Seizures Flashcards
epilepsy
- paroxysmal event
- excessive and abnormal brain activity
- neurons fire excessively at the same time
when is someone most likely to experience a seizure in their life time?
- early childhood
- late adulthood
- 5-10% of population has at least one seizure
etiology of seizures in neonates
perinatal hypoxia and ischemia
etiology of seizures in infants and children
febrile seizures
etiology of seizures in adolescents
infection, trauma
etiology of seizures in young adults
trauma
etiology of seizures in older adults
cerebrovascular diseases, especially strokes
some possible causes for epilepsy
- loss of inhibitory neurons
- excitatory glutametergic synapses
- excitatory AA neurotransmitter
- abnormal tissues
- genetics
- nigra and GABA
- premature brain
- kindling
what are the two broad categories of seizures?
- focal
- generalized
focal seizures
- involve one specific area in the brain
- aura (warning sign) may reflect site of origin
- +/- LOC
generalized seizures
- involve both hemispheres of brain
- symmetrically involved
- no warning signs
- always LOC
frontal lobe seizures
- tingling feeling in hand or arm
- eye or head both turn to one side
temporal lobe seizures
- strange smell or taste
- feeling of deja vu
- lip smacking or chewing movements
- memory, language or emotion changes
parietal lobe seizures
- tingling in or jerking of leg, arm, face
- explained as an abnormal sensation
occipital lobe seizures
- flashing lights or spots
- vomitting
simple focal seizures
pt does not experience LOC
complex focal seizures
pt experiences LOC
simple focal seizures with motor signs
- w/o march (spreading to nearby parts of brain)
- w/ marching
- versive
- postural
- phonatory
versive seizure
head turns to one side, usually opposite of seizure focus
phonatory seizure
pt mumbles words that dont make sense
simple focal seizures with sensory symptoms
- somato-sensory
- visual
- auditory
- olfactory
- vertiginous
- gustatory
vertiginous seizure
pt feels as if they are falling in space
gustatory seizure
pt tastes something specific like a metallic taste
simple focal seizure with autonomic symptoms
- vomitting
- pallor
- sweating
- pupil dilation
- piloerection (goosebumps)
- incontinence (can be bladder or rectum)
simple focal seizures with psychic symptoms
- dysphasia
- dysmnesic
- cognitive
- affective
- illusions
- structured hallucinations
illusions
misinterpret stimulus
automatism
repeated movements
types of generalized seizures
- absence
- myoclonic
- atonic
- tonic-clonic
abscence seizures
- sudden onset
- interruption of activities
- blank stare
- brief upward rotation of eyes
- can last a few seconds to 1/2 min
- ends quickly
tonic phase of seizure
- rigid violent muscle contraction
- sudden contraction of respiratory muscle -> moan
- fall
- respiratory inhibition/ cyanosis
- urinary incontinence
clonic phase of seizure
- small gusts of grunting respiration
- frothing of saliva
- deep respiration
- muscle relaxation
- remains unconscious in deep sleep
myoclonic seizures
- sudden, brief shock-like movement
- usually near going to bed or waking up
- may be exacerbated by volitional movement
atonic seizure
- loss of postural muscle tone lasting 1-2 seconds
- consciousness briefly impaired
- no postictal confusion
- may cause head to droop if short, collapse if long
status epilepticus
- continuous seizures or reptitive descrete seizures with impaired consciousness in inter-ictal period
- lasts 15-30 min
subtypes of status epilepticus
- generalized convulsive status epilepticus
- non-convulsive status epilepticus
generalized convulsive status epilepticus
persistent, generalized electrographic seizures, coma, and tonic-clonic movements
nonconvulsive status epilepticus
absence of seizures or focal seizures with confusion or partially impaired conciousness, minimal motor abnormalitites
