Chapter 19 Seizures and Syncope

Question 1

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

Answer 1

Seizure

Question 2

jerky muscle contractions are known as

Answer 2

convulsions

Question 3

what is a common cause of seizures

Answer 3

Epilepsy

Question 4

What is epilepsy

Answer 4

a chronic brain disorder characterized by recurrent seizures

Question 5

What is the most common type of epileptic seizures

Answer 5

generalized tonic-clonic seizure (grand mal)

Question 6

how long does a generalized tonic-clonic seizure (grand mal) last

Answer 6

rarely more than a few minutes

Question 7

What is meant by postictal state and how long does it last?

Answer 7

it follows a seizure and is the recovery period for the patient

up to 30 min

Question 8

what are symptoms that a patient may have during postictal state

Answer 8

unresponsive extremely sleepy, weak, and disorientated or strokelike symptoms (paralysis)

Question 9

what are other causes of seizures

Answer 9

injuries and other medical conditions

Question 10

In regards to seizures is an EMT task to diagnose the type of seizure

Answer 10

NO….An EMT is to assess for and manage any life-threating conditions and provide reassurance to the patient

Question 11

How are seizures categorized

Answer 11

Primary seizure and secondary seizure

Question 12

which seizure is usually due to a genetic or unknown cause and are generalized or partial seizures

Answer 12

Primary seizure

Question 13

what is meant by generalized seizure?

Answer 13

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

Question 14

what is meant by partial seizures

Answer 14

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

Question 15

A patient suffer from a simple partial seizure (focal motor or Jacksonian seizure) min will remain_________

Answer 15

retain consciousness

Question 16

A patient who suffers a complex partial seizure (psychomotor or temporal seizure) lasting 1-2 will

Answer 16

be unconscious or have an altered mental status

Question 17

Secondary seizures are also referred to

Answer 17

as reactive seizure

Question 18

what causes secondary seizures

Answer 18

insult to the body such as fever, infection, hypoxia, hyperglycemia, hypoglycemia, drug intoxication, drug withdrawal, eclapsia in pregnancy, degenitive brain disease or electrolyte imbalance

Question 19

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

Answer 19

Statues epileptics

Question 20

what takes place during a generalized tonic-clonic seizure (grand mal).

Answer 20

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.

Question 21

What are the 6 signs/symptoms of a generalized tonic-clonic seizure (grand mal).

Answer 21

1. Aura (sound, twitch, anxiety, dizziness, a smell, unpleasant feeling, visual disturbance or odd taste.
2. loss of consciousness
3. Tonic phase (muscle rigidity)
4. Hypertonic phase (extreme muscle rigidity and back hyper extends
5. clonic phase (convulsions) violent jerky loss of bowl/bladder 1-3 min
6. Postictal state (recovery)

Question 22

Characteristics of a complex partial seizure (psychomotor or temporal seizure)

Answer 22

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

Question 23

Characteristics of absence or petit mal seizure

Answer 23

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

Question 24

Characteristics of febrile seizure

Answer 24

most common in children 6mo-6yrs

caused by fever

Question 25

What is known as Todd’s Paralysis

Answer 25

Paralysis to one side of the body following a general seizure an it may last 24hrs

Question 26

a sudden and temporary loss of consciousness is known as

Answer 26

Syncope (fainting)

Question 27

when does Syncope occur

Answer 27

when there is a temporary lack of blood flow to the brain and the brain is deprived of oxygen

Question 28

what causes Syncope

Answer 28

an overwhelming influence of the parasympathetic nervous system that cause the blood vessels to dilate

Question 29

what is a vasovagal faint

Answer 29

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.

Question 30

sometimes bystanders confuse a syncope episode with a seizure because they both have symptom of jerky movement. How can you tell the difference?

Answer 30

with Syncope

episode begins in a standing position
patient remembers felling light-headed
patient responsive immediately after being supine
skin usually pale and moist

Question 31

What are some serious causes of syncope

Answer 31

Myocardial infraction
cardiac dysrhythmias
stroke or TIA
Hypervolemia or blood loss
pulmonary embolism
Cardiac tamponade