Seizures Flashcards
What is a seizure?
- A seziure is a sudden, uncontrolled excessive electrical activity in the brain
What are the possible causes of a seizure?
- abnormal levels of sodium or glucose in the blood
- brain injury (such as stroke or HI)
- Congenital brain defects
- Brain tumour or bleeding in the brain
- Dementia, such as alziemhers disease
- high fever
- infections that affect the brain, such as meningitis, encaphalitis, neuropyphillis or AIDS
- Kidney or liver idsease
- Phenylketonuria (PKU) - causes seizures in infants
- Illicit substances
- alcohol or drug withdrawal
- eclampsia/pre-eclampsia
Explain the term ‘Generalised convulsive status epilepticus’
- formall generalised TC seizures are the most common and best known type of generalised seizure
- they begin with stiffening of the limbs (tonic) followed by jerking of the limbs and face (clonic)
Recite the AV CPG for seizures (adults)
Recite the AV CPG for seizures
Explain the term ‘post ictal’
When can you apply the ‘treat and refer’ guideline for seizures? and what are the contras?
Single Seizure with full recovery.
Contraindications:
- Incomplete recovery (to normal conscious state)
- Suspected non epileptic cause (stroke, hypoxia, OD, hypo)
- First presentation seizure/non-diagnosed
- Different to usual presentation (prolonged, more frequent, concurrent illness eg infection)
- Injury, Aspiration, Immersion sustained
- Patient has been administered MIDAZOLAM (other than patients own)
- Seizure was unwitnessed
- Risk of recurrent seizure if left on scene
ie. Hx of multiple seizures
- pt has feeling impending seizure
- pt is unable to be monitored by responsible adult
- Pregnancy.
ACTION
- Provide patient/carer with self care advice and hand out sheet.
- Encourage to see health provider within 24 hours.
- Use patients own management plan for guidance if available
- Confirm patient and carer understand advice before departing scene.
What is a convulsion?
- an episode of excessive and abnormal motor activity. Involving rapid contraction and relaxation of mucles
What is epilepsy and how is it caused?
- a condition that is characterised by recurrent seizures
- it is caused by excessive cortical nerve cell activity and most commonly presents as GTC seizures
What is epilepsy and how is it caused?
- a condition that is characterised by recurrent seizures
- it is caused by excessive cortical nerve cell activity and most commonly presents as GTC seizures
What are the different types of seizures?
- Generalised onset
- Focal onset
- Unknown onset
What is a generalised onset seizure?
- a seizure that affects both cerebral hemispheres from the beginning of the seizure
What is a myoclonic seizure?
- a rapid, breif contractions of bodily muscles, which usually occur at the same time on both sides of the body
- occassionally occuring in one arm or foot
What is an Atonic seizure?
- sudden loss of muscle tone
- “drop attacks”
- they produce head drops, loss of postural or sudden collapse
- abrupt, without any warning
What is an Atonic seizure?
- sudden loss of muscle tone
- “drop attacks”
- they produce head drops, loss of postural or sudden collapse
- abrupt, without any warning
What is an absensce seizure?
- lapses of awareness, sometimes staring, that begin and end abruptly, lasting only a few seconds
- commonly occuring in children
What are focal onset seizures?
- also known as partial seizures
- caused by an electrical disurbance that commences in a specificarea of one cerebral hemisphere
- it may spread to both hemispheres
- usually lasts < 2 min
What is a pseudoseizure?
- a contraversial diagnosis known as pseudoseizures or non-epileptic seizures
- patients who have seizures but do not have an abnormal EEG
- it implies that the origin of the seizure is psychological rather than organic
What is status epilepticus?
- seizures that are prolonged or occur in a series
- defined as a seizure lasting 30 minutes, or episodes without regain in consciousness
- AV refers to status epilepticus as seizures lasting > 5 mins or multiple seizures without full recovery of consciousness (back to baseline) between seizures
What is subtle status epilepticus?
- may develop from prolonged or uncontrolled GCSE, it is characterised by coma and ongoing electrographical seizure activity with or without subtle convulsive movements (e.g. rhythmic muscle twitches or tonic eye deviation)
- can be difficult to diagnose in the prehospital environment
What is post-ictal?
- a period of decreased consciousness following a seizure (generalised)
- this is when the brain is recovering from the seizure
- lasting 5-30 mins (sometimes longer)
What are the doses of midazolam for adults and children experiencing a seizure?
What do you do if a patient refuses transport post a seizure?
If Pt has a past history of seizures, and refuses transport, leave them in the care of a responsible third person. Advise the person of the actions to take for immediate continuing care if symptoms reoccur, and the importance of early contact with their primary care physician for follow-up.
Can you given midazolam in pregnant patients having a seizure?
Pregnancy – seizures may be a result of epilepsy, eclampsia or another cause. Eclamptic seizures are rare and usually self limiting. It should be noted that Midazolam crosses the placenta and may cause adverse effects to the baby. SE is a life-threatening condition and Midazolam is still indicated in pregnant women.
