require two or more medications that have differ-

ent actions to adequately suppress inappropriate

electrical activity in the brain and prevent seizures

from occurring. Because antiseizure medications

alter the brain’s biochemistry and have potentially

serious side effects, neurologists tend not to treat a

single episode of seizure but opt instead to take an

approach of watchful waiting.

MEDICATIONS TO TREAT SEIZURE DISORDERS

carbamazepine (Tegretol) gabapentin (Neurontin)

lamotrigine (Lamictal) levetiracetam (Keppra)

oxcarbazepine (Trileptal) phenobarbital

phenytoin (Dilantin) tiagabine (Gabitril)

topiramate (Topamax) valproic acid (Depakote)

zonisamide (Zonegran)

Treatment is generally long-term, though chil-

dren may outgrow certain kinds of seizure disor-

ders. Medications successfully prevent seizures in

most people, though require regular monitoring to

ensure that BLOODconcentrations remain thera-

peutic. Dysfunctions of the LIVERand KIDNEYSare

the most significant side effects of antiseizure

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