Epilepsy Flashcards
How do we generally classify epilepsy and what were the older names?
Focal - (partial)
Generalised (complex)
How can we subclassify focal seizures?
Whether the patient lost consciousness or not:
Focal aware vs focal impaired awareness
What was the old name for focal aware
Simple partial seizures
What was the old name for focal impaired consciousness
Complex partial
What’s a second way of classifying focal seizures?
Motor or non motor
Motor = jacksonian march
non motor/other = auraus, deja vu feeling or jamais vu feeling
How do we subclassify generalised seizures
Generalised seizures always result in a loss of consciousness
So we classify not by consciousness but by motor involvement
Motor =
Tonic clonic
Tonic - sustained muscular contraction
Clonic - persistent shaking
Myoclonic jerks - brief contractions
Atonic
Non motor = absence seizures
What was the old name for an absence seizure
Petit mal
What was the old name for a generalised tonic clonic seizure
Grand mal
What is the tonic phase
Patient’s eyes are open.
Elbows flexed.
ARms pronated.
Legs extended.
Teeth clenched.
Pupils dilated.
Breath held cyanosis
Loss of bowel/bladder control
What is the clonic phase
Tremor gives away to violent generalised shaking.
Eyes roll back and forth
Tongue may be bitten
Tachycardia
Breathing starts again at the end of this phase.
What is myoclonus and when it is it normal / pathological
Myoclonus - sudden, brief, generalised muscle contractions
Normal - sleep
Abnormal but common - juvenile myoclonic epilepsy
Other conditions - degenerative conditions, metabolic disease
Causes of a seizure before we diagnose epilepsy
Hypoglycemia
Trauma
Drugs and alcohol
CNS infection
Haemmorhage
Tumours
Vascular disease
Panic attacks
Narcolepsy
Grand mal and petit mal
Grand mal = generalised tonic clonic
Petit mal - Generalised absence seizure
Complex partial vs simple partial
Complex partial = loss of consciousness with focal seizure
Simple partial = no LOC with focal seizure
Status epilepticus management
