Seizures

Question 1

Seizure risk factors

Answer 1

Anything that injures/ damages the brain
-born premature
-brain deformity
-brain haemorrhage
-brain injury
-brain tumour
-infections of brain eg. meningitis, encephalitis
-stroke
-cerebral palsy
-family history
-Alzheimer’s

Question 2

Seizures pathophysiology
definition, causes

Answer 2

-sudden burst of excess electrical activity in the brain causing temporary disruption in normal message passing between brain cells
Causes
-epilepsy
-head injury
-hypoglycaemia
-syncope
-alcohol/ drug withdrawal
-acute alcohol intoxication

Question 3

Types of seizure

Answer 3

-focal onset- one side brain, no loss of awareness
-generalised onset- seizure activity on both sides of the brain
-unknown onset- not witnessed by anyone

Question 4

Stages of seizure

Answer 4

Prodromal
-subjective feeling, confusion, anxiety, headache
Early ictal (start seizure)
-aura, changes of colours of edges of things
Ictal
-variety of presentations, stiffening arms/legs, repeated movement, loss bladder control
Post ictal
-confusion, headache, memory loss, nausea, dysphasia (unable to speak), drowsiness

Question 5

Triggers of epilepsy

Answer 5

-non compliance with medication
-stress
-lack of sleep
-alcohol
-drug abuse
-fever
-photophobia

Question 6

Seizures signs and symptoms

Answer 6

Focal seizures
-depends on where in the brain it happens
-aura- also sign of tonic-clonic seizure
Tonic phase
-loss of consciousness
-muscle stiffness
-bite on tongue
Clonic phase
-limbs jerk quickly and rhythmically
-may lose bladder/ bowel control
-cyanosis/ hypoxia

Question 7

Seizures assessment

Answer 7

-assess/ manage ABCD
-AVPU
-SPO2- if not possible give supplementary O2
-GCS
-CBG
-temperature
-evidence head injury

Question 8

Seizures treatment/ management

Answer 8

-manage airway- often complicated due to trismus
-give O2 if need
-treat underlying cause
-remove/ move items likely to cause harm
-support head
-loosen tight clothing
-prevent crowding
-talk quietly, reassure

If seizing more than 5mins
-give benzodiazepine
-get IV access
-if still seizing after 10 mins give 2nd dose benzodiazepine IV
-if still convulsing seek clinical advice
-consider risk/benefit of 3rd dose