Seizure Disorders

Question 1

Definition of a Seizure

Answer 1

finite event caused by excessive discharge of cerebral neurons. effect awareness movement or sensation.

Question 2

Definition of Epilepsy

Answer 2

Chronic disorder of recurrent seizures

chronic medical condition

Question 3

Pathophysiology of Seizure

Answer 3

• Sudden excessive electrical discharge of aggregates of neurons
• Disruption of normal physiochemical mechanism of nerve cells
• related to decreased inhibition

Question 4

Seizures accompanied by focal lesion of CNS immaturity

Answer 4

• hyper excitable neuron in partially depolarized state near lesion
• susceptible to activation by hyperthermia, hypoxia, hypoglycemia, hypercalcemia

Question 5

Types of Partial Seizures

Answer 5

• Simple partial seizures (focal seizures)
• Complex partial seizures
• Complex partial progressing to generalized

Question 6

Simple partial seizure

Answer 6

• limited to one area of the brain

- consciousness maintained

Question 7

Complex partial seizures

Answer 7

• repetitive behaviors present

- consciousness is altered or lost

Question 8

Complex partial progressing to generalized

Answer 8

can effect all of the surrounding areas as well

Question 9

Types of generalized seizures

Answer 9

• Absence Seizure
• Myoclonic Seizure
• Tonic-Clonic Seizure (Grand Mal)

Question 10

Absence Seizure

Answer 10

Minor convulsive muscular activity with sudden cessation of conscious activity

Question 11

Myoclonic Seizure

Answer 11

• Sudden brief single or repetitive muscular contraction

- Consciousness is generally maintained

Question 12

Tonic-Clonic seizure (Grand Mal)

Answer 12

• Sudden loss of consciousness
• Falls are common
• Generalized rigidity phase followed by a rapid generalized jerking phase

Question 13

Tonic Phase

Answer 13

• eyes open
• elbows fix
• arms pronated
• Legs ext
• teeth clenched
• pupils dilated
• breath held (cyanosis)
• Bowel/bladder control may be lost @ end of phase

Question 14

Clonic Phase

Answer 14

• Tremor gives to violent generalized shaking
• Eyes roll backwards & forwards
• tounge may be bitten
• tachycardia develops
• breathing recommences @ end of phase

Question 15

Generalized Seizures: Convulsive Status Epilepticus

Answer 15

• generalized tonic clonic seizures are prolonged & repeated w/ no recovery in b/t
• medical emergency
• often associated w/tumor, CNS infection, or drug abuse

Question 16

3 common Epilepsies of Childhood

Answer 16

• Severe myoclonic epilepsy of childhood
• Lennox-Gastaut
• Landau-Kleffner

Question 17

Aura

Answer 17

Specific feeling/experience an individual experiences as the onset of a seizure

Question 18

Most common aura

Answer 18

• smell of burnt rubber

- could have a variety of sensory experiences as an aura

Question 19

Medical Management of Seizures

Answer 19

• EEG
• Metabolic studies
• X-ray
• MRI or CT

Question 20

Immediate Management of Seizures

Answer 20

Protect them from Harm!

• lower pt to floor
• soft object under head
• turn head to side if vomiting to prevent aspiration
• Do NOT try to stop the mov NOR force anything into the mouth

Question 21

Control of Seizures

Answer 21

• Support & education
• 80% controlled by meds
• Ketogenic diet-high fats low sugars
• Surgery (if localized to a specific region) requires intense pre-surgical work-up & only successful in 50% of cases

Question 22

Prognosis

Answer 22

• idiopathic epilepsy, dx before 10 there is a 75% remission rate (seizure free for 5 yrs)
• generally not life threatening
• death by asphyxia or drowning