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21 September 2008

Epilepsy / Sawan Gila Babi

Assalamualaikum.....


Hari ni aku nak study pasal epilepsi atau nama lainnya sawan gila babi. Punya la tak best nama tuh. Kalo letak sawan gila kucing ke, kambing ke, ayam ke kan baru sedap sikit sebut. Hehe.. Biasanya perkataan gila babi ni digunakan masa marah kat orang laen aje. Tapi masa sakit pun boleh guna jugak. Haha..




Penyakit gila babi berlaku apabila berlakunya sawan (seizure) yang berulang2. Sawan adalah gangguan dan abnormaliti terhadap kelakuan, kesedaran, dan pergerakan yang disebabkan oleh gangguan aktiviti elektrik yang berlaku dalam otak. Biasanya bertahan selama beberapa saat atau minit dan pulih dengan sendirinya.


Jom kita  tengok summary pasal epilepsi ni.


EPILEPSY/GILA BABI
  • Definition :
    • Common chronic neurologic disorder characterized by recurrent unprovoked seizures (sawan).
    • An epileptic seizure is convulsion (kegeleparan & kekejangan) or transient abnormal event experience by the subject due to paroxysmal cerebral discharge of cerebral neuron.
  • Pathophysiology :
    • Normally, electrical discharge in the brain is synchronized and occur in small group only.
    • In epilepsy, large group of neuron are activated simultaneously and repetitively.
    • Failure in inhibitory synaptic contact between neurons.
  • Classification :
    • Focal/Partial
      • from single location within one hemisphere. Consciousness is not impaired!
      • Category:
        • Simple partial seizure : Consciousness is not impaired. Subcategorized into motor, sensory, psychic and autonomic.
        • Complex partial seizure :  limited to one lobe & causes impairment of consciousness & resnsonsiveness.
      • May evolve to secondary generalized seizure.
    • Generalized : commence in deeper structures (brain stem & thalamus) and may project to both hemisphere. Consciousness is impaired!
      • Absences, tonic clonic, myoclonic, clonic, tonic and  atonic seizures.
  • Causes :
    • 50% are idiopatic.
    • 50% are linked to 2nd factors.
      • Family history, trauma & surgery, pyrexia in children, intracranial mass lession, cerebral lessions, drugs withdrawal and alcohol, encephelitis and meningitis, metabolic disorders, photosensitivity and auditory stimuli, and degenerative brain disorders.
  • Diagnosis :
    • History and physical examination.
    • EEG, MRI, CT scan, PET, and blood test.
  • Treatment :
    • Medication (antiepileptic), surgery, vagus nerve stimulation, ketogenic diet, complementary treatment.
  • Miscellaneous :
    • Status epilepticus,
      • Occurs when seizures follow each other without recovery of consciousness.
      • Medical emergency.
      • Mortality is 10-15%. Death from cardiorespiratory failure.
      • Treatment:
        • Immediate injection of diazepam 10mg followed by IV infusion of 200mg/L/24 hours.
        • Chlormethiazole 0.8% should be given IV if status epilepticus continue to occurs.
        • Ventilatory support must be availavle.

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