Clinical Care: Seizures

Question 1

is characterized by recurrent unprovoked seizures

Answer 1

Epilepsy

Question 2

-Preictal phase can have auras that are associated to onset of seizure
-Focal seizure with retained awareness
-Focal seizure with impaired awareness

Answer 2

Partial Seizures

Question 3

1) Formerly known as simple partial seizure

Answer 3

Partial Seizures:
Focal seizure with retained awareness

Question 4

1) Formerly known as complex partial seizure
- Patients often have no memory of what occurred during the seizure

Answer 4

Partial Seizures:
Focal seizure with impaired awareness

Question 5

Partial Seizures:
Focal seizure with impaired awareness may exhibit automatisms

Answer 5

a) Facial grimacing
b) Gesturing
c) Lip smacking
d) Chewing
e) Repeating words or phrases

Question 6

1) entire brain
2) May or may not lead to alteration of consciousness
3) Most common type is the tonic-clonic seizure (AKA grand mal)

Answer 6

Generalized seizures

Question 7

a) Tonic phase characterized by sudden muscle stiffening
b) Clonic phase characterized by rhythmic jerking
(1 Tongue biting is common in this phase
c) Episodes usually last 1-2 minutes

Answer 7

Generalized seizures: Grand Mal

Question 8

1) Somnolence, confusion or headache that may occur for several hours
2) Patient often have no recollection of event
3) Weakness of limbs may occur (“Todd paralysis”)

Answer 8

Generalized seizures: Postictal phase

Question 9

Video EEG monitoring

Answer 9

Diagnosis of seizure

Question 10

Management and treatment of seizures

Answer 10

1) First Aid
2) Treatment for active seizure

Question 11

Diazepam 5 mg IV/IM Q5-10 minutes; do not exceed 30 mg

Answer 11

Generalized seizures:
Treatment for active seizure

Question 12

a) Clear the room, maintain the airway if needed
b) For partial seizures, redirect gently
c) Started IV catheters
d) Blood work
(1 Electrolytes, LFT, CBC
(2 Finger stick glucose

Answer 12

Generalized seizures:
First Aid

Question 13

Single seizure lasting more than or equal to 5 minutes or 2 or more seizure between which there is an incomplete recovery of consciousness

Answer 13

Complications of seizure
Status epilepticus (EMERGENCY)

Question 14

(1 Diazepam 5mg IV/IM Q5-10 minutes; do not exceed 30mg
(2 Valproic acid 30mg/kg
(3 Correct any underlying problem that may be contributing to seizure
(4 Intubation

Answer 14

Complications of seizure:
Treatment

Question 15

1) Not associated with abnormally excessive neuronal activity

2) Differences between epileptic seizure

a) episodes usually last longer than 2 minutes
b) Patients eyes are closed
c) Incontinence is less common
d) Usually there is no postictal phase

3) Diagnosis is made with video EEG (no changes in electrical activity)

Answer 15

Psychogenic nonepileptic seizure

Question 16

Psychotherapy with cognitive behavioral therapy or interpersonal therapy

Answer 16

Psychogenic nonepileptic seizure:
Treatment