EPILEPSY
epididymitis
See
epididymo-orchitis
.
epididymo-orchitis
Acute inflammation of a
testis
and
epi-
didymis
(coiled tube that runs along the
back of the testis). Epididymo-orchitis
causes acute pain and swelling at the
back of the testis, and, in severe cases,
swelling and redness of the
scrotum
.
The inflammation is caused by infec-
tion. Often, there is no obvious source
of the infection, but sometimes the
cause is a bacterial
urinary tract infection
that has spread via the
vas deferens
(the
sperm duct leading to the urethra) to
the epididymis.
Treatment is with
antibiotic drugs
.
If
there is an underlying urinary tract
infection, its cause needs to be investi-
gated. (See also
orchitis
. )
epidural anaesthesia
A method of administering pain relief
in w hich a local anaesthetic (see
anaes-
thesia, local
)
is injected into the epidural
space (the space around the membranes
that surround the spinal cord) in the
middle and lower back. Epidural anaes-
thesia numbs the nerves that supply the
chest and lower body. The technique is
widely used to relieve pain during and
after surgery, as well as during
childbirth
.
Administering an epidural anaesthetic
The anaesthetic is injected into the epidural space
(the region surrounding the spinal cord within the
spinal canal).
epidural space
The space between the outer membrane
of the
spinal cord
and the walls of the
vertebral canal that surround it.
(See
also
epidural anaesthesia.)
epigastric hernia
A
hernia
(protrusion of an organ or tis-
sue) through a weakened area in the
upper central abdominal wall. The her-
nia may appear as a lump in the centre
of the upper abdomen, between the
base of the sternum (breastbone) and
the navel. (See also
hernia repair.)
epiglottis
The flap of
cartilage
lying behind the
tongue and in front of the entrance to
the
larynx
(voice box). The epiglottis is
usually upright to allow air to pass
through the larynx and into the rest of
the respiratory system. During swallow-
ing, it tilts downwards to cover the
entrance to the larynx, preventing food
and drink from being inhaled into the
trachea (windpipe).
epiglottitis
A potentially life-threatening infection
causing inflammation and swelling of
the
epiglottis
(the flap of cartilage at the
back
of the
tongue
that
closes
off
the windpipe during swallowing). The
swollen epiglottis obstructs breathing
and can cause death by suffocation if
the condition is not treated promptly.
Epiglottitis is now rare due to the
routine
immunization
of infants against
H
aemophilus
influenzae
, the
bacterium
that causes the condition.
epilepsy
A tendency to have recurrent
seizures
.
Seizures are defined as transient neuro-
logical abnormalities that are caused
by abnormal electrical activity in the
brain. Human activities, thoughts, and
emotions are normally the result of the
regulated and orderly electrical excita-
tion of nerve cells in the brain. During a
seizure, a chaotic and unregulated elec-
trical discharge causes various physical
and mental symptoms.
CAUSES
In many
people w ith
epilepsy,
the
cause is unclear, although a genetic
factor may be involved. In other cases,
seizures may be the result of brain
damage from a head injury; birth trau-
ma; brain infection (such as
meningitis
or
encephalitis);
brain tumour;
stroke
(damage to part of the brain caused by
an interruption to its blood supply);
drug or alcohol intoxication; or a
meta-
bolic disorder
.
SYMPTOMS
Many people who suffer from epilepsy
do not have any symptoms between
seizures. Some people experience an
aura
(a peculiar “w arning” sensation)
shortly beforehand. In some cases, a
stimulus such as a flashing light trig-
gers a seizure. Epileptic seizures may
occur more frequently during times of
illness or stress.
TYPES
Epileptic seizures can be classified into
two
broad
groups:
generalized
and
partial seizures.
Generalized
seizures
These
seizures
cause loss of consciousness and may
affect all areas of the brain. There are
two main types of generalized seizure:
tonic-clonic (formerly grand mal) and
absence (petit mal) seizures.
During a tonic-clonic seizure, there
may initially be an aura, then the body
becomes stiff and consciousness is lost.
Breathing may be irregular or may stop
briefly,
then
the body jerks uncon-
trollably.
The
episode
usually
ends
spontaneously after a few minutes. The
person may be drowsy and disorien-
tated
for
a
few
hours
afterwards,
however, and may have no memory
of the event. Prolonged tonic-clonic
seizures are potentially life-threatening.
Absence
seizures
occur
mainly
in
children. Periods of altered conscious-
ness last for only a few seconds and
there are no abnormal movements of
the body. This type of seizure may occur
hundreds of times daily.
Partial seizures
These seizures are caused
by
abnormal electrical
activity in
a
more limited area of the brain. They
may be simple or complex.
In simple partial seizures, conscious-
ness
is
not
lost
and
an
abnormal
twitching
movement, tingling
sensa-
tion, or
hallucination
of smell, vision, or
taste occurs, lasting several minutes.
In one type of partial seizure, called
temporal lobe epilepsy
,
conscious contact
w ith the surroundings is lost. The suf-
ferer becomes dazed and may behave
oddly. Typically, the person remembers
little, if anything, of the event.
DIAGNOSIS
In order to make a diagnosis, a doctor
needs as much information as possible
about the seizures. The patient may not
be able to recall the events, so an accu-
rate account from a witness may be
necessary. Examination of the nervous
system is normally carried out between
seizures. An
EEG
(a method of recording
the activity of the brain),
CTscanning
or
MRI
of the brain, and blood tests may
also be carried out.
E
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