SEIZURES

Question 1

What is a seizure?

Answer 1

A seizure is a potent surge of electrical activity flowing through all parts of the brain, lasting seconds to minutes.

Question 2

What causes seizures?

Answer 2

Seizures are caused by malfunctioning brain cells that fire abnormally, high levels of excitatory neurotransmitters, and low levels of inhibitory neurotransmitters.

Question 3

What are the categories of seizures?

Answer 3

Seizures are categorized as Primary (Idiopathic) or Secondary (Acquired).

Question 4

What are Primary (Idiopathic) seizures?

Answer 4

Recurrent seizures with no identified cause, typically beginning between ages 20-30, with an inherited lower seizure threshold.

Question 5

What are Secondary (Acquired) seizures?

Answer 5

Seizures resulting from brain pathology or systemic issues such as trauma, brain tumors, meningitis, fever, CVA, hypoxia, metabolic disorders, drug/alcohol withdrawal, and kidney/liver failure.

Question 6

What are Partial (Focal) seizures?

Answer 6

Seizures that affect a specific area of the brain.

Question 7

What are Simple Partial seizures?

Answer 7

Seizures with no loss of consciousness, sensory changes, and may involve small movements, lasting ~30 seconds.

Question 8

What are Complex Partial seizures?

Answer 8

Seizures with loss of consciousness, featuring automatism and bizarre behavior.

Question 9

What are Generalized seizures?

Answer 9

Seizures that affect the entire brain, including types such as Tonic-clonic, Absence, Myoclonic, and Atonic.

Question 10

What occurs during the Tonic Phase of a Tonic-Clonic seizure?

Answer 10

Stiffness and rigidity, with jaws clenched, hands clenched, and eyes open with fixed pupils.

Question 11

What occurs during the Clonic Phase of a Tonic-Clonic seizure?

Answer 11

Rhythmic jerking, muscle contractions, and relaxation, lasting 2-5 minutes; incontinence may occur.

Question 12

What is the Postictal Phase of a Tonic-Clonic seizure?

Answer 12

A deep sleep lasting 30 minutes to 4 hours, with no memory of the seizure and confusion.

Question 13

What are Absence seizures?

Answer 13

Brief loss of consciousness with a vacant expression and rapid blinking.

Question 14

What are Myoclonic seizures?

Answer 14

Sudden, brief jerking of muscles, which may include a brief loss of consciousness.

Question 15

What are Atonic seizures?

Answer 15

Loss of muscle tone leading to sudden falls, requiring headgear to prevent injury.

Question 16

What is Status Epilepticus?

Answer 16

Continuous seizures lasting ≥30 minutes, characterized by loss of consciousness and risk of oxygen and glucose depletion.

Question 17

What diagnostic tests are used for seizures?

Answer 17

History, physical examination, EEG, CT scan, MRI, and telemetry with videotaping.

Question 18

What are the goals of pharmacological therapy for seizures?

Answer 18

Control seizures, raise seizure threshold, and maintain therapeutic blood levels.

Question 19

What are common medications for seizures?

Answer 19

Phenytoin (Dilantin), Carbamazepine (Tegretol), Valproate (Dekapen), Clonazepam (Clonopin), Diazepam (Valium), and Luminal (Phenobarbital).

Question 20

What should patients be taught regarding seizure management?

Answer 20

Avoid triggers, ensure proper medication timing and dosage, use protective headgear, wear a MedicAlert bracelet, avoid dangerous activities, and seek emergency care if a seizure lasts >10 minutes.

Question 21

What are some surgical interventions for seizures?

Answer 21

Vagal Nerve Stimulation, Temporal Lobectomy, Corpus Callosal Resection, and Cortical Resection.

Question 22

What should be done during a seizure?

Answer 22

Assess for aura, ensure safety by moving objects away, do not restrain the patient, position them on their side, and administer oxygen if needed.

Question 23

What should be done after a seizure?

Answer 23

Monitor respiratory status, administer anti-seizure medications, and reorient the patient once consciousness returns.

Question 24

What documentation is required during a seizure?

Answer 24

Record timing, phases, movements, affected body parts, and autonomic signs.

Question 25

What documentation is required in the postictal period?

Answer 25

Record level of consciousness, vital signs, and the patient’s condition and behavior after the seizure.