Seizure Flashcards
What are common causes of transient loss of consciousness?
- Neurological- seizures, raised ICP, SAH
- Syncope
- Cardiac (arrhythmias, AS)
- Neurally mediated- vasovagal - Postural hypotension- drug related, autonomic
- Metabolic- hypoglycaemia, addison’s
- Psychogenic
Define syncope
=fainting/passing out. Due to BP drop, reduced HR, change in blood flow to brain
What are the differences between syncope and seizures?
syncope: gradual or abrupt in cardiac, prodrome lightheadedness nausea, brief 1-30 sec, pallor, collapse, rarely confused, recovery in minutes
seizure: sudden, auras, longer 1-3 min, convulsions, rigidity, confusion common, recovery is prolonged
What is non-epileptic attack disorder?
Seizures that are not due to epilepsy are sometimes called ‘non-epileptic seizures’. They can have a physical cause such as low blood sugar (hypoglycaemia) or may be related to how the heart is working. Or they may have a psychological cause
Why is it important to distinguish non-epileptic seizures from epileptic seizures?
risk of iatrogenic harm!
What is the FAST screening tool?
alcohol screening to assess harmful levels
What are common signs and symptoms of alcohol withdrawal?
anxiety, tremor, tachycardia, sweating, palpitations, insomnia, N/V
What are the features of delerium tremens?
confusion/delerium
hallucinations
pins and needles, burning and numbness
coarse tremor
Investigations for patient with alcohol withdrawal?
FBC, glucose, LFTs, U&Es, bone profile and magnesium, coag screen, VBG, ECG, CXR, CT head
Why would you do a CXR to investigate alcohol withdrawal?
to rule out aspiration pneumonia due to high risk
What would be the management of alcohol withdrawal?
benzodiazepines
Oral potassium (if imbalance)
IV thiamine
Addictions liaison service
Why would you treat alcohol withdrawal with thiamine?
risk of wernicke’s encephalopathy
What is the clinical triad of wernicke’s encephalopathy?
opthalmoplegia (paralysis/weakness of eye muscles), ataxia, and confusion
Which groups of patients have high risk associated with benzodiazepine side effects?
elderly
head injury
liver disease
What is the long term management/prophylaxis for alcohol withdrawal in someone with high FAST score?
fixed-dose diazepam plus symptom-triggered treatment
