Seizures Flashcards
- Simple Partial Seizure
* Complex Partial Seizure
Partial seizures
- Absence Seizures
- Tonic-Clonic
- Status epilepticus
Generalized seizures
A clonic seizure that begins in one area of the body (typically the hand or foot) and moves progressively towards the other side of the body. It can be limited to one extremity but can also become grand-mal. It is very very important to identify the exact location the seizure began i.e. right hand. If the seizure is limited to only part of the body, cx may be intact.
Jacksonian (marching seizures)
- loss of consciousness
- may have visual, auditory sensations or excessive emotions
- area of brain involved is usually temporal lobe
- longer than 1 minute with postictal confusion, may progress
- may commit asocial acts, misdiagnosed
- Drug of choice: Dilantin
- • It occurs on dominant hemisphere
Complex Partial Seizures
- Sudden brief cessation of all motor activity
- Blank stare/unresponsiveness
- Lasts 5 – 10 sec
- No aura/ No confusion after
- Drug of choice: Zarontin
- Hard to dx
- We do don see them
- Pt loose consciousness / stares into space for 1 second
- Pt is unresponsive
- Pt is unaware that they are not aware of environment
- Seen in children, they will go on to develop grand mal
- Will often progress to tonic clonic seizure
Absence Seizure – Petit Mal
- Pt will shake for 1 min
- Pt will become cyanotic
- Pt will bite tongue
- Increase salivation
- Pupil fixed and dilated
- If pt bangs his head or bites his tongue you can attempt gently to have them move to their side
- It is preferred not to touch then during this time
- Pt may be incontinent
Clonic phase
as they are falling to the ground their lungs are pressed upon and pt will have epileptic cry (wine) as air is forced out of lungs
• As pt falls to the ground every thing will be tonic back is arched and limbs are flexed and rigid
• At this phase if we attempt to hold down pt, his bones will fx
tonic phase
- increased salivation, may bite tongue, may be cyanotic
- often incontinent of urine/feces
- pupils fixed and dilated
- Postictal
- Drug of choice: Dilantin, Tegretol
Tonic Clonic Symptoms
- with or without aura
- sudden unconsciousness
- tonic phase (15 seconds) intense rigidity - epileptic cry
- clonic phase (45 – 75 seconds)– jerky muscle relaxations and contractions
Tonic Clonic Seizures
- Lack of sleep
- Stress
- Illness
- Flashing light
- Heat
Things that Increase seizures
- Prevents seizure
- High fat
- Low carb
- Low protein
Ketogenic Diet
is gold standard
Problems: - hepatotoxicity
• When taken with alcohol it increases hepatotoxicity. Eliminate ETOH
• Pt shouldn’t smoke
• Minimize caffeine intake
• Pt might develop gingival hyperplasia or gun overgrowth
• Monitor by increase visits to dentist 3 to 4 times a year
• Normal level 10 – 20 mcg/ml
• Gum hyperplasia
Dilantin
- New kid on the block
- Generates small impulse
- Surrounding cells don’t relax but react to impulse
- Cells do no have the chance to respond to abnormal impulses
- The pts like it b/c it creates an elevated mood
Vagus nerve stimulator
- Neurontin was bought to the market for
- Begins in finger and works itself to the shoulder and stops
- Spasmodic motor movement in a area of the body
- This seizure stops itself
- No loss of consciousness
- Lasts less then 1 min
- Drug of choice neurontin
- Motor/sensory symptoms: Automatism: shaking, wobbling doing something a little unusually. Pt may not be aware they are doing it.
Simple partial
