Seizures Flashcards
MOA for seizures
increased cell membrane excitability d/t failure of normal inhibitory mechanisms (GABA)
General etiology
idiopathic degenerative infectious metabolic neoplastic perinatal toxic head trauma vascular eclampsia alcohol withdrawal
Generalized versus partial
G: Grand mal, petit mal, myoclonic
P: simple and complex partial
Grand mal seizure info
Begin with abrupt LOC usually without warning
Pt falls to ground with trunk/extremities ext (tonic)
Then, rhythmic jerking of trunk and extremities (clonic)
often apnea, cyanosis, tongue-biting, urinary incontinence
lasts 60-90 seconds
What is post-ictal phase and Todd’s paralysis
Post-ictal-follows grand mal and pt remains unconsciousness, confused for many minutes
Todd’s- may occur and pt experiences transient postictal focal paresis
Petit mal seizure info
brief, abrupt LOC
blank stare with eyelids twitching
no response to voice
no falls, involuntary mvmt, post-ictal phase, attacls cease abruptly
Typically seen in little kids and then they grow out of it
Myoclonic seizure info
LOC assoc with isolated extremity jerking
Simple partial seizure info
no alt or consciousness
may be: motor- movements often unilateral
sensory-paresthesias/numbness, flashing lights, olfactory hallucinations
Complex partial seizure info
involves change in LOC or mentation
usually bizarre sx like visceral, hallucinations, memory disturbances, dream like states, automatisms, affective disorders
Seizure mimics
syncope, narcolepsy, movement disorders, hyperventilation, psychogenic seizures
Labs for seizure
always check glucose
lytes, BUN, Ca, Mg, PO4, LP if meningitis, toxicology
CT if first time sz, MRI later
EEG
Tx of sz
grand mal, simple or complex partial=phenytoin, carbamazepine, valproic acid, phenobarbital
petit mal=valproic acid, ethosuximide
def of status epilepticus
continuous sz activity lasting >5 min
OR
two or more sz without return of consciousness in btw
Tx of status epilepticus
ABCs, large bore IV, check blood glucose, anticonvulsant therapy
