Seizures

Question 1

Generalized Tonic-Clonic Convulsions (GTC)

Answer 1

what you think of as seizure

• bilateral stiffening of limbs and jerking
• impaired consciousness (since general, all brain)
• sympathetic symptoms: tachycardia, mydriasis
• cyanosis
• foaming at mouth
• urinary incontinence
• tongue biting
• post-ictal weakness, fatigue, amnesia

Question 2

Generalized Convulsions (7)

Answer 2

Tonic-Clonic: GTC
Tonic: just stiffening, no rhythmic jerks
Clonic: just rhythmic jerks, no stiffening
Myoclonic: rapid, brief jerks
Atonic/astatic: loss of postural tone
Absence: brief staring spells
Drop Attack: fall from seizure, but could really be result of any of these

Question 3

Focal Onset Seizures (3)

Answer 3

Simple Partial: without alteration of consciousness
Complex Partial: with alteration of consciousness
Secondary Generalized: SP or CP become generalized

-see focal spike-and-wave on EEG

Question 4

Simple Partial Seizure

Answer 4

• symptoms related to focal brain region
• aura +/-
• NO ALTERATION OF CONSCIOUSNESS
• can become CPS/GTC

Question 5

Complex Partial Seizure

Answer 5

• Staring, altered awareness
• could have gaze/head deviation, limb involvement
• automatisms (brain on repeat so chewing or talking on phone)
• can progress to GTC
• no recall of event
• localize focal deficit by earliest symptom in onset

Question 6

Secondary Generalized Seizure

Answer 6

Seizure begins as partial (focal), transitions to general

Question 7

Seizure causes

Answer 7

• metabolic (acid-base, medication, withdrawal)
• structural (tumor, trauma, stroke, anoxia, meningitis, malformation (AVM))
• Benign (fever in kids)
• genetic (autism, inflammatory, degenerative)

Question 8

Epilepsy

Answer 8

Brain disorder resulting in seizures that are recurrent, unprovoked, stereotyped (same each time)

Question 9

Absence Seizure

Answer 9

Many per day, <10s each, can go unnoticed. Hurt academic performance since spazz
-can have automatisms during

Question 10

Lennox-Gastaut Seizure

Answer 10

infancy-toddler, M>W

• can be axial tonic, atonic, absence, other
• cognitive impairment (helmet kids)
• Slow spike and wave EEG

Question 11

Infantile Spasms

Answer 11

age 3-18mo

• West Syndrome: spasms, hypsarrhythmia (chaotic EEG with flat line in center during event), developmental regression
• limb movement spasms in clusters around sleep-wake
• predisposed: trisomy 21 (Downs), tuberous sclerosis
• treat with ACTH

Question 12

Benign Rolandic Epilepsy

Answer 12

most common childhood epilepsy

• nighttime focal onset, can have rapid secondary generalized seizure
• see speech arrest, drooling, gurgling, facial tonic-clonic activity, facial hemisensory
• cognitive problems
• EEG- bilateral temporal spikes
• outgrow naturally so all good

Question 13

Status Epilepticus

Answer 13

continuous seizure for 30+ min or recurrent seizures for 30+ min and dont regain consciousness between