Desires that are not necessary for survival.

Basic necessities for survival.

Things that are not needed but are nice to have.

Basic necessities for survival.

Desires that are not necessary for survival.

Things that are not needed but are nice to have.

Tangible items that are bought and sold.

Intangible items that are bought and sold.

Items that are not bought and sold.

Intangible items that are bought and sold.

Tangible items that are bought and sold.

Items that are not bought and sold.

Money earned from work or investments.

Money spent on goods and services.

Money earned from work or investments.

The appeal to ethics or credibility.

What is Industry Sector?

A classification of related businesses.

A type of educational institution.

A type of charity organization.

What is Target Audience?

A specific group of people that a product or service is aimed at.

A type of charity organization.

A type of educational institution.

Test the definitions of the following terms: Ethos, Pathos, Logos, Wants, Needs, Goods, Services, Income, Spending, Industry Sector, Target Audience

Can you make a multiple choice of test questions regarding this information given which is Curriculum from Different Points of View There are many definitions of curriculum. Because of this, the concept of curriculum is sometimes characterized as fragmentary, elusive and confusing. However, the numerous definitions indicate dynamism that connotes diverse interpretations of what curriculum is all about. The definitions are influenced by models of thought, pedagogies, political as well as cultural experiences. Let us study some of these definitions. 1. Traditional Points of View of Curriculum In early years of the 20th century, the traditional concepts held of the “curriculum is that it is a body of subjects or subject matter prepaid by the teachers for the student’s to learn”. It was synonymous to the “course of study” and “syllabus” Robert M. Hutchins views curriculum as “permanent studies” where the rules of grammar, reading, rhetoric and logic and mathematics for basic education are emphasized. Basic education should emphasize the 3 Rs and college education should be grounded on liberal education. On the other, Arthur Bestor as an essentialist, believes that the mission of the school should be intellectual training, hence curriculum should focus on the fundamental intellectual disciplines of grammar, literature and writing. It should also include mathematics, science, history and foreign language. The definition leads us to the view of Joseph Schwab that discipline is the sole source of curriculum. Thus in our education system, curriculum is divided into chunks of knowledge we call subject areas in basic education such as English, Mathematics, Science, Social Studies and others. In college, discipline may include humanities, sciences, language and many more. To Phoenix, curriculum should consist entirely of knowledge which comes from various disciplines. Academic discipline became the view of what curriculum is after the cold war and the race to space. Joseph Schwab, a leading curriculum theorist coined the term discipline as a ruling doctrine for curriculum development. Curriculum should consist only of knowledge which comes from disciplines which is the sole source. Thus curriculum can be viewed as a field of study. It is made up of its foundations (philosophical, historical, psychological and social foundations); domains of knowledge as well as its research theories and principles. Curriculum is taken as scholarly and theoretical. It is concerned with broad historical, philosophical and social issues and academics. Most of the traditional ideas view curriculum as written documents or a plan of action in accomplishing goals. 2. Progressive Points of View of Curriculum On the other hand, to a progressivist, a listing of school subjects, syllabi, course of study, and a list of courses or specific discipline do not make a curriculum. These can only be called curriculum if the written materials are actualized by the learner. Broadly speaking, curriculum is defined as the total learning experiences of the individual. This definition is anchored on John Dewey’s definition of experience and education. He believed that reflective thinking is a means that unifies curricular elements. Thought is not derived from action but tested by application. Caswell and Campbell viewed curriculum as “all experiences children have under the guidance of teachers”. This definition is shared by Smith, Stanley and Shores when they defined “curriculum as a sequence of potential experiences set up in the schools for the purpose of disciplining children and youth in group ways of thinking and acting”. Marsh and Willis on the other hand view curriculum as all the “experiences in the classroom which are planned and enacted by the teacher, and also learned by the students”. Points of View on Curriculum Development From the various definitions and concepts presented, it is clear that curriculum is a dynamic process. Development connotes changes which are systematic. A change for the better means any alteration, modification or improvement of existing condition. To produce positive changes, development should be purposeful, planned and progressive. This is how curriculum evolves. Let us look at the two models of curriculum development and concepts of Ralph Tyler and Hilda Taba. Ralph Tyler Model: Four Basic Principles. This is also popularly known as Tyler’s Rationale. He posited four fundamental questions or principles in examining any curriculum in schools. These four fundamental principles are as follows: 1. What educational purposes should the school seek to attain? 2. What educational experiences can be provided that are likely to attain these purposes? 3. How can these educational experiences be effectively organized? 4. How can we determine whether these purposes are being attained or not? In summary, Tyler’s Model show that in curriculum development, the following considerations should be made: (1) Purpose of the school, (2) Educational experiences related to the purposes, (3) Organization of the experiences, and (4) Evaluation of the experiences. On the other hand, Hilda Taba improved on Tyler’s Rationale by making a linear model. She believed that teachers who teach or implement the curriculum should participate in developing it. Her advocacy was commonly called the grassroots approach. She presented seven major steps to her model where teachers could have a major input. These steps are as follows: 1. Diagnosis of learner’s needs and expectations of the larger society. 2. Formulation of learning objectives. 3. Selection of learning content. 4. Organization of learning content. 5. Selection of learning experiences. 6. Organization of learning activities. 7. Determination of what to evaluate and the means of doing it. Thus as you look into curriculum models, the three interacting processes in curriculum development are planning, implementing and evaluating. Types of Curriculum Operating in Schools From the various concepts given, Allan Glatthorn(2000) describes seven types of curriculum operating in the schools. These are (1) Recommended curriculum- proposed by scholars and professional organizations. (2) Written Curriculum- appears in school, district, division or country documents. (3) Taught Curriculum- what teacher’s implement or deliver in the classrooms and schools. (4) Supported Curriculum- resources-textbooks, computers, audio- visual materials which support and help in the implementation of the curriculum. (5) Assessed Curriculum- that which is tested and evaluated. (6) Learned Curriculum- which the students actually learn and what is measured and (7) Hidden Curriculum- the unintended curriculum. 1. Recommended Curriculum- Most of the school curricula are recommended. The curriculum may come from a national agency like the Department of Education, Commission on Higher Education (CHED), Department of Science and Technology (DOST) or any professional organization who has stake in education. For example the Philippine Association for Teacher Education (PAFTE) or the Biology Teacher Association (BIOTA) may recommend a curriculum to be implemented in the elementary or secondary education. 2. Written Curriculum- This includes documents, course of study or syllabi handed down to the schools, districts, division, departments or colleges for implementation. Most of the written curricula are made by curriculum experts with participation of teachers. These were pilot-tested or tried out in sample schools or population. Example of this is the Basic Education Curriculum (BEC). Another example is the written lesson plan of each classroom teacher made up of objectives and planned activities of the teacher. 3. Taught Curriculum- The different planned activities which are put into action in the classroom compose the taught curriculum. These are varied activities that are implemented in order to arrive at the objectives or purposes of the written curriculum. These are used by the learners with the guidance of teachers. Taught curriculum varies according to the learning styles of students and the teaching styles of teachers. 4. Supported Curriculum- In order to have a successful teaching, other than the teacher, there must be materials which should support or help in the implementation of a written curriculum. These refer to the support curriculum that includes material resources such as textbooks, computers, audio-visual materials, laboratory equipment, playgrounds, zoos and other facilities. Support curriculum should enable each learner to achieve real and lifelong learning. 5. Assessed Curriculum- This refers to a tested or evaluated curriculum. At the duration and end of the teaching episodes, series of evaluations are being done by the teachers to determine the extent of teaching or to tell if the students are progressing. This refers to the assessed curriculum. Assessment tools like pencil-and-paper tests, authentic instruments like portfolio are being utilized. 6. Learned Curriculum- This refers the learning outcomes achieved by the students. Learning outcomes are indicated by the results of the tests and changes in behavior which can either be cognitive, affective or psychomotor. 7. Hidden Curriculum- This is the unintended curriculum which is not deliberately planned but may modify behavior or influenced learning outcomes. There are lots of hidden curricula that transpire in the schools. Peer influence, school environment, physical condition, teacher-learner interaction, mood of the teachers and many other factors made up the hidden curriculum.

1. What is the main purpose of including theme and main idea questions in a text? a) To test your reading comprehension skills b) To understand the overall message or lesson of the text c) To practice identifying specific details in the text d) To improve your vocabulary and word knowledge 2. What is the purpose of finding the theme in a text? a) To summarize the main idea of the text in a few words b) To identify the specific details and examples in the text c) To understand the order of events in the text d) To analyze the author's writing style and techniques 3. Which of the following represents the theme of a text? a) A long sentence that describes the setting of the story b) A single word or short phrase that captures the main idea of the text c) A list of characters and their traits d) A detailed description of the plot and conflict in the story 4. How does identifying the main idea of a paragraph help you understand the text? a) It allows you to make connections between different parts of the text b) It helps you identify the author's purpose for writing the text c) It enables you to predict what will happen next in the story d) It helps you remember the specific details and examples in the paragraph 5. Which of the following best describes the main idea of a paragraph? a) The specific details and examples that support the theme of the text b) The order of events and actions in the paragraph c) The overall message or lesson conveyed by the paragraph d) The vocabulary words and their definitions in the paragraph 6. In a short paragraph about dogs, what could be a possible theme? a) Running and playing in the park b) Different breeds of dogs and their characteristics c) The loyalty and companionship dogs provide d) How to train a dog to do tricks 7. What might be the main idea of a paragraph about the importance of recycling? a) Recycling reduces pollution and conserves natural resources b) The process of recycling and how it works c) The different types of materials that can be recycled d) The history of recycling and its impact on society 8. Which of the following could be the theme of a paragraph about the benefits of reading? a) The importance of reading for academic success b) How to choose the right book to read c) The different genres of literature and their characteristics d) The role of libraries in promoting reading 9. If a paragraph discusses the life cycle of a butterfly, what would be the most likely main idea? a) The different colors and patterns of butterfly wings b) The stages of a butterfly's life from egg to adult c) The habitats and environments where butterflies live d) The types of plants that attract butterflies for feeding 10. What is the purpose of including vocabulary words and their meanings in context in a text? a) To test your knowledge of different words and their definitions b) To understand the specific details and examples in the text c) To improve your reading comprehension skills d) To practice using new words in your own writing

Classic A highly regarded work of literature or other art form that has withstood the test of time 32. Classical, Classicism Deriving from the orderly qualities of ancient Greek and Roman culture; implies formality, objectivity, simplicity, and restraint 33. Climax The high point, or turning point, of a story or play 34. Coming-of-age story / novel A tale in which a young protagonist experiences an introduction to adulthood. The character may develop understanding via disillusionment, education, does of reality, or any other experiences that alter his or her emotional or intellectual maturity 35. Conceit A witty or ingenious thought; a diverting or highly fanciful idea, often stated in figurative language 36. Connotation The suggested or implied meaning of a word or phrase. Contrast with denotation 37. Consonance The repetition of two or more consonant sounds in a group of words or a line of poetry 38. Couplet A pair of rhyming lines in a poem Denotation The dictionary definition of a word. Contrast with connotation 40. Denouement The resolution that occurs at the end of a play or work of fiction 41. Deus Ex Machina In literature, the use of an artificial device or gimmick to solve a problem 42. Diction The choice of words in oral and written discourse

Vocabulary List 1. Avocation Definition: A hobby or activity someone enjoys doing in addition to their main work. Example: Drawing cartoons was his favorite avocation after school. 2. Supercolossal Definition: Extremely large; even bigger than enormous. Example: They ordered a supercolossal pizza to share. 3. Repress Definition: To hold back or keep feelings or thoughts hidden. Example: She tried to repress her anger during the argument. 4. Subliminally Definition: In a way that affects the mind without someone realizing it. Example: The music subliminally made the store feel calmer. 5. Thrombosis Definition: A medical condition where a blood clot forms inside a blood vessel. Example: The doctor warned that lack of exercise can increase the risk of thrombosis. 6. Sclerosis Definition: A hardening of body tissue, especially arteries or organs. Example: The patient was diagnosed with sclerosis that affected his mobility. 7. Distortion Definition: A change that makes something appear different from what it really is. Example: The funhouse mirror caused a distortion of her reflection. 8. Philanthropy Definition: The act of giving money or help to improve the lives of others. Example: His philanthropy helped build a new library for the town. 9. Prevarications Definition: Lies or evasive statements used to avoid telling the truth. Example: The teacher grew tired of the student’s prevarications about missing homework. 10. Syndrome Definition: A group of symptoms or behaviors that occur together. Example: The doctor studied the syndrome to better understand the illness. 11. Schizophrenic Definition: Relating to a mental disorder where a person may have difficulty distinguishing reality from imagination. Example: The character in the story showed schizophrenic behavior. 12. Subsidize Definition: To support financially, usually with money from the government or an organization. Example: The city decided to subsidize public transportation. 13. Phenomenal Definition: Very remarkable or impressive. Example: The athlete gave a phenomenal performance in the race. 14. Demented Definition: Showing disturbed or irrational behavior. Example: The villain in the movie had a demented laugh. 15. Patron Definition: A person who supports or regularly visits a business, artist, or organization. Example: She was a loyal patron of the local bookstore. 16. Cultural Lag Definition: When ideas and beliefs take longer to change than technology or society. Example: Cultural lag can make it hard for laws to keep up with new technology. 17. Omens Definition: Signs believed to predict something that will happen in the future. Example: Some people think black cats are omens of bad luck. 18. Antagonistic Definition: Showing hostility or opposition. Example: The rival teams were antagonistic toward each other. 19. Voluptuous Definition: Curvy and attractive in a full, rich way. Example: The sculpture showed a voluptuous figure. 20. Oscilloscope Definition: A device used to view and measure electrical signals. Example: The scientist used an oscilloscope to study the sound waves. 21. Putrid Definition: Rotting and giving off a very bad smell. Example: The garbage smelled putrid after sitting in the sun. 22. Fixated Definition: Focused or obsessed with something. Example: He became fixated on winning the competition. 23. Mundane Definition: Ordinary, dull, or routine. Example: She was tired of the mundane chores she had to do every day. 24. Ghouls Definition: Evil or ghost-like creatures that feed on the dead in stories or legends. Example: The haunted house story was filled with ghouls and monsters. 25. Maladjusted Definition: Unable to cope well with the demands of life or society. Example: The counselor helped the maladjusted student deal with stress. 26. Incongruous Definition: Not fitting in; out of place. Example: The fancy chandelier looked incongruous in the small cabin. 27. Tribute Definition: Something done or given to show respect or admiration. Example: The concert was a tribute to the famous musician. 28. Audibly Definition: In a way that can be heard clearly. Example: He audibly sighed when the test ended. 29. Proficiency Definition: Skill or competence in doing something. Example: Her proficiency in math helped her tutor other students.

Electrostatics The section of CBSE Class 12 Physics electrostatic potential and capacitance notes mainly deals with the in-depth analysis of electromagnetic phenomena when they are not performing any movements. Additionally, it is divided into ten further sub-topics to study the companion processes of reaching the state. These are - 1. Electric charge In this section of Physics ch 2 Class 12 notes, you get to learn about the basic features of electric charge and its expression in Physics. Along with its basics, the sections help to understand the full potential of charge. Different aspects of Charge included in Class 12 Physics Chapter 2 notes are - Definition Type: Positive and Negative Charge Unit and dimensional formula Point Charge Properties of Charge Comparison of Charge and Mass Methods of Charging Electroscope 2. Coulomb's Law Force is created when charges of opposite signs attract each other, and they repulse if the signs are the same. Coulomb's law tries to define this phenomenon through a mathematical formula, explicitly mentioned in Physics Class 12 notes Chapter 2. Moreover, there is key information about the variation of the constant k and its effect on a medium. Coulomb's law's vector form and the principle of superimposition are also explained in ch 2 Physics Class 12 notes. (Image will be uploaded soon) 3. Electric Field As stated in Class 12 Physics Chapter 2 notes, every positively or negatively charged particle has their respective electric fields. It feels a force at the time of interaction which might be attraction or repulsion. As it arises from electric charge, it is crucial to know about its different parts like - Electric field intensity Relation between electric force and electric field Super imposition of electric field Point charge Continuous charge distributions Properties of Electric Field Lines Motion of Charged Particles in an Electric field Learning more about the electric field from electric potential and capacitance notes Class 12 helps a student to get a grasp of upcoming chapters. 4. Electric Potential Energy When energy helps a charge to move from an electric field, it is known as the Electric Potential Energy. This section of electrostatic chapter Class 12 notes requires a student to study the Electron volt (eV), and the potential energy that an n number of charges can hold. 5. Electric Potential This section of Class 12 Physics Chapter 2 notes focuses on in-depth learning of Electric Potential or Voltage. Basically, it defines the potential movement of energy. 6. Relation between Electric Field and Potential Apart from knowing more about the relationship between the two values, Physics Class 12 Chapter 2 notes also discuss equipotential surfaces. 7. Electric Dipole Essentially, 'Dipoles' are two opposite points of charge represented with q and –q, with their distance between each other being 2a. Electric Dipoles are crucial in your study of Physics Class 12 Chapter 2 notes to learn more about electric fields and their potential. Additionally, Class 12 Physics Chapter 2 notes focus on the influence of electric dipoles on a uniform electric field mainly through Force and Torque, Work, and Potential Energy. In the last part of Electrostatics, further focus is on using the formulas to their fullest potential. It includes subsections of Electric Field, Electric Potential Energy, Electric Potential, and Electric Dipole. In the notes for electrostatic potential and capacitance, you will find proper solutions accompanied by clear and crisp diagrams for better understanding. 8. Gauss's Law Apart from just discussing the Gauss's Law, in Physics Class 12 ch 2 notes there is a thorough explanation of its properties and applications. The Gauss' Law states that net electric flux passing through a hypothetical closed surface is equal to the net electric charge present within the same closed surface. Being a broad part of the whole chapter, you may need to spend a little more time on it. Moving forward, it starts discussing the properties of conductors in relation to Gauss's Law. The Class 12 Physics notes Chapter 2 perfectly defines the journey to Gauss' Law from Coulomb's Law. Here is the Gauss's Law present in the Class 12 Physics ch 2 notes, (image will be uploaded soon) 9. Capacitors There is a dedicated section about Capacitors in the Class 12 Physics Chapter 2 notes elucidating its functions and importance as storage of potential electric energy. After explaining the structure of a capacitor, it points out the different types, parallel plate, spherical and cylindrical. The section of Chapter 2 notes of Physics Class 12 is further divided into subheads like: Properties of an ideal battery Grouping of capacitors Simple circuits (Series and Parallel) Dielectric Van de Graaff generator Combination of drops Charge distribution method Wheatstone Bridge-based circuit Extended Wheatstone Bridge Infinite network of capacitors Redistribution of charge between two capacitors Vedantu prepares the Class 12 Physics Chapter 2 notes with help from subject matter experts. In the PDF, you get a comprehensive idea of the topic along with potential answers to the most asked questions. Furthermore, the detailed explanation on each section and subsections are written in a simple language allows a student to ace their exams with wholesome knowledge. These Physics Chapter 2 Class 12 notes are going to be one of the best supplementary study materials besides a student’s textbooks. Visit the Vedantu website or download the app to get your hands on all important notes! Important Questions A charge of 4 × 10–8C is uniformly distributed on the surface of a spherical conductor, having a radius of 15 cm. Determine the electric field just outside this sphere at a point that is 15 cm from the centre of this sphere. Determine the capacitance given that the distance between the two plates has been reduced by half and the parallel plate capacitor holds a capacitance of 20 pF (where 1pF = 10-12 F) having air between the two plates. What will be the total capacitance of a combination where three capacitors, each having a capacitance of 20 pF, are connected in series. A square having a side of 10 cm has a 500 µC charge at its centre. Determine the work done to move a charge of 10 µC between two points that are diagonally opposite each other on the square. At an equatorial point, what will be the electrostatic potential because of an electric dipole? Calculate the work done to move a test charge, q, through a length of 1 cm along the equatorial axis of an electric dipole? Polarisation A capacitor has its plates enclosed in a medium that can be filled by insulating substances. A net dipole moment is then induced by an electric field in the dielectric. This event causes the field in an opposite direction. Equipotential Surface An equipotential surface is a type of surface where the potential always has a constant value. If considered as a point charge, the concentric spheres that are centred at a particular area of this charge are basically equipotential surfaces. Advantages of Vedantu's Revision Notes: A Comprehensive Resource for Effective Learning There are several reasons why one may refer to Vedantu's revision notes for studying a subject like Electrostatic Potential and Capacitance. Here are some key points: Comprehensive Coverage: Vedantu's revision notes provide a comprehensive coverage of the entire topic, ensuring that all important concepts and subtopics are included. Concise and Organized: The notes are designed to be concise, focusing on the key points and core ideas. They are organized in a structured manner, making it easy for students to navigate and revise the content. Simplified Explanation: The revision notes offer simplified explanations of complex concepts, making them more accessible and easier to understand. This helps students grasp the material more effectively. Key Formulas and Equations: The notes highlight the key formulas and equations relevant to the topic, ensuring that students have a clear understanding of the mathematical aspects of Electrostatic Potential and Capacitance. Examples and Illustrations: Vedantu's revision notes often include examples and illustrations that help clarify concepts and provide practical applications, enabling students to better relate theory to real-world scenarios. Quick Recap: The revision notes serve as a quick recap of the important points, allowing students to review the material efficiently before exams or assessments. Exam-Oriented Approach: Vedantu's revision notes are designed with an exam-oriented approach, focusing on the topics and concepts that are frequently asked in examinations. This helps students prepare effectively and increase their chances of scoring well. Accessible Anytime: Vedantu's revision notes are easily accessible online, allowing students to study at their convenience and revise the material anytime, anywhere.

[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.

TEST: The present simple

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