Epilepsy

Epilepsy, also called seizure disorder, chronic brain disorder that briefly interrupts the normal electrical activity of the brain to cause seizures, characterized by a variety of symptoms including uncontrolled movements of the body, disorientation or confusion, sudden fear, or loss of consciousness. Epilepsy may result from a head injury, stroke, brain tumor, lead poisoning, genetic conditions, or severe infections like meningitis or encephalitis.

DIAGNOSIS

In persons suffering from epilepsy, the brain waves, electrical activity in the part of the brain called the cerebral cortex, have a characteristically abnormal rhythm produced by excessive electrical discharges in the nerve cells. Because these wave patterns differ markedly according to their specific source, a recording of the brain waves, known as an electroencephalogram (EEG) is important in the diagnosis and study of the disorder (see electroencephalography). Diagnosis also requires a thorough medical history describing seizure characteristics and frequency.

IV TREATMENT

There is no cure for epilepsy but symptoms of the disorder may be treated with drugs, surgery, or a special diet. Drug therapy is the most common treatment—seizures can be prevented or their frequency lessened in 80 to 85 percent of cases by drugs known as anticonvulsants or antiepileptics. Surgery is used when drug treatments fail and the brain tissue causing the seizures is confined to one area and can safely be removed. A special high-fat diet known as a ketogenic diet produces a chemical condition in the body called ketosis that helps prevent seizures in young children. Like any medical condition, epilepsy is affected by general health. Regular exercise, plenty of rest, and efforts to reduce stress can all have a positive effect on a person with a seizure disorder.

Cerebral Palsy

Cerebral Palsy, a range of neuromuscular disorders caused by injury to an infant's brain sustained during late pregnancy, birth, or any time during the first two years of life. People with cerebral palsy have a wide range of difficulties, from a clumsy walk to an inability to speak or swallow, caused by faulty messages sent from the brain to the muscles. In the mid-1800s, William Little, an English physician, first described cerebral palsy in connection with birth injuries.

CAUSES

Advances in diagnostic technology have led to a much better understanding of the causes of cerebral palsy. Over half of the cases are now thought to be due to prenatal causes such as an infection that spreads from the mother to the fetus, maternal stroke that prevents proper blood supply to the fetus, exposure to environmental toxins, or problems in brain development.

The remaining cases are due to adverse events such as traumatic birth delivery, premature birth and its complications, meningitis (infection of the brain or its protective coverings), or head injury due to child abuse. Very rarely, heredity plays a role. In some cases, it is difficult to pinpoint a single event that may have caused cerebral palsy.

TREATMENT AND PREVENTION

Injury to the brain in individuals with cerebral palsy is permanent, and full recovery is not possible. Damaged brain tissue does not regenerate, but to some extent, normal nerve cells and nerve pathways can take over some function from injured areas, with some limitations. The degree of severity varies so greatly from case to case that it is difficult to make a general prognosis.

Successful treatment of cerebral palsy requires input from a variety of professionals. Physicians address health issues such as poor eyesight or restrictions in joint motion. Physical and occupational therapists help the child develop skills necessary to the activities of daily living. Speech pathologists deal with swallowing and speech dysfunction. Psychologists and educators work with emotional or learning difficulties. Nutritionists ensure normal growth. These professionals and numerous others work together as a team with the child or adult to help the individual achieve as much independence and competence as possible. In addition, family involvement in treatment, especially with children, is an essential component. With therapy, training, and community support, most individuals with cerebral palsy can lead meaningful and productive lives.

Many causes of cerebral palsy are preventable, especially those that occur at or after birth. Good prenatal care has been shown to minimize the likelihood of premature birth; new vaccines against Hemophilus influenzae have reduced the incidence of meningitis; and family support programs have reduced the number of cases of severe child abuse. Such preventive measures are cost-effective in that they reduce the expense of supporting individuals with cerebral palsy.

Disorders of the Nervous System

Consideration of disorders of the nervous system is the province of neurology; psychiatry deals with behavioral disturbances of a functional nature. The division between these two medical specialties cannot be sharply defined, because neurological disorders often manifest both organic and mental symptoms. For a discussion of functional mental illness, Mental Illness.

Diseases of the nervous system include genetic malformations, poisonings, metabolic defects, vascular disorders, inflammations, degeneration, and tumors, and they involve either nerve cells or their supporting elements. Vascular disorders, such as cerebral hemorrhage or other forms of stroke, are among the most common causes of paralysis and other neurologic complications. Some diseases exhibit peculiar geographic and age distribution. In temperate zones, multiple sclerosis is a common degenerative disease of the nervous system, but it is rare in the Tropics.

The nervous system is subject to infection by a great variety of bacteria, parasites, and viruses. For example, meningitis, or infection of the meninges investing the brain and spinal cord, can be caused by many different agents. On the other hand, one specific virus causes rabies. Some viruses causing neurological ills affect only certain parts of the nervous system. For example, the virus causing poliomyelitis commonly affects the spinal cord; viruses causing encephalitis attack the brain.

Inflammations of the nervous system are named according to the part affected. Myelitis is an inflammation of the spinal cord; neuritis is an inflammation of a nerve. It may be caused not only by infection but also by poisoning, alcoholism, or injury. Tumors originating in the nervous system usually are composed of meningeal tissue or neuroglia (supporting tissue) cells, depending on the specific part of the nervous system affected, but other types of tumor may metastasize to or invade the nervous system (see Cancer). In certain disorders of the nervous system, such as neuralgia, migraine, and epilepsy, no evidence may exist of organic damage. Another disorder, cerebral palsy, is associated with birth defects.

Treatment of Kidney Diseases and Disorders

Treatment of severe kidney disease may include kidney dialysis, a procedure in which blood is circulated through a machine that removes wastes and excess fluid from the bloodstream. Some patients use dialysis for a short time, while their kidneys recover from injury or disease. Others must use dialysis for their entire lives or until they undergo a kidney transplant. Kidney transplants are the most common of all transplant operations and have excellent success rates (see Medical Transplantation).

Kidney Dialysis

Kidney Dialysis, also known as hemodialysis, medical treatment used to remove waste materials from the blood of patients lacking renal function (see Kidney). Blood from an artery is pumped through a dialyzer, or artificial kidney, where it flows past a semipermeable membrane. Dialysis fluid passing on the other side of the membrane removes unwanted elements in the blood by diffusion. The blood is then returned to the body through a vein.

See also Treatment of Kidney Diseases and Disorders