Lecture 8: Seizures/Syncope Flashcards
Epilespsy is generally defined as?
2 or more unprovoked seizures
What continues to be a problem worldwide for patients with epilepsy based on longstanding stigma?
Stricter laws when compared to?
- Unemployment and underemployment of these pt’s continues to be a problem
- Driving restrictions - in most states stricter laws for pt who has had a seizure when compared to persons w/ DUI convictions!
Which type of seizure is nearly always picked up (90%) as a positive finding on a single EEG?
Petit mal (with Hyperventilation)
How many sleep-deprived EEG’s are necessary for positive findings in 85% of all types of epilepsy?
3 sleep-deprived EEG’s
What is the single most important piece of information alongside EEG in the diagnosis of epilepsy? (this is going to be a test Q)
HISTORY of the event(s) - preferably by witness
Where does the seizure activity begin with Partial Seizures?
Activity begins on one side of the brain
What are 3 types of Parial Seizures and how does each manifest?
- Simple partial: pt is aware (conscious)
- Complex partial: pt loses consciousness
- Secondarily generalized (partial onset): symptoms that are initially associated with a preservation of consciousness that then evolves into a loss of consciousness and convulsions
What parts of the brain involved with generalized seiures?
Both sides of the brain
What are the 7 types of generalized seizures?
- Absence (petit mal)
- Tonic-clonic (grand mal)
- Myoclonic
- Tonic
- Clonic
- Atonic
- Clonic-tonic-clonic
What is the difference between a tonic and a clonic seizure?
- Tonic = Muscle stiffness, rigidity (think increased tone)
- Clonic = Repetitive, jerking movements
Which type of seizure is characterized by focal motor or sensory activity, no LOC, lasting only seconds and no post-ictal state?
Simple partial seizure
What are the characteristic of a complex partial seizure (i.e., signs/symptoms, time-line, consciousness post-ictal)?
- Nonresponsive staring, possible preceding aura
- Automatisms (action performed unconsciously or involuntarily)
- Loss of consciousness
- Last 1-3 mins
- Post-ictal state
What is a secondary generalized (partial onset) seizure (symptoms, consciousness, timeline, post-ictal)?
- Starts on one side of brain and then progresses to bilateral tonic-clonic activity
- Loss of consciousness
- Lasts 1-3 mins
- Post-ictal state
What is seen with an Absence (petit mal) seizure, how long does it last, how does the patient feel after?
- Nonresponsive staring, rapid blinking, chewing, clonic hand motions
- Loss of consciousness
- Lasts 10-30 sec
- No post-ictal state
*Abrupt onset and abrupt end
What is seen with a tonic-clonic seizure, how long does it last, and how does the patient feel afterwards?
- Bilateral extension followed by symmetrical jerking of extremities
- Loss of consciousness
- Lasts 1-3 mins
- Post-ictal state