PROBLEM 3.

01 NERVOUS SYSTEM STUDY GUIDE 1

CONVULSION VS SEIZURE VS FIT VS EPILEPSY.
A convulsion is a general term that people use to describe
uncontrollable muscle contractions. Some people may use it
interchangeably with the word "seizure," although a
seizure refers to an electrical disturbance in the brain.
Seizures may cause a person to have convulsions, but this
is not always the case. Seizures aka fits, are a symptom of
epilepsy. But not all people who appear to have seizures
have epilepsy. Epilepsy is defined as a brain disorder
characterized by recurrent seizures not provoked by specific
events such as fever or acute cerebral insult.1. DEFINE A
SEIZURE.
1. Seizures are the manifestation of abnormal
hypersynchronous or hyperexcitable discharges of
cortical neurons. A seizure results when a sudden
imbalance occurs between the excitatory and inhibitory
forces within the network of cortical neurons in favor of a
sudden-onset net excitation.
Seizures result from the synchronous interactions of large
2. GIVE AN OVERVIEW OF THE GENERAL CAUSES OF populations of neurons that intermittently discharge in
SEIZURES. abnormal patterns. Paroxysmal depolarisation of cortical
neurons involves several mechanisms, including increased
Classifying the type of seizure helps doctors diagnose
excitability resulting from changes in intrinsic voltage-
whether or not a patient has epilepsy.
dependent membrane currents; loss or decrease of
postsynaptic inhibition, as well as an increase in excitatory
synapses. In neurons showing "epileptic" behavior, ordinary
synaptic inputs may elicit exaggerated or pathologically
amplified responses. Development of sustained experimental
seizures in the laboratory reflects decreasing effectiveness of
inhibitory mechanisms accompanied by increasing evidence
of excitation. Eventually, progressive depolarization occurs in
neurons both within and outside the original focus. The
seizure ends as phasic repolarizations interrupt the
continuous firing pattern (the correlate of the clonic phase)
and gradually restore membrane potentials to normal or to a
temporary hyperpolarized state (postictal depression).

PATHOPHYSIOLOGY. Under normal circumstances,

recurrent and collateral inhibitory circuits in the cerebral
cortex limit synchronous discharge of neighbouring groups of
neurons. The inhibitory transmitter gamma-aminobutyric
acid (GABA) is particularly important in this role, and drugs
that block GABA receptors provoke seizures. Conversely,
excessive stimulation by excitatory neurotransmitters, such
as acetylcholine, glutamate and aspartate, provoke seizure
activity. It is likely that both reduction of inhibition and
excessive excitation play a part in the genesis of most
seizures. The cerebral cortex in epilepsy exhibits
hypersynchronous, repetitive discharges involving large
groups of neurons, intracellular recordings of which
demonstrate bursts of highfrequency action potentials
associated with a reduction in the transmembrane potential
(paroxysmal depolarisation shift). In animal models, cells
undergoing repetitive epileptic discharges undergo
morphological and physiological changes which make them
more likely to produce subsequent abnormal discharges.
3. DESCRIBE A TONIC-CLONIC aka GRAND MAL
SEIZURE.
Tonic-clonic seizure aka convulsions. As implied by the
name, they combine the characteristics of tonic and clonic
seizures. Tonic means stiffening, and clonic means
rhythmical jerking.
Tonus- tone or tonicity; the slight, continuous contraction of
a muscle, which in skeletal muscles helps to maintain normal
posture.
Clonus - series of involuntary, rhythmic, muscular 4. DISCUSS THE NEURONAL ACTIVITY AND ITS
contractions and relaxations. A sign of certain neurological CONSEQUENCES IN A TONIC-CLONIC SEIZURE.
conditions, particularly associated with upper motor neuron
lesions.
The tonic phase comes first.
 All the muscles stiffen.
 Air being forced past the vocal cords causes a cry or
groan.
 The person loses consciousness and falls to the
floor.
 A person may bite their tongue or inside of their
cheek. If this happens, saliva may look a bit bloody.

After the tonic phase comes the clonic phase.

 The arms and usually the legs begin to jerk rapidly 5. DISCUSS HOW ELECTROLYTE IMBALANCES OR
and rhythmically, bending and relaxing at the TOXINS MAY CAUSE SEIZURES.
elbows, hips, and knees.
 After a few minutes, the jerking slows and stops.

6. DISCUSS HOW INFECTION OF THE BRAIN OR

The person’s face may look dusky or a bit blue due to MENINGES MAY CAUSE SEIZURES.
tightening of the chest muscle making it difficult to breath
can also make loud moan or noise due to air forcefully
expelled from the lungs through the vocal cord or the seizure 7. FEBRILE VS NONFEBRILE CONVULSIONS.
lasts too long. Saliva that is not swallowed during the seizure
may froth at the mouth. Stiffness of muscles can also FEBRILE CONVULSION. This is a unique form of seizures that
increase the abdominal pressure putting force on bladder occurs in early childhood and only in association with an
and bowel resulting in urinary incontinence or fecal elevation of temperature. The underlying pathophysiology is
incontinence. Consciousness, or a person’s awareness, unknown, but genetic predisposition clearly contributes to
returns slowly. These seizures generally last 1 to 3 minutes. the occurrence of this disorder.
Afterwards, the person may be sleepy, confused, irritable, or AFEBRILE CONVULSION.
depressed. A tonic-clonic seizure that lasts longer than 5
minutes needs immediate medical help. Call 911 for
emergency help. A seizure that lasts more than 10 minutes,
or three seizures in a row without the person coming to
between them, is a dangerous condition. This is called status
epilepticus; emergency treatment in a hospital is needed.
After the Seizure (Postictal Period)
After a seizure, the person may remain unconscious for
several minutes as the brain recovers from the seizure
activity. Neuronal fatigue, ie, the neurons themselves are at
rest after prolonged intense excitation, for a certain duration.
He or she may appear to be sleeping or snoring. Gradually
the person regains awareness and may feel confused,
exhausted, physically sore, sad or embarrassed for a few
hours. The person may not remember having a seizure, and
may have other memory loss. Occasionally, people may have
abnormal or combative behavior after a tonic-clonic seizure
while the brain is recovering.