OCT. 18, 2001 | The Epilepsy Clinic at the University of Arkansas for Medical Sciences (UAMS) Medical Center is a comprehensive program for diagnosing and treating epilepsy. Its clinical staff includes Naim I. Haddad, M.D., and Bashir S. Shihabuddin, M.D., neurologists who have undergone specialized medical training to deal with epilepsy. “Normal brain function involves millions of tiny electrical charges passing between nerve cells in the brain and to all parts of the body,” Dr. Haddad explains. “In people with epilepsy, this normal pattern is periodically interrupted by sudden and very intense bursts of electrical energy – causing seizures that temporarily affect awareness, movement and/or sensation. About 10 percent of the U.S. population will have one seizure at some point in their lifetime, but that doesn’t mean they have epilepsy. When seizures continue to occur, it’s diagnosed as epilepsy.” Registered E.E.G. technician Dawn Johnson prepares a patient for an electroencephalogram. This test is an important component in diagnosing epilepsy. (Johnpaul Jones, UAMS Media Services) Free Seminar on Epilepsy Nov. 10 OCT. 11, 2001   UAMS Medical Center Epilepsy Clinic 501-686-8000 1-800-942-8267

See more information from Dr. Haddad at Today's KTHV-11. Known causes for seizures are head trauma; serious infection, such as encephalitis (inflammation of the brain) and meningitis (inflammation of the membranes surrounding the brain and spinal cord); brain tumors; stroke; Alzheimer’s disease; lead poisoning; genetic/congenital problems with brain development before birth; and many other conditions.  However, in seven out of 10 seizure cases, the cause is unknown. The two primary categories of seizures are generalized and partial. Generalized, or grand mal, seizures occur when the electrical disturbance sweeps through the entire brain at once and causes loss of consciousness, falls and convulsions. In partial seizures – the most common form of seizure in adults – the electrical disturbance hits only one part of the brain, thereby affecting only the physical and mental activities that area controls. Partial seizures are classified as either simple or complex.  “When having a simple partial seizure, the person remains awake, aware and able to talk normally to others, but he experiences changes in movement, emotions and sensations,” Dr. Shihabuddin explains. “The person’s hand or foot might start shaking, then the shaking spreads to his arm, leg or one entire side of his body. He may have sudden feelings of fear or anger. He might hear imaginary voices or unusual buzzing or ringing sounds, experience strange and unpleasant tastes and smells, or have distorted vision. Nausea and other abdominal discomfort, sweating, flushing and paleness may also occur. After the seizure, the person can usually remember exactly what happened. “During a complex partial seizure, the person loses control of his speech and actions. The seizure starts with a blank stare and loss of contact with surroundings. Frequently, the person then mumbles and chews, picks at his clothing and performs simple, unorganized movements repeatedly. In severe cases, he tries to undress or becomes agitated and starts screaming and flailing his arms and legs. After the seizure, he’s confused and can’t remember what happened.” Other types of seizures include absence (or petit mal) seizures and atonic seizures (drop attacks), which are most commonly seen in children, and myoclonic seizures (including infantile spasms). At the UAMS Medical Center Epilepsy Clinic, seizure diagnosis begins with obtaining a detailed medical history of the patient. Blood tests are usually performed also to determine if the patient’s liver, kidneys and blood cells are functioning normally and if there are any infections, vitamin deficiencies or exposure to poisons. If infection or bleeding in the brain is suspected, a spinal tap is done to analyze fluid from the spinal canal. Diagnosis also includes electroencephalography (EEG), video monitoring and magnetic resonance imaging (MRI). “We perform an EEG to confirm the diagnosis and to classify the epilepsy,” Dr. Haddad says. “This painless outpatient procedure translates the brain’s electrical activity into a series of wavy lines. The abnormal patterns on the patient’s EEG not only show us the part of the brain where the seizures start, but also may suggest the best medicine for treating the seizures. Oftentimes, we hook the patient up to the EEG equipment for an extended time period and video-monitor him, so we can view the tape and correlate the changes in his brain waves with the clinical symptoms he experiences during a seizure. Another important diagnostic tool we use is brain imaging – usually MRI – to look for brain tumors, blood clots, malformations and scar tissue that might be producing seizures.” More than a dozen seizure-preventing medications are available. Physicians may prescribe them individually or in combination for best effect. If medicines are unsuccessful, surgery is an option for some patients. Surgery involves either interrupting the spread of electrical energy in the brain or removing a small portion of the brain where seizures always begin. For patients who have partial seizures that resist control by other methods, there is vagus nerve stimulation. This therapy prevents seizures by implanting a small battery in the chest wall and programming the battery to send tiny pulses of electrical energy to the brain every few minutes via the vagus nerve in the neck. Links on This Page Free seminar: http://www.uams.edu/today/101101/epilepsy.htm Medical Center: http://www.uams.edu/medcenter/ Today's KTHV-11: http://www.kthv.com/askthedoctor/default.asp