Convulsions Flashcards
What is a seizure
SEIZURE is a transient occurrence
of signs and or symptoms
resultng from abnormal excessive
or synchronous neuronal actvity
in the brain
EPILEPSY
Epilepsy is a disorder
characterized by two or more
unprovoked seizures occurring
more than 24 hours apart beyond
neonatal period
CONVULSION
A convulsion is any seizure ( no
necessary epileptc) characterized
by excessive, abnormal muscle
contractons which are usually
bilateral
SEIZURES VS EPILESY
SEIZURE
A seizure is the event
EPILEPSY
Epilepsy is the disease associated
with spontaneous recuring
seizures
PRE-ICTAL
Was there any warning before the spell ?
• What was the child doing before the spell ?
• What the child asleep or awake ?
• Was there a fever or an illness ?
ICTAL
Was the child responding ? What was the Level of consciousness
• What body movements occurred
• How long did the spell last ?
• How many episodes did the child experienced ?
Terminology
- Jerking/ Shaking
- Stfening
- Staring
- Falling
POST-ICTAL
• How did the child fell afer the spell?
• Did the child seem confused and tred afer the spell ?
• How long did it take for the child to get back to baseline conditon?
• Did the sufered headache or weakness afer the spell?
CLASSIFICATION
FOCAL ONSET
Generalized onset
Focal onset
Motor onset
- Tonic
- Clonic
Non-motor onset
- Sensory
- Behavioral
- Emotonal
Generalized onset
Motor onset
- Tonic-clonic
- Tonic
- Myoclonic
Non-motor onset ( Absence)
EVALUATION
- Seizures or seizure mimic ?
- Is it provoked or unprovoked ?
- Is it generalized or focal ?
- Etology?
- Any associated morbidity
- Any impairment in behaviour, mood and educaton ?
- Treatment received tll now?
SYMTOMATIC SEIZURES
• CNS Infectons
• CNS trauma
• Cerebrovascular Stroke
• Tumors
• Metabolic
• Congenital brain malformatons
• Febrile seizures
DIFFERENTIAL DIAGNOSIS
Syncope
• Breath holding
• Apneic of prematurity
• Panic atacks
• Benign neonatal sleep myoclonus
• Jiteriness
Neonatal seizures definition
An abnormal synchronous electrical discharge of a group of neurons in
the central nervous system.
Neonatal brain is hyperexcitable and more likely to have seizures
CLINICAL MANIFESTATIONS
Clinical manifestaton may be
- Subtle: eye deviaton, eye futering, bucco-lingual
- Pedaling of arms and legs
- Focal: tonic or clonic
- Generalized: multfocal rhythmic jerking, generalized posturing or
myoclonic
IMPORTANT CAUSES
• Brain damage form hypoxic –ischemia, bleeding, infract
• Brain malformaton
• Meningits or encephalits
• Hyperbilirubinemia kernicterus
• Hypoglycemia
• Metabolic
• Drug withdrawal
INVESTIGATIONS
BLOOD
- Infectons
- Biochemicals
- Metabolic
LUMBAR PUNCTURE
- CSF examinaton
BRAIN IMAGING SUCH AS CRANIAL ULTRASOUND, CT-SCAN OR MRI
EEG
If you are with someone having a tonic-clonic seizure (where
the body stifens, followed by general muscle jerking), try to:
Stay calm and remain with the person.
• If they have food or fuid in their mouth, roll them onto their side
immediately.
• Keep them safe and protect them from injury.
• Place something soft under their head and loosen any tight clothing.
• Reassure the person until they recover.
• Time the seizure, if you can.
• Gently roll the person onto their side after the jerking stops
If a person has a seizure when they are in a wheelchair, car seat or stroller:
Leave the person seated with the seatbelt on (unless it is causing injury).
• Put the wheelchair brakes on.
• If it’s a tilt wheelchair, tilt the seat and lock in position.
• Support their head until the seizure has ended.
• Lean the person slightly to one side to aid drainage of any fuid in the mouth.
After the seizure, if the person is having trouble breathing or they need to
sleep, take them out of the chair and put them in the recovery position.
If their breathing difculties continue, call for help and ambulance and
closely monitor the person. Be prepared to performCPRif they stop
breathing.
When to call for help and ambulance for an epileptic seizure
The seizure lasts for5or more minutes or longer than
what is normal for the person
• A second seizure quickly follows
• The person is not responding for more than 5 minutes
after the seizure ends
• The person has breathing difculties after the jerking stops
• It is the child’s frst known seizure
• The person is injured
• You are in doubt
