seizure disorders

Question 1

What are seizures ?

Answer 1

abnormal, synchronous discharges of neurones causing sudden change in behaviour, movement and/or consciousness

Question 2

What are some main signs and symptoms of a seizure ?

Answer 2

• jerking movements
• LOC
• strange, unexplained smells
• deja-vu
• tongue biting
• incontinence

symptoms depend on which neurones are effected

Question 3

What is a focal seizure ?

Answer 3

a seizure affecting 1 hemisphere of the brain

Question 4

What are the two types of focal seizure ?

Answer 4

focal aware = remains conscious

focal impaired awareness = impaired consciousness/LOC

Question 5

What is a generalised seizure?

Answer 5

a seizure involving both hemispheres and LOC

Question 6

What is a focal-to-bilateral seizure ?

Answer 6

when a focal seizure (1 hemisphere) becomes a generalised seizure (both hemispheres)

Question 7

What are the subtypes of generalised seizures ?

Answer 7

• tonic seizure (flexed muscles)
• atonic seizure (relaxed muscles)
• clonic seizure (convulsions)
• tonic-clonic seizures (tonic phase followed by clonic phase)
• myoclonic seizures (small muscle twitches)
• absence seizures (“spaced out” - patient loses then regains consciousness)

Question 8

What is the most common type of generalised seizures ?

Answer 8

tonic-clonic seizures

Question 9

What seizure activity is considered a medical emergency ?

Answer 9

status epilepticus = seizure lasting 5+ mins or multiple in that timeframe without returning to normal between

• usually tonic clonic

Question 10

What is the medical emergency ‘status epilepticus’ treated with ?

Answer 10

benzodiazepines to enhance inhibitory effects of GABA

Question 11

What are some common symptoms experienced after a seizure ?

Answer 11

• postictal confusion
• Todd’s paralysis (unilateral limb paralysis/weakness)

Question 12

What are some investigations used to assess after a seizure ?

Answer 12

• imaging (MRI, CT)
• EEG

Question 13

What are some things that can cause seizures ?

Answer 13

• ## tumours

Question 14

What is the treatment for epilepsy ?

Answer 14

• anticonvulsants
  which drug is dependent on specific patient needs and category of epilepsy syndrome
• surgery to remove an obstructive cause
• nerve stimulation (vagus nerve)

Question 15

What can sometimes trigger seizures in an otherwise healthy person ?

Answer 15

severe infection/illness

Question 16

What can sometimes trigger seizures in a susceptible person ?

Answer 16

• illness/infection
• dehydration
• over tiredness

Question 17

how does memory of the event differ in someone experiencing syncopal blackout vs epileptic seizures ?

Answer 17

syncope = regain awareness and memory quickly

seizure = may not remember anything until paramedic arrival/hospital admission