Convulsions

Seizures or convulsions are associated with the electrical activity of the brain. They have an impact on major systems of the body and can be fatal if not treated. Seizures are classified predominantly based upon their site of occurrence and the affected organ or system.

Types of Convulsions

General or clonic seizures: In most cases, generalized seizures are also called as tonic-clonic seizures as they involve the entire body. In common parlance, it also referred as epileptic attacks. Patients experience changes in sensations such touch, taste, smell and vision. Hallucinations or auras are also experienced as they begin to influence the emotional balance of a person.

Focal or Partial seizures: These types of seizures are cause because of disturbed electrical activity in the brain which is localized to one part of the brain. It acts on the temporal region of the brain leading loss of memory and balance in extreme conditions.

Petit mal Seizures: These are temporary and their effects are usually limited to 20 seconds. They generate temporary muscle spasms which happen because of electrical imbalances in the brain.

Epilepsy: This type of seizure is closely related to general seizures. The factors associated with the onset of epilepsy may include preexisting conditions such as ischemic heart disease, Alzheimer disease, meningitis and encephalitis.

Fever induced convulsions: These types of seizures predominantly occur in children, infants and toddlers. The initial phase of these convulsions is very intense as they cause much discomfort to the child. They usually subside within a few hours. Most of the fever induced convulsions are caused by viruses and ear infections.

Clinical manifestations

Most convulsions or seizures are characterized by classical muscle spasm symptoms which includes rigorous shaking and frothing with prolonged effects like unconsciousness (blackout). Since the predominant reason associated with convulsions are related to the electrophysiology of the brain, neurological symptoms such as confusion, hallucination, dementia, drooling, lack of bladder control and sudden loss of balance may also be noticed.

Convulsions also have effects on the emotions of a person as many people complain of unprecedented symptoms such as sudden aggression, depression, mood swings, panic, extreme laughter and joy for a temporary period of time. Warning signs often appear before any form of seizure such as dizziness, sensitivity to light, vertigo and nausea.

Seizures can also occur as a result of withdrawal from use of drugs such as barbiturates, valium or benzodiazepines. Drug abuse and alcohol abuse along with preexisting health complications such as end-stage renal disease, renal failure and congenital heart disease can indicate high percentage of seizure onset. Seizures also occur in conditions such as Steven Johnson syndrome, a disease occurring in children. In addition to these clinical manifestations, seizures can occur because of severe brain injury, shock or even during athletic events as result of extreme adrenaline levels in the blood.

Diagnosis and Treatment

Epileptics are diagnosed with a meticulous examination of their history. Various biochemical tests such as sodium levels, SGOT, SGPT and blood glucose levels are analyzed. Electro encephalogram is done to understand the electrophysiology of the brain. In some cases, neurologists recommend MRI and CT scans to understand the presence of any abnormalities or to identify any kind of trauma caused in the brain or the spinal cord.

In most cases seizures are treated with antidepressants as the predominant cause of any form of seizure is depression. Anti epileptic drugs such as sodium channel blockers and GABA transaminase inhibitors are recommended.

Dysgeusia

Dysgeusia refers to a distortion in the sense of taste that leaves a persistent foul, metallic taste in the mouth. The taste could even be described as bitter and rancid that stays on and disturbs the desire to eat.

Dysgeusia, if sustained, can have an impact on the quality of life of patients. It can lead to problems like loss of appetite, malnutrition and depression. Dysgeusia can occur at any age. However, taste disturbances are common among the elderly taking multiple medications. Our taste buds are found on the tongue and on the roof of the mouth. They contain cells that collect taste information and send it to the brain. The sense of taste is closely associated with the sense of smell. Some people with Dysgeusia also have an altered sense of smell that affects sense of taste. This is because most of the taste sensations are controlled by nerve cells involved with smell.

Dysgeusia could be caused by several conditions ranging from simple cold and dental problems to serious ones like cancer treatment that alters an individual's sense of taste. Some of the causes are listed below.

• Deficiency of zinc or vitamins in the body
  
• Problem related to the brain or entire nervous system
  
• Chemotherapy treatment
  
• Excessive smoking
  
• Brain tumor
  
• Cold, ear infections and dental related problems like gingivitis, tooth abscess
  
• Certain medications
  
• Copper, lead or mercury poisoning
  
• Gastric reflux
  
• Jaundice

Diagnosis of Dysgeusia

Dysgeusia is most often diagnosed during a clinical examination. The physician will make note of the history of the patient and will also enquire about the present medical condition that may be causing taste distortion. He may order few blood tests to assess zinc and other vitamin deficiencies that might be causing metallic taste. There are certain 'taste tests' to identify the sense of taste and smell. Taste tests allow the patient to respond to different concentrations of a substance. Sometimes a chemical that releases sour, sweet, bitter and salty taste is directly applied on the tongue that helps in determining if Dysgeusia is present or not.

If the Dysgeusia is related to neurological condition that has damaged the nerves of mouth or head, CT scan and other imaging tests are performed to assess the extent of damage.

Treatment of Dysgeusia

Many a times, Dysgeusia is reversible. Treatment for the condition depends upon the underlying disease that is causing the metallic taste. Dysgeusia disappears on its own if it is caused by minor problems like cold and dental infections. However, Dysgeusia may almost become untreatable, if it is caused by nerve damage.

If, certain medication is causing the bitter taste in the mouth, the doctor may alter the dosage or prescribe alternate medicine to provide relief. Recent studies show that artificial saliva and mouth wash containing pilocarpine gives much needed relief in cases of medicine-induced Dysgeusia.

Some simple remedies to improve the saliva flow in the mouth also go a long way in treating taste distortion. Chewing on breath mints, sugarless gum, or lozenges will encourage saliva and remove the bitter taste in the mouth.

Most patients suffer from Dysgeusia due to zinc deficiency. Such patients are treated with zinc supplementation.

Few natural remedies like rinsing the mouth with salt solution, brushing twice or thrice a day, consuming citrus fruits, adding more seasoning and spice to the food, and drinking more water are simple measures that help in treating Dysgeusia.

Otolaryngologist

Also known as otorhinolaryngolongists or ENT specialists, otolaryngolongists are doctors who specialize in diagnosing and treating disorders of the ear, nose and throat. After completing medical school, a one year residency in general surgery is compulsory further followed by four years of residency in otolaryngology. Being specialists in the ENT organs, otolaryngolongists perform the following functions:

• Primarily treat disorders related to ear, nose, and throat.
  
• Treat conditions like sinus and problems with nasal cavities by either prescribing medicines or performing surgery.
  
• They treat allergies and help improve the shape and look of the nose (rhinoplasty).
  
• They treat hearing problems, ear infections, balance disorders of the ears, tinnitus (ear noise), cranial nerve disorder etc.
  
• They treat conditions like sleep apnea.
  
• They cure tonsils either through medication or surgery, they treat throat disorders including voice and swallowing disorders.

Modern techniques used in the field of otolaryngology

ENT field has seen a lot of innovations in use of equipment and technology, modern methods have paved avenues for better treatment methods.

• Modern equipment have paved ways for these specialists to perform reconstructive surgeries for nose, jaw, ear and facial areas.
  
• RAST (radio-allergosorbent-test) is used for curing allergies.
  
• Technique called the skin endpoint titration is used to cure allergies.
  
• Endoscope technique is used to treat sinus and other blockages.
  
• Modern audio logic equipment is used to diagnose and treat hearing problems.

Guide to choose the right otolaryngologist

• Ask your family physician to refer to the right specialist.
  
• Check if the specialist you have chosen is certified by an authorized board.
  
• Check if the hospital where your specialist practices has the required infrastructure and modern equipment needed for your treatment.