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Hypertensive Crisis With Encephalopathy
Findings in hypertensive encephalopathy include a reduced level of consciousness, delirium, agitation, stupor, seizures, or cortical blindness in the setting of acute severe high BP. Focal neurologic signs are rare and suggest ischemic or hemorrhagic stroke rather than encephalopathy. Hypertensive encephalopathy is a cause of reversibleposterior leukoencephalopathy syndrome, which is often seen in the setting of cyclosporine- or tacrolimus-induced hypertension or that caused by bevacizumab or bortezomib. Brain computed tomography or magnetic resonance imaging showing areas of cerebral edema confirms the diagnosis of encephalopathy. The edema typically localizes in posterior brain regions perfused by the vertebral arteries, which have less sympathetic innervation and thus less dampening of BP oscillations than the carotid arteries. The areas of brain edema will resolve with timely treatment of the hypertensive crisis.
Catherine Lamy, Jean-Louis Mas, in, 2016
Seizures And Blood Pressure
Little is known about the impact of seizures on blood pressure, which is vital to maintaining an adequate quantity and supply of blood to the brain and the heart. New advances in non-invasive continuous measurement of blood pressure has made it feasible to record blood pressure around the time of seizures.
Bozorgi et al. reported a case of a woman with refractory epilepsy who had a generalized tonic-clonic seizure while undergoing video-EEG monitoring with simultaneous non-invasive blood pressure recording. Immediately after the seizure, she had a significant drop in systemic blood pressure lasting more than 1 minute.
More recently, Hempel et al. performed a prospective systematic assessment of blood pressure during and after seizures in 37 patients. They found that:
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What Is Hypertension In Cats
Hypertension in cats describes high blood pressure that is present throughout the entire body.
When a cats heart contracts, it pushes blood throughout the body and creates pressure on the walls of the arteries. This pressure is called systolic blood pressure . When the heart relaxes and fills with blood, the pressure on the artery walls is called diastolic blood pressure . So blood pressure is a measurement of the amount of pressure on the artery walls.
A cats blood pressure is measured in the same way as a humans, with the systolic number over the diastolic number, measured in millimeters of mercury, or mmHg. A humans normal blood pressure is 120/80 mmHg.
In cats, the diastolic blood pressure measurement, or the bottom number, is less reliable and considered a less important component of hypertension. So hypertension in cats is typically diagnosed on the basis of an elevated systolic blood pressure, or top number.1
Feline hypertension is generally diagnosed when the SBP is greater than 160 mm Hg or if the SBP is greater than 150 mmHg and there is clear evidence of organ damage due to hypertension.
What Does A Typical Seizure Look Like
A dog with a generalized seizure often begins showing abnormal behaviors prior to the actual seizure. Dogs may hide, whine, act anxious, tremble, or salivate for anywhere from several seconds to several hours prior to a seizure. This period of time is called the pre-ictal phase, or aura.
In a generalized, or tonic-clonic seizure, the dog will typically be seen to suddenly fall on his side. The legs will first become stiff, and this stiffening is often followed by rhythmic/jerky paddling motions. The head is often held back, with the neck extended. Dogs may vocalize, will often have repeated chewing or chomping motions of the jaw, and often will salivate excessively. Typically, dogs will also urinate or defecate during seizures. Seizures typically last approximately one to two minutes, although prolonged seizures can occur and require treatment.
Once the seizure has ended, dogs will have a prolonged post-ictal recovery period. This period may last up to 24 hours, depending on the individual dog. During the post-ictal period, dogs are typically confused and disoriented. They may be observed to pace and wander aimlessly, while some dogs may show further signs such as blindness, increased thirst, and increased urination.
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Blood Pressure During Generalized Convulsive Seizures
A drop in systemic BP should be counteracted by an increase of HR via the arterial baroreflex which, in turn, may be compromised by seizure-related alterations of the reflex loop. Indeed, the baroreflex sensitivity was recently shown to be markedly impaired in the early postictal period following 7 FBTCS in 7 patients, whereas BRS was intact after 19 FS in 19 patients . These findings were largely replicated in a study by Esmaeili et al. including 9 FBTCS and 14 FS of 18 patients . The apparent impairment of BRS in the aftermaths of FBTCS is possibly due to metabolically mediated muscular hyperemia in skeletal muscles following the generalized tonic-clonic convulsions on the one hand and the massive release of catecholamines with subsequent acceleration of HR on the other hand. Alternatively, exhaustion or suppression of neuronal activity after FBTCS may compromise brain stem function including the networks in the caudal VLM, the rostral ventral medulla, and the NA . For instance, FBTCS are commonly followed by a postictal generalized electroencephalographic suppression and in one patient, postictal hypotension was observed in association with PGES . Opposite to this assumption, however, postictal changes of BP and BRS were not related to occurrence or duration of PGES . Altogether, these results must be taken with caution and larger-scale studies are needed to confirm this hypothesis.
What Should I Do If Someone Im With Has A Seizure
If you’re with someone who’s having a seizure, there are several things you can do as part of seizure first aid. Some Dos and Donts include:
Dos
Dont
- Dont restrain them. You could hurt the person or get hurt yourself.
- Dont put anything in their mouth. There are many myths about seizures and epilepsy. One myth is that putting something in a persons mouth like a belt or spoon can keep them from swallowing or biting their tongue. ++Dont do this.++ You shouldnt put anything into the mouth of someone having a seizure. You could hurt them or get hurt yourself.
- Dont panic. Stay calm. If others around you are panicking, reassure them as best you can. Nearly 98% of seizures don’t last more than five minutes.
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High Blood Pressure Can Double The Risk Of Developing Epilepsy
BOSTON, Mass. People with high blood pressure are twice as likely to develop epilepsy, warns a new study. A team from the Boston University School of Medicine say a growing number of older people could suffer from the potentially deadly condition unless they take steps to reduce their risk for hypertension.
Epilepsy, which causes frequent seizures, is the third-most common neurological condition affecting elderly people, after strokes and dementia-related diseases. Researchers believe the number of older adults developing late-onset epilepsy will rise in countries with an aging population.
While often caused by strokes, there is no explanation why the condition affects some people and not others in more than a third of cases. The new study finds high blood pressure, also known as hypertension, could be a part of the puzzle.
Nearly half of all U.S. adults have hypertension, according to the Centers for Disease Control and Prevention. Thats roughly 116 million people with a blood pressure higher than 130/80 mmHg.
Our study shows that hypertension, a common, modifiable, vascular risk factor, is an independent predictor of epilepsy in older age, says co-author Dr. Maria Stefanidou in a media release.
Who Does It Affect
Everyone can have seizures, but some people have medical conditions that make them happen more easily. Seizures are also more likely at certain ages. Children are more likely to have seizures and epilepsy, but many grow out of the condition. The risk of having a seizure or developing epilepsy also starts rising at age 50 because of conditions like stroke.
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Differences Between Seizures And Epilepsy
Some important differences between seizures and epileptic seizures include:
- Some medical conditions that cause nonepileptic seizures may be life threatening. A person could potentially die from dehydration, diabetes, or a brain injury.
- When an underlying medical condition causes seizures, a person may have other symptoms prior to the seizure, such as high blood pressure or malnourishment.
- Diagnosing epilepsy requires excluding other syndromes and diseases. When diagnosing some other conditions, a single test may offer clarity. For example, if a person has a seizure and very high blood glucose, a doctor may conclude that uncontrolled diabetes is the culprit.
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High Blood Pressure Worse Than Diabetes And Smoking
The study followed 2,986 Americans over the age of 45 who attended a medical exam as part of the Framingham Heart Study between 1991 and 1995. Follow-up exams kept track of them over the next 19 years. During that time, doctors diagnosed 55 new cases of epilepsy.
The risk of developing epilepsy was twice as high for those with high blood pressure or who were taking medication for it, even after controlling for strokes. In comparison, other medical conditions like diabetes and lifestyle choices such as smoking did not increase the risk of epilepsy.
In this study we show that hypertension is an independent predictor of new-onset epilepsy and carries a 2-fold risk of developing unprovoked seizures after the age of 45, Dr. Stefanidou adds in a statement to SWNS. Conversely, no other common cerebrovascular risk factors showed a significant association.
Epilepsy affects parts of the brain, causing frequent seizures, with possible symptoms ranging from jerking and shaking to collapsing. An ideal blood pressure is considered to be around 120/80 mmHg, with doctors categorizing anything above 140/90 mmHg as high blood pressure.
Fortunately, people can lower their blood pressure by making lifestyle adjustments like eating healthy foods and exercising on a regular basis.
The findings are published in the journal Epilepsia.
South West News Service writer Tom Campbell contributed to this report.
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How Are Seizures Treated In A Child
The goal of treatment is to control, stop, or reduce how often seizures occur. Treatment is most often done with medicine. Many types of medicines are used to treat seizures and epilepsy. Your childs healthcare provider will need to identify the type of seizure your child is having. Medicines are selected based on the type of seizure, age of the child, side effects, cost, and ease of use. Medicines used at home are usually taken by mouth as capsules, tablets, sprinkles, or syrup. Some medicines can be given into the rectum or in the nose. If your child is in the hospital with seizures, medicine may be given by injection or intravenously by vein .
It is important to give your child medicine on time and as prescribed. The dose may need to be adjusted for the best seizure control. All medicines can have side effects. Talk with your childs healthcare provider about possible side effects. If your child has side effects, talk to the healthcare provider. Do not stop giving medicine to your child. This can cause more or worse seizures.
While your child is taking medicine, he or she may need tests to see how well the medicine is working. Your child may have:
Your child may not need medicine for life. Some children are taken off medicine if they have had no seizures for 1 to 2 years. This will be determined by your childs healthcare provider.
How Can I Help My Child Live With Epilepsy
You can help your child with epilepsy manage his or her health:
-
If age-appropriate, make sure your child understands the type of seizure he or she has and the type of medicine that is needed.
-
Know the dose, time, and side effects of all medicines. Give your child medicine exactly as directed.
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Talk with your childs healthcare provider before giving your child other medicines. Medicines for seizures can interact with many other medicines. This can cause the medicines to not work well, or cause side effects.
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Help your child avoid anything that may trigger a seizure. Make sure your child gets enough sleep, as lack of sleep can trigger a seizure.
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Make sure your child visits his or her healthcare provider regularly. Have your child tested as often as needed.
Keep in mind that your child may not need medicine for life. Talk with the healthcare provider if your child has had no seizures for 1 to 2 years.
If your childs seizures are controlled well, you may not need many restrictions on activities. Make sure your child wears a helmet for sports such as skating, hockey, and bike riding. Make sure your child has adult supervision while swimming.
Seizures may affect your childs ability to drive a vehicle. Talk with your childs healthcare provider about the laws in your state.
Girls with epilepsy should talk with their healthcare provider about the effect of seizures on birth control and family planning.
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Stroke And Brain Problems
High blood pressure can cause the arteries that supply blood and oxygen to the brain to burst or be blocked, causing a stroke. Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities. A stroke can also kill you.
Having high blood pressure, especially in midlife, is linked to having poorer cognitive function and dementia later in life. Learn more about the link between high blood pressure and dementia from the National Institutes of Healths Mind Your Risks®external icon campaign.
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Common Causes Of Drug
Senior Care Consultant Pharmacist and President of MZ Associates, Inc.Norwich, New YorkRecipient of the Excellence in Geriatric Pharmacy Practice Award from the Commissionfor Certification in Geriatric Pharmacy.
US Pharm. 2010 35:20-23.
It has been established that the elderly, particularly those with some degree of neurologic disease, are especially susceptible to the actions of medications.1 In light of the ubiquity of polypharmacy in seniors, this column has previously presented an overview of the causes of seizures in the elderly with reference to the risk of drug-induced events.2 In this issue, which focuses on neurologic diseases, a narrower discussion regarding seizures will be presented. The scope is a focus on specific agents associated with drug-induced seizures. Recognizing their potential risk and raising awareness about this problem may assist with the development of appropriate medication regimens and associated monitoring parameters to better tailor the pharmaceutical care plan to the individual patient.
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What To Do During A Seizure
Most of the time a seizure lasts less than 3 minutes, so by the time an emergency medication is ready to be given, the seizure is over. The most important thing during a seizure is for you to stay calm and protect the person having a seizure.
The following guidelines apply to tonic-clonic seizures or complex partial seizures.
Cushion the head. Banging the head against a hard surface during a seizure may lead to head trauma. Use any available soft object, and, if needed, use your foot. Loosen tight neckwear to ease breathing. Turn the person onto his/her side. This position helps the tongue fall to the side of the mouth, leaving the airway clear for normal breathing. Do not insert any object into the persons mouth. An object in the mouth will not prevent tongue biting, nor will a person swallow his/her tongue, as some people think. In fact, if an object is placed into the mouth, you may cause more harm by breaking teeth or losing the object in the throat, causing choking. Do not restrain a person during a seizure unless there is a danger. They may become aggressive if you do so. Allow them to do what they want to do. Talk to them in a soft voice to reassure them.
Afterward, tell the person that he/she has had a seizure and make sure theyre breathing normally. Check the persons awareness by asking a few questions, such as, Where are you? or What is the day today? If a tonic-clonic seizure has occurred, inform the doctor.
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