Response to question A
Generalized seizures affect both portions of the cerebral hemisphere whereas partial seizures are limited to a particular area within the cerebellum that has been damaged. For example temporal lobe seizures can manifest as mystical expressions and may be misdiagnosed as schizophrenia. The etiology of both generalized and partial seizures can be due to accidents hereditary- genetic ion channel/ receptor defects; brain damage due to infection. However, partial seizures occurring from underlying conditions such meningitis, high fever, concussion or chemical excitation as side effects of drugs are not classified as epileptic seizures even though they may develop later into that state. Any age group is affected. However, generalized seizures usually begin in childhood ( Fogarasi, Janszky Tuxhorn & Peri-ictal, 2006).
The prognosis for partial seizures is long term recurrence and progression into the generalized category. Generalized seizures can influence shorter life span since the patient could die during a seizure from suffocation. Treatment is through ant-psychotic medications for partial seizures and anti-epileptic for epilepsy (Provan, Drew; Andrew & Krentz 2005).
Response to Question B
Inflammation of the brain membranes and spinal cord is diagnosed as meningitis where as inflammation of the brain tissue is encephalitis. Both meningitis and encephalitis can be caused either by a bacteria or virus ( Marieb. & Hoehn, 2007). The body’s immune system was designed to contain bacteria and viruses when they invade. During combat between white blood cells and organisms entering the blood stream infection can progress into the cerebrospinal fluid, and then membranes surrounding the spinal cord subsequently, brain tissues attached to them become infected (Sáez-Llorens &, McCracken, 2003).
Bacterial meningitis is caused by streptococcus pneumoniae and bacterium neisseria meningitidis affecting mostly adults while listeria monocytogenes and escherichia coli are organisms seem mostly among infected children. Viruses mostly found in meningitis cases are varicella zoster, HIV, and herpes simplex type 2 ( McCance & Huether, 2009). Primary encephalitis can be caused by the same bacteria responsible for meningitis. Secondary encephalitis in most cases occurs in response to immunization (Provan, Drew; Andrew & Krentz 2005).
Meningitis and encephalitis are diagnosed from neurological examinations; laboratory screening and cultures of cerebrospinal fluid to find bacteria and viruses. CT scans and MRIs are ordered particularly for encephalitis. Recommended treatment for bacterial meningitis is corticosteroids beside the antibacterial culture and sensitivity antibiotics recommendations obtained from laboratory investigations (Provan, Drew; Andrew & Krentz 2005). Complications/ prognosis include permanent brain damage and death. Encephalitis is treated symptomatically with a better chance of recovery. Symptoms include stiff neck and mental confusion are peculiar to encephalitis while fever, generalize neurological dysfunctions including severe headaches are characteristic features common to both conditions (Jmor; Emsley &Fischer 2008).
differential diagnosis of childhood extratemporal seizures. Epilepsia; 46:1280
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