What is our Nutrition Month Theme for this year?

New normal na nutrisyon sama-samang gawan ng solusyon

NUTRITION MONTH QUIZBEE 2022

Create me a multiple choice test questions with 4 options on the following topic:Consumer Education for Different Audience 1. Children and Youth: - Focus: Building foundational knowledge about basic consumer concepts, making safe choices, understanding money and value, and recognizing scams and unsafe situations. 2. Teens and Young Adults: - Focus: Building financial literacy, responsible debt management, understanding contracts and agreements, responsible technology use, online safety, and consumer rights. 3. Working Adults and Families: - Focus: Managing budgets, making informed purchasing decisions, understanding credit and debt, finding consumer protection resources, and navigating complex financial products (mortgages, insurance, investments). 4. Seniors: - Focus: Protecting themselves from scams and fraud, understanding common consumer issues like telemarketing, identity theft, and online scams, managing medications and healthcare costs, and accessing community resources. 5. Special Populations: - Focus: Adapting consumer education programs to the specific needs of people with disabilities, immigrants, refugees, and other marginalized communities. 6. Business and Industry:- Focus: Understanding ethical marketing practices, complying with consumer protection laws, and providing clear and accurate information to consumers. 7. Policymakers and Regulators: - Focus: Understanding consumer needs, developing effective consumer protection laws, enforcing regulations, and ensuring a fair and competitive marketplace. Adapting consumer education programs for children, teens, and seniors requires tailoring content and delivery methods to their unique needs and learning styles. Children (Ages 5-12): - Understanding the concept of money: Teaching children about saving, spending, and the value of money. - Developing basic budgeting skills: Helping children learn to make choices about how to spend their allowance or pocket money. EFFECTIVE STRATEGIES •Focus on basic concepts: Introduce core concepts like saving, spending, and budgeting in a fun and engaging way. Use simple language and relatable examples. •Real-life scenarios: Use age-appropriate scenarios to illustrate financial concepts, like buying toys or snacks. •Parental involvement: Encourage parent participation and provide resources to help them reinforce lessons at home. Teens (Ages 13-18): - Building budgeting and financial planning skills: Teaching teens how to manage their money, set financial goals, and plan for the future. - Navigating the digital marketplace: Equipping teens with the knowledge and skills to make safe and informed online purchases, understand digital marketing, and protect themselves from scams. EFFECTIVE STRATEGIES • Practical skills: Focus on skills relevant to teens, like managing money for social activities, saving for college, and understanding credit cards. • Digital literacy: Address the growing influence of online shopping, social media advertising, and financial scams. • Real-world applications: Connect financial concepts to real-life decisions teens make, like choosing a part-time job or making purchases online. Seniors (Ages 65+) - Managing retirement savings and healthcare costs: Providing information and resources on retirement planning, Medicare and Medicaid, and other healthcare options. - Navigating the digital world: Offering technology training and resources to help seniors access online services and information safely and securely. EFFECTIVE STRATEGIES • Addressing specific concerns: Focus on topics relevant to senior citizens, like retirement planning, managing healthcare expenses, and avoiding scams. • Clear and concise communication: Use simple language and visual aids to ensure easy understanding. • Social interaction: Create opportunities for seniors to share experiences and learn from each other. Teaching Financial Literacy in school and Communities In Schools: Curriculum Integration: Financial literacy concepts can be seamlessly integrated into existing subjects, making learning more relevant and engaging. - Math: Budgeting exercises, calculating interest rates, analyzing financial data, and understanding compound interest are all natural applications of math skills. - Social Studies: Exploring the history of money, financial institutions, economic systems, and the impact of financial decisions on society provide valuable context. - Economics: Discussions about supply and demand, inflation, investment, and the role of consumers in the economy enhance financial literacy. Dedicated Courses: Offering elective courses or workshops specifically focused on personal finance provides deeper dives into crucial topics. - Personal Finance: Cover budgeting, saving, investing, credit, debt management, and insurance. - Entrepreneurship: Introduce concepts like business planning, marketing, financial forecasting, and managing cash flow. In Communities: Community Centers and Libraries: Workshops, seminars, and classes tailored to adults and families provide accessible learning opportunities. - Financial Planning: Cover budgeting, retirement planning, debt management, and estate planning. - Homeownership: Provide guidance on buying, selling, and maintaining a home. - Consumer Protection: Educate individuals about their rights and how to avoid scams. Partnerships with Financial Institutions: Collaborations with banks, credit unions, and financial advisors offer valuable resources, workshops, and financial literacy programs. Consumer Education for Low-Income and Vulnerable Populations Low-income refers to individuals or households with limited financial resources, typically below a certain threshold. Low-income individuals may face challenges like: 1. Limited education and job opportunities 2. Poor living conditions and housing 3. Food insecurity and malnutrition Causes of low income: 1. Unemployment or underemployment 2. Low-paying jobs or minimum wage 3. Limited education or skills 4. Single parenthood or large family size Vulnerable population'' is a term that is used to describe a group of people who possess some sort of disadvantage. elderly people, people with low incomes, homeless people, people in prison, migrant workers, pregnant women, Family Consumer Education: Managing Household Finances and Resources Financial literacy is the ability to understand and manage personal finances effectively. 1. Debt Debt is money you spend that isn’t yours. If you borrow money from the bank, use a credit card, or take out a short-term loan, or a payday loan, you are accumulating debt. Good debt is considered money borrowed for things that are absolutely necessary for making a life e.g. a house and for advancing your money-making potential e.g. an education. Bad debt is considered borrowing money or using a credit card to pay for things you don’t need, such as expensive clothes, hi-tech electronics, eating out at restaurants, going on holidays, etc. 2. Saving Saving is an essential part of financial wellness, a secure present, and a happy future. 3. Budgeting Budgeting is the life skill of planning and managing your money. By understanding exactly where your money goes every month, you are empowered to create an actionable plan by which you can spend less, by curtailing those unnecessary expenses and saving more for the things you need and want. 4. Investing Investing is all about creating and growing the wealth you need to enjoy a financially secure and happy future. It’s about putting your money into something that will make you a profit over time, such as property, retirement funds, and unit trusts Integrating Consumer Education into the Home Economics Curriculum. Integrating consumer education into the home economics curriculum can provide students with essential skills for making informed choices about their personal finances, food, clothing, and overall well-being. Here are some strategies and ideas for effectively incorporating consumer education: Financial Literacy Budgeting: Teach students how to create and manage a personal budget, including setting financial goals, tracking expenses, and understanding savings. Saving and Investment: Cover the basics of saving, including different saving accounts, and introduce concepts related to investing. Food and Nutrition Food Label Literacy: Engage students in learning how to read and interpret food labels, including nutrition facts and ingredient lists. Grocery Shopping Skills: Teach students how to compare product costs, understand unit pricing, and make healthy, budget-friendly choices while shopping. Clothing and Textile Education Consumer Choices in Clothing:Discuss factors influencing clothing purchases, such as quality, price, and sustainability. Fashion and Trends: Analyze the impact of marketing and advertising on consumer behavior regarding clothing. Sustainable Purchasing Eco-Friendly Choices: Raise awareness about environmentally friendly products and the importance of sustainability in consumer choices. Project-Based Learning - Assign real-life projects where students must apply their knowledge, such as creating a meal plan within a budget, planning a shopping list based on nutrient needs, or evaluating the cost-effectiveness of different products. Technology Integration - Use technology to teach students about online shopping, price comparison websites, and apps that aid budgeting and financial planning. Collaborative Learning Opportunities - Organize team projects where students work together to solve consumer-related problems, emphasizing teamwork and communication skills. Assessment and Reflection - Incorporate assessments that allow students to reflect on what they have learned about consumer education and how they can apply these skills in their daily lives.

Life Processes Identify and define the seven life processes (MRS GREN). Classification Group living organisms based on observed similarities and differences. Classify vertebrates into taxonomic groups based on visible physical characteristics. Construct a dichotomous key to classify vertebrates. Cells Compare the structure of generalised plant and animal cells, and selected microbes (e.g. bacteria, fungi and Amoeba) Distinguish among cell wall, cell membrane, nucleus, cytoplasm, temporary and permanent vacuoles, mitochondrion, chloroplast, endoplasmic reticulum and ribosomes. Relate the structure of organelles to their functions; Identify specialised cells such as blood cells, ciliated epithelial cells, nerve cells, root hair cells, sperm cells and egg cells. Explain the importance of cell specialisation in multicellular organisms; include hierarchy of cells, tissues, organs; organ systems and then organism Diffusion, Osmosis, Active transport and Osmoregulation Explain the processes of diffusion, osmosis and active transport. Identify everyday instances of these processes occurring. Discuss the importance of diffusion, osmosis and active transport in living systems. Nutrition in Plants Describe the process of photosynthesis in green plants; test for end products, starch or reducing sugar (glucose). Relate the structure of the leaf of a flowering plant to its function in photosynthesis; draw and label the external features and the internal structure (cross section) of a leaf as seen in cross section under the light microscope. Nutrition in Humans Discuss the importance of a balanced diet in humans. State components of a balanced diet (carbohydrates, fats, proteins, vitamins and minerals, water and roughage and their roles) along with the results of their deficiency or surplus. Suggest dietary recommendations for treating and preventing named deficiency and physiological diseases (such as those outlined in the manual and your notes). Perform tests to distinguish among food substances - Test for proteins (Biuret), fats (grease spot), starch (iodine), reducing sugars (Benedict’s solution). The Digestive System in Humans Relate the structures of the human alimentary canal to their functions; Draw and label simple diagrams of the alimentary canal and internal structure of a tooth required. Describe mastication and the role of teeth in the mechanical breakdown of food to be included. (Compare types of teeth in humans and compare types of teeth in herbivores and carnivores.) Explain the role and importance of enzymes role of digestive enzymes in the mouth, stomach and pancreatic enzymes in the small intestine. Discuss properties of enzymes. Deduce from tables and graphs the effects of temperature and pH on enzyme activity. Experimental Skills Follow all drawing rules as outlined in the drawing skills checklist posted in the classroom (including calculation of magnification).

Classification of plants • Plants can be classified as cultivated and wild plants. • Both cultivated and wild plants are very useful to people, animals and the environment. 1. Cultivated plants: • Cultivated plants are plants grown by people for selling. • They can be grown in the field, vegetable garden, home garden and orchard. Classification of plants 2. Wild plants Wild plants are plants that grow on their own outside the garden, orchard or field. They have many uses such as: • Food for people and animals • Shelter • Source of fuel in form of firewood. • Examples include, grasses, msasa, yellow wood, mahogany, mopane Plant Nutrition • The presence of plant nutrients in the soil make them grow well. • The three major plant nutrients are nitrogen, phosphorus and potassium. Sources of plant nutrients • The source for plant nutrients are grouped into organic and inorganic sources. Organic sources of plant nutrients • These are found in nature. • They are natural materials such, decayed plant and animal matter which include: • Animal manure from cattle, sheep, goats, poultry and pigs. • Green manure • Legume crops like beans, peas and groundnuts. • Humus • These material sources may also be called natural fertilizers. Inorganic sources of plant nutrients • These are sources of plant nutrients made by people in industries. They include: • Compound fertilizers like compound A, B, C and D. • These have two or more nutrients. • Straight fertilizers like ammonium nitrate, single super phosphate and urea. • A straight fertilizer supplies a single or more nutrient to the crop. A straight fertilizer A Compound fertilizer Sources of N,P,K • Ammonium nitrate and Urea- contain nitrogen Double super Phosphate, Single super phosphate-contain phosphorus • Muriate of Potash contains Potassium 2 . Compound fertilisers -have two or three of the three major plant nutrients (N.P.K). N-nitrogen P-phosphorus K-potassium Examples Compound D Wednesday 17 May 2023 Revision exercise (Plant nutrition) 1 .Name the 3 plant nutrients needed by plants. 2. What are the 2 groups of plant nutrients sources? 3. Give 3 examples of organic sources of plant nutrients. 4. What is a straight fertilizer? 5. Compound fertilizer supplies ……………or ………………. Nutrients. Vegetable crops • A vegetable is any part of a plant that is eaten by humans as food part of a meal. • Vegetables are grouped and named according to the part that is eaten. • These are leaf, root, fruit, flower, bulb, tuber and legume vegetables. Leaf vegetables Types of veg Legume etable cropsvegetables Fruit vegetables Root, bulb and tuber Flower vegetables Cabbage Peas Tomato Root: carrots Cauliflower Rape Green beans Pepper Parsnip broccoli Spinach Melons Beetroot Tsunga Cucumber Bulb: onion Lettuce Squash Garlic kale Egg plant Leek chillies Tuber: Irish potato Wednesday 31 May 2023 Vegetable crops 1. What is a vegetable? 2. Which one is not a vegetable from the list below? a. Covo B. cabbage C. wheat D. tomato 3. Choose a vegetable which is not a fruit vegetable. a. tomato B. pepper C. kale D. egg plant 4. From which pair of vegetables do we eat the flower? A. cauliflower and garlic B. broccoli and cauliflower C. broccoli and rape D. cauliflower and pepper 5. Give one example of a vegetable belonging to each of the following groups. a. root b. legume c. bulb 6. Name any 5 groups of vegetable classification according to the parts eaten. Growing leaf vegetables • Although there are many types of vegetables, the leaf, fruit and bulb vegetables are widely grown. • Leaf vegetables form the greater part of vegetable crops. • Leaf vegetables belong to a family called brassica. • Brassicas include cabbages, lettuce, spinach, covo and many others. • Each brassica family has got its own varieties called cultivar. • They usually grow under the same climatic conditions and are affected by the same pests and diseases. • The selection of a variety depends on the following : The intended use of the vegetable, for example, salad, stew or snacks. Days taken to mature. Disease resistant Season of the year Seedbed preparation • Brassica vegetables are usually raised in seedbeds. • The seedbeds are prepared by: • Marking the position of the bed 1 meter in width by any length using a tape measure, hammer and pegs. • Digging a seedbed to a depth of 25 to 30cm using a hoe. • Breaking lumps of soil using a garden rake. Soil requirements • Brassicas need: • Well drained soils. • Fertile soil for good growth • Slightly acidic soils (pH 5.5-6) Climatic requirements • Brassicas need cool to warm temperatures. • Very low temperatures cause cabbages to flower which is called bolting. • Brassicas can be grown throughout the year. Seedbed preparation • Brassica seedlings are usually raised in seedbeds. • A seedbed is prepared by: Marking the position of the bed 1 metre in width by any length using a tape measure, hammer and pegs. Digging a seedbed to depth of 25 to 30 cm using a hoe. Breaking lumps of soil using a garden rake. This is done in order to have a fine tilth and improve soil to seed contact. Making ridges that a 15cm high. Apply 3 to 5kg/m² of well decomposed manure. 60 to 100g/m² of compound fertilizer can be added into the soil. Management of vegetable crops • After transplanting the seedlings, the seedlings need to be looked after. (a)Controlling weeds: all vegetables must be kept weed free. • This is done either by hand pulling weeds or shallow cultivation using a hand fork. (b) Pest control: common pests that affect the brassicas are aphids and diamond black moth larva. • Aphids are small green insects that suck the juice from the leaves leaving them with curls. • They are controlled by spraying malathion using the instructions on the label. (c) Disease control: bacterial diseases are common in brassicas. • Common diseases are black rot and soft rot, especially in cabbages. • These are controlled by: Crop rotation Early planting Planting resistant cultivars (d) Top dressing: brassicas are top dressed using Ammonium Nitrate at a rate of 2.5g per plant. • Top dressing is usually done 3 or 4 weeks after germination. FIELD CROPS • Field crops are crops that are grown on a large piece of land. • Example of field crops:  Maize  Cotton  Groundnuts  Roundnuts  Wheat  Sunflower  Tobacco  Sugar cane  Tea  Coffee  Soya beans  sorghum Classification of field • Field crops can be classified according to use such crops cereal, fibre, sugar and oil. 1. Cereal crops: • A cereal is a grass grown for its edible seeds. • They are also known as grain crops. • The major cereal crops are maize, wheat, rice, barley, sorghum and millet. 2 . fiber crops : • these are crops which are grown for their fiber and are used in making textiles, ropes and rugs. • Important fiber crops are cotton, flax and sisal 3. Oil seed crops: • These crops are grown for the purpose of extracting oil from their seed. • The main oil seed crops are groundnuts, sunflower, soyabean and cotton seed. 4 . Sugar crops : • Sugar crops include sugarcane,

Your Skin Do you know that your skin is the largest organ in your body? Home Economics and Livelihood Education 7 Seibo College 32 You need to clean and protect your skin from the different elements to maintain a clear and smooth looking skin, free from cuts and wounds. Ways of taking care of your skin: a. Eat nutritious food. b. Treat wounds and other skin disorder immediately. c. Take a bath using luffa. d. Apply skin softener. e. Have enough sleep. Your Hair Your hair is said to be your crowning glory. It gives your face an added beauty and radiant looks. So that, keeping your hair shinning through regular washing and combing will do wonders to your look. Suggested ways for keeping your hair glossy and healthy: a. Wash your hair regularly or as it becomes dirty. b. Comb or brush your hair everyday. c. Each time you wash your hair, clean your comb as well. d. You may use soapy water or shampoo. e. For a softer hair, you may use a conditioner. Your Teeth and Gums Home Economics and Livelihood Education 7 Seibo College 33 Caring for your teeth and gums are equally important as well. Never neglect your teeth, otherwise you will not be able to give your close-up smile. Remember the following in caring for your teeth and gums: a. Brush your teeth after each meal. b. Rinse your mouth with water after eating between meals. c. Use dental floss to remove food particles between the teeth. d. Visit your dentist at least twice a year for tooth examination. e. Eat foods rich in vitamins and minerals. Your Hands and Feet One of the most useful part of the body is your hand, which manages all your tasks together with your feet, which support the entire body. Ways on taking care of your hands and feet: a. Always keep your hands clean. b. Wash your hands before and after eating. c. Wash your feet before going to sleep. d. If your feet easily perspire, soak them in warm salty water for about 15 minutes daily. e. Dry with a clean towel. Dust with powder. Home Economics and Livelihood Education 7 Seibo College 34 If you have any questions, you can go to your learning facilitator, but if everything is clear to you, proceed to the next activities. Your Nails: a. Clean your finger nails with soapy water. b. Keep your nails short. c. Use a nail cutter to trim them. d. In trimming , follow the curve of your nails. e. Use a nail file to keep the edges smooth. My dear learners, you are now well informed with the different ways of keeping yourself clean and healthy. You are old enough to be responsible in keeping yourself neat and clean. Therefore, keep these in mind; your personal cleanliness is your primary duty to

• There are two groups of animals which are important in agriculture. • The groups are domestic and wild animals. 1. Domestic animals • These are animals which are trained to live with people in their homes. • Some examples includes : Uses of domestic animals • Source of food, for example milk, eggs and meat. • For cultural purposes, for example paying lobola. • Some are used for transport and labour. • Domestic animals can also be a source of income. 2 . Wild animals • These are animals which are found in game reserves and in the forests • They are also called game animals. • Examples of wild animals are: Uses of wild animals • Some of the wild animals give us meat, hides and ivory. • Wild animals attract visitors from other countries, so the country gets money. Wednesday 06 September 2023 Exercise: Domestic animals 1. What is a domestic animal? [2] 2. What is a wild animal? [2] 3. Name any 4 domestic animals that you know. [4] 4. State any 2 uses of domestic animals. [2] 5. Name any 3 wild animals that you know. [3] 6. Give 2 uses of wild ani mals. [2] 7. Wild animals can also be called animals. [1] • Animals, like human beings need good food to help them to grow and reproduce. • The main sources of food for animals include stock feeds, pastures, veld grass, crop remains and cereal grains. • These foods contain the most needed essential nutrients. Nutrient Function carbohydrates Gives energy Fats Give energy and warmth Proteins Helps in growth and repair of body parts Minerals Help in the formation of bones and teeth Vitamins Help develop good sight, improve fertility and help animals fight diseases Water Transports food in the body, cools the body and remove waste from the body. • Livestock are domesticated animals that are kept for food, use or for sale. • Small livestock has many uses. • They are a good source of food. • They also give us manure to use in gardens. • We get clothes and medicine as well from small livestock • Examples of small livestock are rabbits, sheep, goats and all form of poultry Poultry • All animals that are kept by farmers which have wings and feathers and lay eggs are called poultry. • They are a good source of white meat, eggs and manure. • They are also a source of income when we well them and their products. • Poultry includes chicken, guinea fowl, ducks, turkey, pigeons and quail birds. Rabbits • Rabbits have 3 known uses which are: They are kept for meat Kept for pelts. (pelt is animal skin used to make blankets, hats and jackets) They are used at agricultural shows • Rabbits are cheap to buy, easy to keep and feed. • They take about 4 months to mature. • Rabbits are fed using green vegetables and rabbit pellets. Wednesday 20 September 2023 Small livestock 1. Give 3 examples of small livestock. [3] 2. State 3 things that are provided by small livestock. [3] 3. What are the 2 uses of rabbits? [2] 4. Pelts are used to make _________________ [1] 5. State any 4 examples poultry. [4] 6. Rabbits take ___________ months to mature. [1] 7. What is poultry? • Apiculture is the keeping of bees in order for them to produce honey for sale. • Apiculture is very important because: (i) Provides honey - a valuable nutritional food (ii) Provides bees wax - which has many uses in industry Uses of wax For making candles Polish furniture Make crayons Prevent tools from rusting (iii) Honey bees are excellent pollinating agents, thus increasing agricultural yields. BEE COLONY Inhabitants of the bee colony and their roles • A honey bee colony typically consists of three kinds of adult bees: workers, drones and the queen 1. Workers • Workers are the smallest and constitute the majority of bees occupying the colony. • They do not lay eggs. • Workers have specialized structures, such as brood food glands, scent glands, wax glands, and pollen baskets. • these allow them to perform all the labors of the hive. Roles of the worker bees they forage for nectar, pollen, water, and plant sap. They clean and polish the cells. feed the brood. care for the queen. remove debris. handle incoming nectar. build beeswax combs. guard the entrance. 2. Drones • Drones (male bees) are the largest bees in the colony. • They are generally present only during late spring and summer. • The drone’s head is much larger than that of either the queen or worker. • Drones have no stinger, pollen baskets, or wax glands. • Their main function is to mate with the queen. 3 . Queen • Each colony has only one queen. • The queen is the largest of the bees in a bee colony. • The Queen Bee plays a vital role in the hive because she is the only female with fully developed ovaries. • She produces both fertilized and unfertilized eggs. • Queens lay the greatest number of eggs in the spring and early summer. • The queen also produce chemical scents that help regulate the unity of the colony. 1. What is apiculture? [2] 2. Give 3 reasons why apiculture is important in Zimbabwe. [3] 3. Name the 3 inhabitants of the bee colony. [3] 4. Briefly explain the roles of each inhabitant named in number 3. • Apart from using hand tools, farmers also use some farm implements and machinery to carry out their field work. • Machines help farmers do their work more easily and quickly. • The most common implements used by farmers to grow, harvest and transport their produces are:  mouldboard plough Cultivator Scotch cart Harrow Planter Maize sheller  combine harvesters Boom sprayers Disc harrow Spike toothed harrow KNAPSACK SPRAYER • Farming is a business. • Communal farmers grow crops and keep animal mainly for their own use. • If there is any extra they sell to get money. • Commercial farmers grow crops and keep animals for sale. • Crops and animals produced are called farm produce. • There are places were farmers have to sell their produce. • Farmers can take their produce to local markets. • A market is a place where buying and selling occurs. • Some of the local markets includes: A shopping centre A school A nearest bus stop A local village A school Local Grain Marketing Board depot (GMB) Types of farm produce Beef Fruits Mutton Eggs Vegetables Pork Milk Chicken Cereals/grains beans

[t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ • It is the commonest cause. no cause can be detected ( 65 % ) • It may be associated with positive family history in some cases. • It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: • Somatic: • Psychic: • Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: • Somatic: • Psychic: • Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: • High frequency ( 50 attacks / day). • Falling to the ground without warning. • Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. • The jerks are bilateral contractions, mainly of the shoulders and arms. • However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly • Simple: • As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: • Focal fits: • Motor jacksonian fits: 2. General Sensory fits: • Focal fits: • Sensory jacksonian fits: 3. Special Senso1y fits: • Visual hallucinations: • Auditory hallucinations: • Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY • Usually: • The cause: • Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. • It is associated with: • EEG: • It is not associated with: normal. • Missed ttt. • Menses. • Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. • Alcohol use & Drug abuse ( e.g. cocaine ). • S timulation by photons & Hyperventilation. • S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: • It is the most specific test for epilepsy because it records the electrical activity of the brain. • It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" • To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" • To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: • The patient stays free of symptoms for at least 2 years. • The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " • Place the patient on the ground, to guard against falling from bed. • Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). • Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.

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