Chapter 19 Seizures and Syncope Flashcards
A sudden and temporary alteration in the brain function caused by massive, continuing electrical discharge in a group of cells in the brain is known as
Seizure
jerky muscle contractions are known as
convulsions
what is a common cause of seizures
Epilepsy
What is epilepsy
a chronic brain disorder characterized by recurrent seizures
What is the most common type of epileptic seizures
generalized tonic-clonic seizure (grand mal)
how long does a generalized tonic-clonic seizure (grand mal) last
rarely more than a few minutes
What is meant by postictal state and how long does it last?
it follows a seizure and is the recovery period for the patient
up to 30 min
what are symptoms that a patient may have during postictal state
unresponsive extremely sleepy, weak, and disorientated or strokelike symptoms (paralysis)
what are other causes of seizures
injuries and other medical conditions
In regards to seizures is an EMT task to diagnose the type of seizure
NO….An EMT is to assess for and manage any life-threating conditions and provide reassurance to the patient
How are seizures categorized
Primary seizure and secondary seizure
which seizure is usually due to a genetic or unknown cause and are generalized or partial seizures
Primary seizure
what is meant by generalized seizure?
Generalized seizures involves both cerebral hemispheres (large Lobes) of the brain and the reticular activating system (wake/sleep system)
They produce loss of consciousness, either briefly or for a longer period of time, and are sub-categorized into several major types:
- Generalized tonic clonic seizures
- Myoclonic seizures
- Atonic seizures
- Absence seizures
what is meant by partial seizures
In partial seizures the electrical disturbance is limited to a specific area of one cerebral hemisphere (side of the brain).
Partial seizures are subdivided into simple or complex
A patient suffer from a simple partial seizure (focal motor or Jacksonian seizure) min will remain_________
retain consciousness
A patient who suffers a complex partial seizure (psychomotor or temporal seizure) lasting 1-2 will
be unconscious or have an altered mental status
Secondary seizures are also referred to
as reactive seizure
what causes secondary seizures
insult to the body such as fever, infection, hypoxia, hyperglycemia, hypoglycemia, drug intoxication, drug withdrawal, eclapsia in pregnancy, degenitive brain disease or electrolyte imbalance
a life-threatening condition in which the brain is in a state of persistent seizure lasting longer than 5 minutes, or recurrent seizures without regaining consciousness between seizures for greater than 5 minutes
Statues epileptics
what takes place during a generalized tonic-clonic seizure (grand mal).
The tonic phase comes first: All the muscles stiffen. Air being forced past the vocal cords causes a cry or groan. The person loses consciousness and falls to the floor. The tongue or cheek may be bitten, so bloody saliva may come from the mouth. The person may turn a bit blue in the face. After the tonic phase comes the clonic phase: The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. After a few minutes, the jerking slows and stops. Bladder or bowel control sometimes is lost as the body relaxes. Consciousness returns slowly, and the person may be drowsy, confused, agitated, or depressed.
What are the 6 signs/symptoms of a generalized tonic-clonic seizure (grand mal).
- Aura (sound, twitch, anxiety, dizziness, a smell, unpleasant feeling, visual disturbance or odd taste.
- loss of consciousness
- Tonic phase (muscle rigidity)
- Hypertonic phase (extreme muscle rigidity and back hyper extends
- clonic phase (convulsions) violent jerky loss of bowl/bladder 1-3 min
- Postictal state (recovery)
Characteristics of a complex partial seizure (psychomotor or temporal seizure)
lasts 1-2 min
patient awake but unaware of surroundings
blank stare the
chewing or smacking lips, or rolling fingers
mumbles or repeats words
fits of rage
Characteristics of absence or petit mal seizure
most common in children blank star beginning and ending abruptly last only a few seconds rapid blinking, chewing, and lack of attention
no emergency care needed
Characteristics of febrile seizure
most common in children 6mo-6yrs
caused by fever
What is known as Todd’s Paralysis
Paralysis to one side of the body following a general seizure an it may last 24hrs
a sudden and temporary loss of consciousness is known as
Syncope (fainting)
when does Syncope occur
when there is a temporary lack of blood flow to the brain and the brain is deprived of oxygen
what causes Syncope
an overwhelming influence of the parasympathetic nervous system that cause the blood vessels to dilate
what is a vasovagal faint
is a malaise mediated by the vagus nerve. When it leads to syncope or “fainting”, it is called a vasovagal syncope, which is the most common type of fainting. Vasovagal syncope more commonly affects young adults.
sometimes bystanders confuse a syncope episode with a seizure because they both have symptom of jerky movement. How can you tell the difference?
with Syncope
episode begins in a standing position
patient remembers felling light-headed
patient responsive immediately after being supine
skin usually pale and moist
What are some serious causes of syncope
Myocardial infraction cardiac dysrhythmias stroke or TIA Hypervolemia or blood loss pulmonary embolism Cardiac tamponade
