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logic disease that demands the employment of special diagnostic and therapeutic measures, as in the case of a brain tumor A more common and less grave circumstance is for a seizure to be but one in an extensive series recurring over a long period of time, with most of the attacks being more or less similar in type In this instance they may be the result of a burned-out lesion that originated in the past and remains as a scar The original disease may have passed unnoticed, or perhaps had occurred in utero, at birth, or in infancy, in parts of the brain inaccessible for examination or too immature to manifest signs It may have affected a very small or silent area in a mature brain The increasingly re ned techniques of magnetic resonance imaging (MRI) are now beginning to reveal small zones of cortical dysplasia and hippocampal sclerosis, both of which tend to be epileptogenic Patients with such long-standing lesions probably make up the majority of those with recurrent seizures but are necessarily classi ed as having idiopathic or cryptogenic epilepsy, because it is often impossible to ascertain the nature of the original disease and the seizures may be the only sign of brain abnormality There are other types of epilepsy for which no pathologic basis has been established and for which there is no apparent underlying cause except perhaps a genetic one These epilepsies have been referred to as primary Included in this category are hereditary forms, such as certain generalized tonic-clonic (grand mal) and absence seizure states Some authors (Lennox and Lennox; Forster) have reserved the term idiopathic for recurrent seizures of these types excel qr code generator QR Code Excel Generator Add-in: Create QR - Code barcode image ...
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ssrs qr code free How to create barcodes in Excel 2007-2016 with StrokeScribe Active ... If you need to create barcodes in bulk quantities, use the examples for QR Code and ... Seizures have been classi ed in several ways: according to their supposed etiology, ie, idiopathic (primary) or symptomatic (secondary); their site of origin; their clinical form (generalized or focal); their frequency (isolated, cyclic, or repetitive, or the closely spaced sequence of status epilepticus); or their electrophysiologic correlates A distinction must be made between the classi cation of seizures (the clinical manifestations of epilepsy: grand mal, petit mal, myoclonic, partial, and others), considered below, and the classi cation of the epilepsies, or epileptic syndromes, which are disease constellations, most of which may manifest several seizure types These are discussed later in the chapter The classi cation to be followed here was rst proposed by Gastaut in 1970 and was then re ned repeatedly by the Commission on Classi cation and Terminology of the International League Against Epilepsy (1981) This classi cation, based mainly on the clinical form of the seizure and its electroencephalographic (EEG) features, has been adopted worldwide and is generally referred to as the International Classi cation A modi ed version of it is reproduced in Table 16-1 The strength of the International Classi cation lies in its easy applicability to patients with epilepsy and its universal adoption The main value of classifying a seizure by its clinical and EEG features is the reasonable predictability of response to speci c med- Copyright 2005, 2001, 1997, 1993, 1989, 1985, 1981, 1977, by The McGraw-Hill Companies, Inc Click here for terms of use Table 16-1 International classi cation of epileptic seizures I Generalized seizures (bilaterally symmetrical and without local onset) A Tonic, clonic, or tonic-clonic (grand mal) B Absence (petit mal) 1 With loss of consciousness only 2 Complex with brief tonic, clonic, or automatic movements C Lennox-Gastaut syndrome D Juvenile myoclonic epilepsy E Infantile spasms (West syndrome) F Atonic (astatic, akinetic) seizures (sometimes with myoclonic jerks) II Partial, or focal, seizures (seizures beginning locally) A Simple (without loss of consciousness or alteration in psychic function) 1 Motor frontal lobe origin (tonic, clonic, tonic-clonic; jacksonian; benign childhood epilepsy; epilepsia partialis continua) 2 Somatosensory or special sensory (visual, auditory, olfactory, gustatory, vertiginous) 3 Autonomic 4 Pure psychic B Complex (with impaired consciousness) 1 Beginning as simple partial seizures and progressing to impairment of consciousness 2 With impairment of consciousness at onset III Special epileptic syndromes A Myoclonus and myoclonic seizures B Re ex epilepsy C Acquired aphasia with convulsive disorder D Febrile and other seizures of infancy and childhood E Hysterical seizures ications and to some extent in prognosis Basically, this classi cation divides seizures into two types partial, in which a focal or localized onset can be discerned, and generalized, in which the seizures appear to begin bilaterally It is also useful clinically and etiologically to separate epilepsies that originate as truly generalized electrical discharges in the brain from those which spread secondarily from a focus to become generalized The primary generalized epilepsies are a group of somewhat diverse, age-dependent phenotypes that are characterized by generalized 25- to 4-Hz bifrontally predominant spikes or polyspike-and-slow-wave discharges that arise without underlying structural abnormalities In most instances, these individuals have normal intelligence What is most signi cant is that a genetic component underlies many of these disorders (see below) By contrast, seizures that begin locally and evolve into generalized tonic-clonic seizures, termed secondary generalized seizures, generally have no such genetic component and are usually the result of underlying brain disease, either acquired or due to congenital malformations or metabolic defects Quite often, the initial focal phase is missed, leading to misdiagnosis Individuals with secondary generalized epilepsies tend to have more diffuse brain dysfunction and may have a progressive course These seizures may be of different types, including atonic, myoclonic, and tonic-clonic seizures An increas- free bulk qr code generator excel QR Code Excel Generator Add-in: Create QR - Code barcode image ...
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