Epilepsy and Seizures Flashcards
What is the definition of seizures?
Transient disturbance of cerebral function due to abnormal
paroxysmal neuronal discharge in the brain (electrical issue)
What is the definition of epilepsy?
any disorder characterized by recurrent unprovoked seizure
What percentage of children will experience a febrile seizure by age 14 years?
1%
What are some causes of seizures?
Vascular diseases
Trauma
Metabolic disorders
Tumors/space occupying lesions
Infectious diseases
Degenerative disorders
Pediatric age group
What are the three classifications of seizures?
Focal seizures
Generalized seizures
Status Epilepticus
What type of seizure has only a restricted part of one cerebral hemisphere has been activated?
Focal Seizures
What is a another name for Focal Seizures?
partial seizures
What type of seizure has diffuse brain involvement?
Generalized Seizures
What are the types of generalized seizures?
Absence
Atypical Absence
Myoclonic
Tonic-Clonic
Atonic
Which type of generalized seizures has the following characteristics:
Impairment of consciousness - Stop speaking, stare off into space (“blank stare”)
Mild tonic, clonic, or atonic components
Autonomic component (eneurisis)
Absence Seizures
Which type of generalized seizures has the following characteristics:
Marked changes in tone
Gradual onset and termination
Common in patient with multiple seizure types
Developmental delayed patient
Atypical Absence
Which type of generalized seizures has the following characteristics:
Sudden loss of consciousness
Tonic phase
Clonic phase
Sluggish postictal period of minutes to hours
More than likely won’t remember the seizure event, but they may remember right
before (a certain smell, etc)
Tonic-Clonic Seizures
Tonic-Clonic Seizures are also known as?
Grand Mal Seizures
List some precipitating factors for tonic-clonic seizures
Lack of sleep
EtOH
Certain medications
Missed meals
Emotional stress
Menstruation
Flickering lights
music
Which type of seizures has the following characteristics:
Further convulsions without consciousness between attacks
Can cause permanent brain damage secondary to hyperthermia, circulatory collapse, or excitotoxic neuronal changes
Mortality rate 20%
Tonic-Clonic Status Epilepticus
What is the mortality rate of Tonic-Clonic Status Epilepticus?
Mortality rate 20%
What are some causes of Tonic-Clonic Status Epilepticus?
Poor compliance with medications
Alcohol withdrawal
Intracranial (Infections, neoplasms, etc)
Metabolic disorders
Drug overdose
An EEG is used why?
To help classify seizure disorder
Alcohol Withdrawal Seizures happen within what time frame of alcohol withdrawal?
within 48 hours of alcohol withdrawal
What is the most common seizure disorder during childhood?
Febrile Seizures
What is the peak incidence of febrile seizures?
14-18 month olds
But can happen any time between ages 6 months to 6 year olds
What is the criteria for a febrile seizure?
Age 6 months – 5 years
Fever of 38.8 or higher
Non-CNS infection
What are the characteristics of a febrile seizure?
Usually generalized tonic-clonic
Brief <5 minutes (most typically <2 min)
Occur in presence of otitis media, viral URI, and roseola
What are the two classifications of a febrile seizure?
Simple and Complex
Features of a simple febrile seizure?
Generalized
Brief
Single (do not recur within 24 hours)
Features of a complex febrile seizure?
Focal
Prolonged >10 min
repetitive
What is the pathophysiology of a Psychogenic Non-Epileptic Seizure (PNES)?
Conversion disorder or malingering
What are the characteristics of a Psychogenic Non-Epileptic Seizure (PNES)?
Usually no tonic phase
Asynchronous thrashing – limb thrashing that is worse with restraints
Consciousness may be normal or “lost” – shouting, swearing, etc
Postictal no change in behavior
Video EEG
What two labs are drawn in a suspected PNES and why?
Creatinine kinase - Will expect some rise due to thrashing (muscle activity)
Prolactin level - these levels are not elevated in PNES patients
What labs should you order in a seizure patient?
CBC
Glucose
LFTs
Renal
Syphilis
LP - If any signs of infection are present
Creatinine kinase
Prolactin level
