Seizures Flashcards
When is the highest incidence of seizures?
Childhood and late adulthood
What is epilepsy?
recurrent unprovoked seizsures
What is the pathophys of seizures?
Abnormal, excessive, hypersynchronous discharge from CNS neurons
Etiology of seizures for young adults (18-35)?
- Trauma
- Metabolic disorders (alcohol withdrawal, uremia)
- CNS infection
Etiology of seizures for older adults (>35 yrs)
- Cerebrovascular disease
- Brain tumor
- Metabolic issues
- Degenerative disorders (alzheimer)
- CNS infection
What is a focal seizure with retained awareness?
PARTIAL SEIZURE
- one part of brain affected
- presentation depends on focal area involved
What is a focal seizure with impaired awareness?
PARTIAL SEIZURE
- One part of brain affected
- Pt appears to be awake but no normal responses
- No memory of what occured
- automatisms
What are automatisms?
- Facial grimacing
- Gesturing
- Lip smacking
- Chewing
What part of the brain is involved with generalized seizures?
Entire brain
What is the most common type of generalized seizure?
Tonic-Clonic
What is happening during the tonic phase?
Sudden muscle stiffening
What is happening during the clonic phase?
Rhythmic jerking and tongue biting
How long to tonic-clonic phases last?
1-2 minutes
What are the other types of seizures?
- Absence
- Clonic
- Atonic
What happens during the postictal phase?
- Somnolence
- Confusion
- HA
- No recollection
- Weakness
How can you diagnose a seizure?
Video EEG monitor
General first aid for seizure?
- Maintain airway
- Start IV
- Blood work
What blood work do we obtain for seizures?
- Electrolytes, LFT, CBC
2. Finger stick glucose
Treatment for active seizure?
- Diazepam 5mg IV/IM q5-10 max 30mg
* MEDEVAC
What is an emergent seizure?
Status Eplilepticus
What are the traits of a status epilepticus?
- Lasts >/= to 5 minutes
* 2 or more seizures without complete recovery between
What is the treatment for status epilepticus?
- Diazepam 5mg IV/IM q5-10 min
- Valporic acid
- Airway
What is different about a psychogenic noneplileptic seizure
- Eyes are closed
- Incontinence not an issue
- Tonic-Clonic longer than 2 minutes
- No postictal phase
- Not associated with abnormal excessive neuronal activity
Diagnosis of psychogenic nonepileptic seizure?
EEG shows no electrical activity
Treatment for psychogenic nonepileptic seizure?
Psychotherapy
What is a partial seizure?
Only involves part of the brain.
- The part of the brain involved will have associated symptoms
- Focal
What is the most common seizure?
Partial seizure
What are the two types of partial seizures?
Focal with awareness
Focal without awareness
What is the difference between the two types of partial seizures?
Without awareness is without awareness
- There’s also automatism such as;
- facial grimace
- gesturing
- lip smacking
- chewing
- repeating words or phrases
How are seizures treated?
- First aid
- Airway and maintain O2 sats
- IV catheter
- Diazepam 5mg IV/IM Max 30mg
What is the mechanism of diazepam on seizures?
Assists with GABA neurotransmission to increase inhibition (Remember GABA is an amino acid neurotransmitter inhibits activity in the nervous system)
What labs and imaging should be done for seizures?
Blood
* CBC, LFT, Electrolytes
Imaging
* EEG for Dx
What area of the brain does a generalized seizure involve?
All of it
What is the most common type of generalized seizure and what happens in it?
(Tonic - Clonic) / (Grand Mal)
Tonic
* Muscle Stiffening
Clonic
* Twitching/jerking
**1 -2 minutes
What are some other types of generalized seizures>
- Absence
- Clonic
- Atonic
What happens during the postictal phase of seizures?
- Confusion
- Somnolence
- No recollection typical
- Weakness
Treatment for status epilepticus?
- Diazepam 5mg IV/IM
- Valporic Acid
- Correct underlying issue
- Intubate
How can you tell someone is faking and having a psychogenic nonepileptic seizure?
- Episodes longer than 2 minutes
- Can remember and recover immediately (no postictal phase)
- Eyes closed
** EEG shows no changes in electrical activity
