Neuro- Seizures

Question 1

What is Epilepsy

Answer 1

• Recurrent seizures

NOTE:
Epilepsy is a group of neurological diseases characterized by epileptic seizures.[1][2] Epileptic seizures are episodes that can vary from brief and nearly undetectable to long periods of vigorous shaking.[3] In epilepsy, seizures tend to recur, and have no immediate underlying cause[1] while seizures that occur due to a specific cause are not deemed to represent epilepsy.[4]

Question 2

What is a 2* seizure

Answer 2

It is provoked by something else. Like going to the discotheque.

NOTE: Often has a generalized known underlying cause (a factor that triggers a discharge) Sometimes genetic component

Question 3

Common triggers of a seizure

Answer 3

• Febrile (referring to fever, common in children)
• Metabolism related
• Hypoglycemia
• Hypoxia
• Electrolyte imbalance

Question 4

Etiology of unprovoked seizure?

Answer 4

Unprovoked
• Idiopathic
• Genetic??

Question 5

Are seizures a disease

Answer 5

• not a disease it’s a mnfts of another disease
• sudden, uncontrolled neural discharge→ altered sensation, altered movements, altered behaviour
• mnfts vary according to site of discharge

Question 6

Types or Classification of seizures

Answer 6

1) partial seizures: meaning the focal origin/start is in one hemisphere
a) simple partial seizure no loss of consciousness
b) complex partial loss of consciousness

2) generalized seizures: meaning the origin is in both hemispheres

Question 7

Pathology of seizures?

How will it spread? and how does it stop?

Answer 7

• “epileptogenic focus” in cerebral cortex & hippocampus triggered discharge with inc amplitude and frequency -> Spreads to other areas
• normal neuronal inhibition blocked-> abn muscle action and LOC
• inhibitory neurons ultimately control discharge and the seizure ends
• Just before end of seizure will be intermittent contraction and relaxation phase

Question 8

What is the post-ictal phase?

Answer 8

AKA post seizure

• Epileptogenic cells completely inhibited
• CNS depressed

Question 9

Complications of seizure?

Answer 9

• Inc brain activity req more ATP -> inc 02 and glucose demand -> perfusion to brain not adeq -> hypoxia and lactic acidosis -> brain damage

Especially if the seizure last a long time

Question 10

Dx of epilepsy

Answer 10

• Hx
• Neuro exam (reflex and cranial nerves?)
• Underlying cause! (The key)

Question 11

Tx During, STAT after and Later on

Answer 11

•	During: protect from injury
•	Stat after: ensure brain fx (resps, airway, all lifesaving measures)
•	Later
o	Underlying cause
o	Anticonvulsant drugs
o	Sx if drug fails