Approach According To Age Groups Flashcards
Infants <1 month
Perinatal hypoxia, ischemia
Trauma - ICH
Acute CNS infection
Metabolic dysfunction : low glucose, low/ high sodium, low pyridoxine, low calcium
Withdrawal symptoms,
Developmental disorder, genetic
Children <12 years
Febrile
Genetic disorder ( primary epilepsy syndrome, metabolic, degenerative)
CNS infection
Developmental
Trauma
Idiopathic
Adolescents
Trauma, tumour, genetic ( metabolic?) infection, alcohol withdrawal illicit drug use
Young adults
Trauma, alcohol withdrawal/ illicit drug use, tumour, idiopathic
Older adults
CV disease, tumour, alcohol/drugs, metabolic alzheimers, degenerative a,
VITAMIN for seizure
Vascular - hypertensive encephalopathy, emboli strokes, eclampsia
Infection ; cerebral malaria, meningitis ( neck stiffness, photophobia, headaches, vomiting) , encephalitis
Trauma
Arterio-venous M and autoimmune like vasculitis
Metabolic hypoglycemia, hypoxia, hyponatremia MS
Idiopathic
Neoplasms
Others : fever, sleep deprivation, drugs/ alcohol,
Epilepsy most common in which age group
30% in early childhood but also in teens and older adults
Pack approach to a fitting patient
Ensure environment safe , protect airways, never withhold/ put things in their tongue. Establish IV access, get glucose, Give 100% face mask oxygen if need be??.. If glucose <3 10% 5ml/kg dextrose if after 15 minute still low repeat 10% 2ml/kg dextrose once it is more than 3 continue with 5% dextrose 1L 6 hourly
Fitting and not pregnant / <20 weeks give 10mg IV diazepam/ 4 mg IM/IV lorazepam slow infusions over 5 minutes If still continues after 10 minutes repeat the doses then if still maintains fitting and doesn’t recover their Consciousness give phenytoin 20 mg IV over 1hr , can repeat 10mg over 30 minutes Iv if fail to stop
Red flags for seizures
Meningitism
Subarachnoid Haemorrhage ( severe headaches)
Weakness asymmetrical in limbs
Alcohol, metabolic derangements, eclampsia, trauma
HIV no history of epilepsy
