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Epilepsy

Epileptic seizures are commonly traced to brain injury or family history. About 0.5% to 2% of the population is likely to suffer an epileptic seizure at some point in time. When the delicate balance of electrical activity in the brain is disturbed, a person suffers seizures. When there are more than a couple of episodes of seizures, it is a condition of epilepsy. Status epilepticus refers to continuous or intermittent seizure activity for more than 5 minutes without recovery of consciousness.


In a typical epileptic seizure, the neuronal activity is hampered bringing on convulsions, muscle spasms and possible loss of consciousness. Each person has a different threshold of resistance to seizures. Inherited condition of neurological disorder can lead to electrical instability causing epileptic seizures. Those dependent on alcohol or drugs may experience seizures during withdrawal. Rarely is a brain tumor the cause of epilepsy. Brain injury is a possible cause of epilepsy. This can be due to a birth defect or head injury or infection such as meningitis. Sometimes a person may experience idiopathic epilepsy where there is no clear cause for the seizures.


Diagnosis of epilepsy can be made with investigative tests such as EEG, CT scan or MRI scan. Anti-epilepsy drugs (AEDs) can control the seizures though there is no cure. These medications help the patient in leading a better quality of life. AEDs are prescribed after studying the person's nature of seizures, general health, age and gender. These medications must be taken in prescribed doses to maintain desired level in the body to prevent further seizures. When some possible triggers have been identified for epileptic seizures, the patient must try and avoid them. These triggers could range from emotional disturbance to lack of sleep. The Vagus Nerve Stimulator (VNS) has been approved by the FDA for the treatment of epilepsy. The VNS is surgically implanted into the chest, near the collarbone. It is a small device, much like a pacemaker that sends weak electrical impulses to the brain through the vagus nerve. These electrical signals are helpful in preventing sudden electrical bursts in the brain that trigger off an epileptic attack.


Aphasia

Aphasia is the inability to communicate verbally or by written words. Aphasia can be usually due to brain injury or a stroke. It can also be the result of a brain tumor, Alzheimer or Encephalitis. Aphasia can be permanent or temporary (usually known as transient aphasia). Aphasia is sometimes confused with Apraxia which is a condition that affects the muscles used in speech rather than the language function.

Aphasia can be grouped as below based on the cause and the area of the brain affected:


  • Global Aphasia : Occurs due to head trauma on the language areas of the brain. Language ability affected may vary based on the location and the extent of the injury.

  • Wernicke's Aphasia : Partial or total loss of the ability to understand written or spoken words though the affected person may still retain the ability to speak - but with made-up words.

  • Transcortical Aphasia : Partial or total loss of the ability to express verbally or by writing words although the individual may have the ability to repeat words, phrases or even sentences

  • Conduction Aphasia : Affected person loses the ability to repeat words, phrases or sentences

  • Subcortical Aphasia : Partial or total loss of the ability to express verbally or by using written words due to damage to the non-language dominated areas of the brain

  • Anomic Aphasia : Partial or total loss of the ability to recall the names of persons or things.

  • Broca's Aphasia : Hearing comprehension is not affected


As Aphasia develops following a head trauma, tumor, disease (Alzheimer's) or infection (encephalitis), the pathways for language comprehension or production are disrupted. This occurs in the left hemisphere of the brain. MRI (magnetic resonance imaging) and CT (Computed tomography) scans can show the extent of the damage and the area affected. Coupled with standardized tests like Boston Diagnostic Aphasia Examination, the Western Aphasia Battery and Porch Index of Speech Ability, can indicate the severity of Aphasia and probable course of speech therapy.



Shaken Baby Syndrome

Also known as SBS, shaken baby syndrome is a type of imposed head trauma. This trauma may occur from either throwing the child, or hitting the child on the head or by shaking the child too much. This is unlike regular head injuries because it can happen only if somebody harms the child. Many parents bring their children to the doctor very late, as they have not observed the problem in the infant in an early stage. SBS can also lead to severe brain injury, thus parents who leave their children with caretakers have to be on extra vigil for unusual symptoms. Depending on the duration of the harm caused the symptoms vary.


  • Lassitude and nausea and petulance are the main symptoms.
  • Poor sucking, decline in appetite and lack of smile.
  • Breathing trouble and seizures.
  • Unable to lift the head and to center the eyes or follow movement.
  • Pupil sizes may vary and stiffness will occur.

When the baby is shaken continuously, the head rotates in frenzy as the infant neck muscles are hardly developed and offer very little support to the head. The movement causes the brain to move back and forth inside the skull and thereby causes injury to the nerves and blood vessels and also tears off the brain tissue. As the brain hits against the inside of the skull, damage is caused to brain in the form of bruising and bleeding. If the baby's head is hit against any hard object, then the damage caused is even worse. With less damage caused the injury will heal within a period of time. If the damage caused is severe, then specific treatment has to be provided depending on the area of damage. Speech loss and hearing impairment has to be treated accordingly. The child has to be given special care and kept under constant vigil under the right care for the right kind of support.

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Collection of Pages - Last revised Date: November 17, 2019