Seizures

Question 1

Signs/Symptoms of Focal Seizures - with or without loss of consciousness

Answer 1

Motor seizures - focal motor activity, anatomic spread or march of activity (Jacksonian), versive movement (turning of the eyes, head and/or trunk), vocalization or arrest of speech
Sensory seizures - paresthesias, feelings of distortion of an extremity, vertigo, gustatory sensation, olfactory symptoms, auditory symptoms, visual phenomena
Autonomic seizures - epigastric “rising” sensation, sweating, piloerection, pupillary changes
Without impairment - dejavue, distortions of time, affective changes, illusions, formed hallucinations –> auras
With impairment - repetitive semipurposeful movements - oral-buccal, complex motor - regions of both hemispheres
Start in “silent” area of the brain - frontal lobe, clinically apparent when they spread to neighbouring cortex such as the pre central gyrus of the frontal lobe or the hippocampus of the temporal lobe

Question 2

Generalized seizures

Answer 2

Consciousness may be impaired - initial manifestation
Motor manifestations are bilateral
Absence - nonconvulsive, low amplitude myoclonic movements, mild tonic involvement of the limbs/trunk/simple motor automatisms

Question 3

Carpopedal spasm

Answer 3

a spasmodic contraction of the muscles of the hands and feet or especially of the wrists and ankles in disorders such as alkalosis and tetany

Question 4

Chvostek’s signs

Answer 4

Chvostek’s sign is the twitching of the facial muscles in response to tapping over the area of the facial nerve.
- Hypocalcemia and Hypoparathyroidism