Epilepsy Flashcards
Seizure definition
abnormally excessive or synchronous neuronal activity in the brain
*on the EEG: will look normal unless having an active seizure
Epilepsy definition
recurrent, unprovoked seizures (>/= 2)
2 Seizure classifications, further classifications
- Primary generalized (all parts of cortex simultaneously)
- Partial-onset (starts in one region, w/wo spread)
- further classified as insidious or symptomatic
Types and description of primary generalized seizures
- Generalized tonic-clonic (GTC)
- Absence seizures (staring spells- peds)
- Myoclonic seizures (shaking)
- Tonic Seizures (rigid)
Types of Partial Onset seizures
- Simple partial seizures (SPS) - doesn’t spread
2. Complex partial seizures (CPS)- spreads
Location related seizure: Temporal Lobe
- time frame
- what it starts with
- what happens when it’s over
- lasts 1-3mins
- Starts with oral movements (chewing, lip smacking)
- lethargy afterwards
Location related seizure: Frontal Lobe
- time frame
- when does it occur
- afterwards
- lasts 10-15s
- usually when a person is waking up
- may have vocalizations, no auras
- no lethargy phase afterwards
Location related seizure: Occipital Lobe
- what is associated with these
aura
Location related seizure: Parietal Lobe
- where it originates
- what is associated with it
- originates in hippocampus
- associated with sensory aura
Medical Treatment
Antiepileptic drugs - will cycle through drugs until they can prevent a seizure
Why do you want to prevent a seizure
disturbance to the brain and some damage!
in GTCs increase in CPK after seizure
Surgery: Temporal lobe
easiest, accessible,
Surgery: Vascular malformations, low grade tumors
easy enough, can go in and deal with it (not as easier as temporal lobe surgery)
Surgery: Corpus Callostomy
if seizures are so bad they will consider doing this
Surgery: Hemisppherectomy
If seizures are so bad they will consider this (gets performed more often in children
Surgery: Gamma knife radiosurgery
clinical trials
Surgery: Brain stimulation
clinical trials
only works if pt has partial onset (specific location)
when they sense it is starting, the simulation is applied to shift electrical activity in the brain
What is the least harmful procedure for pregnancy when you have seizures
- get seizures under control with 1 medication; control should be at its best (seizure during pregnancy is very harmful)
- do not change medication after conception
What to do if pt has a seizure in clinic
- put pt into supine (nothing in the mouth, no turning head)
- Time the seizure
- make astute observations (what were they doing when it started, what happened when it started, what happened during it, how did it end)
- Call RR team or 911
- Postictal time (time of unconsciousness afterwards)
