Seizure - Silvia

Question 1

10% of the population will have a ____ in their lifetime

0.5% will have ___.

Epilepsy — ___ or more _____ seizures

Provoking factors

• Fever
• Closely associated concurrent ____

Allowable Provoking factors

• “____ seizures”
• Flashing ___
• ____ epilepsy
• Stresses
• ___ Deprivation
• Severe ___ distress
• ___ injury
• Drug intoxication

Comorbidities:

• ___ differences
• ____ dysfunction
• Higher rates of ___/__
• Poor ___
• SUDEP (Sudden Unexplained Death in Epilepsy Persons)
• __ to ___% of deaths in patients with epilepsy
• Higher in ____

Risk factors

• Polypharmacy
• Intractable epilepsy
• Nocturnal seizures
• Generalized ____-___ type
• Epilepsy >__ years
• Age __ to ___
• ____ gender
• ____ non-compliance

Answer 1

10% of the population will have a seizure in their lifetime

0.5% will have epilepsy

Epilepsy — two or more unprovoked seizures

Provoking factors

• Fever
• Closely associated concurrent illness

Allowable Provoking factors

• “reflex seizures”
• Flashing lights
• reading epilepsy
• Stresses
• sleep Deprivation
• Severe emotional distress
• head injury
• Drug intoxication

Comorbidities:

• learning differences
• memory dysfunction
• Higher rates of anxiety/depression
• Poor sleep
• SUDEP (Sudden Unexplained Death in Epilepsy Persons)
• 2 to 18% of deaths in patients with epilepsy
• Higher in children

Risk factors

• Polypharmacy
• Intractable epilepsy
• Nocturnal seizures
• Generalized clonic-tonic type
• Epilepsy > 10 years
• Age 20 to 45
• male gender
• medication non-compliance

Question 2

Seizure Types:

1.

2.

3.

What are the clinical presensations in each?

Answer 2

1. Partial Seizures
   - Simple partial seizures
   - Complex partial seizures
   - Partial seizures with secondary generalization
2. Unclassifiable epileptic seizures
   - Infantile spasms
3. Generalized Seizures
   - Clonic
   - Atonic
   - Tonic-Clonic
   - Myoclonic
   - Absence
   - Tonic

Partial Seizures

Introduction affects only 1 area of the brain though can spread and become a secondary generalized seizure

medial temporal lobe is most common site of generation

most common cause is mesial temporal sclerosis

often preceded by seizure aura

simple partial

consciousness unaffected

motor, somatosensory, special sensory, autonomic, or psychic

complex partial - sign of cross

impaired consciousness

often characterized by automatisms like lip-smacking or hand-wringing

aura, alteration, and amnesia

Generalized Seizures

diffuse, affecting the entire brain

absence

blank stare (think absence of mind!)

impaired consciousness although no postictal confusion

most commonly affect children and do not continue past age 20

aka petit mal

3 Hz

myoclonic

single or repetitive muscle jerks

tonic-clonic

alternating tonus (stiffening) and clonus (movement)

aka grand mal

tonic

stiffening. extension, no clonus

atonic

“drop” seizures

sudden loss of muscle tone resulting in a fall

commonly mistaken for fainting

clonic:

repetitive

Question 3

What types of treaments are available for seizures?

1. Medication
   - Enhance ____
   - _____ Excitation
2. Non-medication
   - ___ ___ Stimulator
   - ___ Surgery
   - ____ Diet

Answer 3

1. Medication
   - Enhance Inhibition
   - Decrease Excitation
2. Non-medication
   - Vagus Nerve Stimulator
   - Epilepsy Surgery
   - Ketogenic Diet

Question 4

SUDEP:

occurs in __ to __% of children.

Risk factors:

polypharmacy, age __ to ___. __ _gender, medical non-compliance and intractable seizures

Answer 4

SUDEP:

occurs in 2 - 18% of children.

Risk factors:

polypharmacy, age 20 - 45, the male gender, medical non-compliance and intractable seizures