Seizures Flashcards
analgesics that may lower seizure threshold
fentanyl, tramadol
Smoking cessation medication that increases risk of seizure
Wellbutrin (Zyban)
produced by electrical impulses from through the entire brain
generalized seizures
produced by electrical impulses in a relatively small part of the brain.
partial seizures
most common type of seizure
tonic clonic (grand mal)
tonic phase
generalized body stiffening usually for 30-60 seconds
clonic phase
violent jerking for 30-60 seconds
most common symptom of absence seizures
Facial automatisms (repetitive blinking)
Awareness, Memory preserved, and Consciousness preserved, but there are sudden feelings of fear, anger, sadness, happiness or nausea
simple partial seizure
usually in temporal lobes, last 30 seconds to 2 minutes, awareness is impaired. Sx include lip smacking, chewing, fidgeting ect
complex partial seizure
Factors that can activate an epiloptogenic focus
hyperthermia, hypoxia, hypoglycemia, hyponatremia
Signs related to neurological disorders which may cause seizures
Café au lait spots, Axillary freckling, Hyperpigmented macules, asymmetry of body
4 conditions that can mimic a seizure
REM behavior disorder, TIA, Transient global amnesia, Migraine
sudden arousals from REM sleep immediately followed by complicated, often aggressive, behaviors for which the patient is amnestic
REM Behavior Disorder
Deficit of short-term memory that begins abruptly and persists for minutes to hours, without other cognitive or motor impairment
Transient Global Amnesia
Most important diagnostic test for seizures
EEG
Tx for Status Epilepticus after ABCs
IV and give thiamine and glucose. Midazolam 2.5mg IM or 5mg IV. If not effective after 20” give Phenobarbital IV
Common Anti-seizure meds
Dilantin(phenytoin), Tegretol(carbamazapine), Levetiracetam (Keppra), Topamax (topiramate)
anti-seizure meds that can cause gingival hyperplasia
dilantin and phenobarbitol
Dosing recommendations for Keppra (Levetiracetam)
Start at low dose with gradual increase not more often than once every 2 weeks. Do not suddenly stop taking as seizures may become worse
Dosing recommendations for Topiramate (Topamax)
Starting dose is up to 25mg (1 to 3mg/kg/day) taken nightly for the first week. Increase dose as needed by 1-3 mg/kg/day administered in two divided doses
What should be done to minimize the risk of kidney stones associated with Topiramate (Topamax)?
Increase oral fluids
Adjunctive therapies that can be considered for seizures
Biofeedback, ketogenic diet, Vagal nerve stimulation
high fat/low carb: Body burns fat instead of glucose for energy
ketogenic diet
