SEIZURES Flashcards
If a patient states they didn’t feel well, his co-worker reports that he then collapsed, his eyes rolled in the back of his head, he then tenses up and began shaking, what diagnosis?
Seizure
What is the definition of a seizure?
A paroxysmal (comes and goes) event due to abnormal CNS discharge with resultant manifestations depending on area involved.
What is the definition of epilepsy?
Recurrent seizures
Physiologically, what’s occurring during a seizure?
Burst of electrical activity, influx of extracellular calcium and sodium – thus the propagation of action potentials
In what population are seizures most common in?
Children
If a child under the age of 5 has recurrent episodes of seizures, is it epilepsy?
NO
What are some of the triggers for seizures?
Fevers in children, genetics, TBI, strokes, infection, stress, sleep deprivation, meds, and menses
What can help you make the diagnosis of a seizure?
History is key, EEG, MRI (to R/O structural abnormalities), prolactin levels, possibly a lumbar puncture (if infection is suspected)
What are the two basic type of seizures?
partial vs. generalized
What are the types of partial seizures?
Simple partial or Complex partial
If a patient has an abnormal jerky movement or stiffening of the body, or hear/smell/tastes things that are not there, and doesn’t not lose consciousness, what type of seizure is it?
Simple partial seizure
What are 2 other ways a simple partial seizure can present?
Autonomic – strange or unpleasant sensations in the stomach, chest, head, or heart rate
Psychic – garbled speech, deja-vu
Where is the brain is a simple partial seizure occurring?
ONE hemisphere
What are 3 variations of simple partial seizures?
Jacksonian March – motor activity begins distally (fingers) and spreads to the whole extremity
Todd’s Paralysis – local paralysis for minutes to hours
Epilepsia Partialis continua – continues for hours to days
If a patient has a continuous stare, but then doesn’t know what just happened for the past minute, what diagnosis are you thinking?
Complex partial seizure
Where does a complex partial seizure occur in the brain?
Start in the temporal lobe → then quickly involve other areas
What often accompanies the complex partial seizure stare?
Usually an aura – but often isn’t noticed by the patient
Ictal stage – chewing or picking (very subtle)
Post-ictal confusion – impaired consciousness (can just last a few second to a few minutes)
How do you diagnose a complex partial seizure?
EEG
What differentiates a generalized seizure from a partial seizure?
Generalized = both hemispheres of the brain are firing simultaneously
Partial = a portion of the brain is firing
So, what is it known as/what part of the brain is involved, if the seizure begins as a partial but then spreads and becomes more generalized?
Partial seizure with secondary generalization
Frontal lobe
What is the key difference in a generalized seizure, and what are the two types?
Generalized seizures = sudden loss of consciousness
Either Convulsive (gran-mal or tonic clonic) or Nonconvulsive (petit-mal or absence)
What form of a seizure is common in kids and often presents like daydreaming for less than 10 seconds?
Simple absence seizure
What is a simple absence seizure lasted longer than 10 seconds?
Complex or atypical absence seizure
What does an atypical absence seizure correlate with?
Mental retardation
