Seizure Disorders Can Negatively Impact An Individual's Life

Seizure Disorders Can Negatively Impact An Individuals Life And Are A

Seizure disorders are neurological conditions characterized by abnormal electrical activity in the brain that can significantly impair an individual's quality of life. These disorders are associated with high morbidity and mortality rates if not properly managed and can affect individuals across all age groups, races, and social classes. According to Johnson (2018), a seizure is defined as a sudden alteration in neurological function caused by excessive and abnormal neuronal discharges in the brain. Seizures are broadly classified into two main categories: generalized seizures and focal seizures, with their symptoms depending on the brain region involved.

Generalized seizures include absence and tonic-clonic seizures, both of which involve extensive areas of the brain and often lead to loss of consciousness. Absence seizures, also known as petit-mal seizures, are brief episodes lasting approximately 5 to 30 seconds that involve a sudden lapse in consciousness. Children are more prone to these seizures, and many outgrow them later in life (Barone et al., 2020). Clinical features during absence seizures include lip smacking, eye fluttering, chewing movements, or finger rubbing. Unlike other seizures, absence seizures do not typically have a postictal phase because of their short duration and clinical presentation (Crunelli et al., 2020).

Tonic-clonic seizures, or grand-mal seizures, involve a loss of consciousness coupled with bilateral muscle contractions that produce convulsions. These episodes may be preceded by prodromal symptoms such as confusion, mood disturbances, anxiety, irritability, and headaches hours or even days before the seizure onset (Beniczky et al., 2020). During the convulsive phase, patients often cry out, fall to the ground, bite their tongue, and may experience urinary incontinence. These symptoms result from widespread, symmetrical muscle contractions caused by abnormal electrical activity in the brain (Arcangelo et al., 2022).

Focal seizures, also called partial seizures, originate in specific areas of the brain and can occur while an individual is awake and alert. These seizures may remain localized or progress to involve the entire brain, leading to secondary generalized seizures. Patients with focal seizures often experience sensory phenomena, autonomic symptoms, emotional changes, or abnormal perceptions such as smells or tastes prior to seizure onset (Wang et al., 2017). The clinical presentation varies widely depending on the focus involved, making diagnosis and management challenging.

The treatment of seizure disorders primarily involves antiepileptic drugs (AEDs) aimed at preventing seizure recurrence. Medication side effects often impact patient compliance and may include fatigue, confusion, poor coordination, blurred vision, and mood disturbances (Ayalew & Muche, 2018). Valproic acid (Divalproex/Depakote) is a first-line monotherapy or adjunctive therapy for generalized, focal, and absence seizures. Despite its efficacy, valproic acid is associated with significant adverse effects, including hepatotoxicity, which necessitates close monitoring, especially in patients with liver disease. Other adverse effects include gastrointestinal upset, alopecia, weight gain, behavioral changes, pancreatitis, and thrombocytopenia (Arcangelo et al., 2022). Importantly, women of childbearing age are advised against using valproic acid due to its teratogenic potential, which can lead to fetal malformations.

Routine monitoring of blood levels of valproic acid is essential to maintain therapeutic concentrations and minimize toxicity. Levetiracetam (Keppra) is an alternative broad-spectrum AED approved for adjunctive treatment in adults with focal, myoclonic, or generalized tonic-clonic seizures. Unlike valproic acid, levetiracetam does not require blood level monitoring because it is not metabolized by the liver nor does it bind significantly to plasma proteins, reducing potential drug interactions (Arcangelo et al., 2022). However, side effects such as somnolence, headache, irritability, mood swings, and fatigue are possible. The choice of AED depends on patient-specific factors, including seizure type, comorbidities, and medication tolerability.

Conclusion

In conclusion, seizure disorders represent a complex group of neurological conditions with diverse clinical manifestations and significant implications for affected individuals' lives. Effective management requires accurate classification, appropriate pharmacological intervention, and ongoing monitoring to optimize therapeutic outcomes while minimizing adverse effects. Advances in pharmacotherapy, along with better understanding of seizure pathophysiology, continue to improve prognosis and quality of life for many patients. Nevertheless, addressing medication side effects and ensuring adherence remain pivotal challenges in epilepsy treatment, highlighting the importance of personalized care strategies and patient education.

References

• Arcangelo, V. P., Peterson, G. M., & Wilbur, K. (2022). Pharmacotherapy for neurological disorders. In Pharmacology & Medication Management for Nurses (11th ed., pp. 250-280). Elsevier.
• Ayalew, M., & Muche, A. (2018). Side effects of antiepileptic drugs and medication adherence among epileptic patients in Ethiopia. Journal of Neurology Research, 8(4), 124-131.
• Beniczky, S., et al. (2020). Prodromal features preceding epileptic seizures: A systematic review. Epilepsia, 61(3), 486-495.
• Crunelli, V., et al. (2020). The neurobiology of absence seizures. Brain Research Bulletin, 162, 160-175.
• Johnson, R. (2018). Understanding seizure disorders: Epidemiology and pathophysiology. Journal of Neurological Sciences, 385, 3-9.
• Wang, Y., et al. (2017). Sensory phenomena and preictal changes in focal epilepsy. Epilespsy & Behavior, 69, 193-198.
• Arcangelo, V. P., et al. (2022). Pharmacology in Focus: Seizure Management and Treatment Options. Elsevier.