Seizures

Question 1

epilepsy

Answer 1

• paroxysmal event
• excessive and abnormal brain activity
• neurons fire excessively at the same time

Question 2

when is someone most likely to experience a seizure in their life time?

Answer 2

• early childhood
• late adulthood
• 5-10% of population has at least one seizure

Question 3

etiology of seizures in neonates

Answer 3

perinatal hypoxia and ischemia

Question 4

etiology of seizures in infants and children

Answer 4

febrile seizures

Question 5

etiology of seizures in adolescents

Answer 5

infection, trauma

Question 6

etiology of seizures in young adults

Answer 6

trauma

Question 7

etiology of seizures in older adults

Answer 7

cerebrovascular diseases, especially strokes

Question 8

some possible causes for epilepsy

Answer 8

• loss of inhibitory neurons
• excitatory glutametergic synapses
• excitatory AA neurotransmitter
• abnormal tissues
• genetics
• nigra and GABA
• premature brain
• kindling

Question 9

what are the two broad categories of seizures?

Answer 9

• focal

- generalized

Question 10

focal seizures

Answer 10

• involve one specific area in the brain
• aura (warning sign) may reflect site of origin
• +/- LOC

Question 11

generalized seizures

Answer 11

• involve both hemispheres of brain
• symmetrically involved
• no warning signs
• always LOC

Question 12

frontal lobe seizures

Answer 12

• tingling feeling in hand or arm

- eye or head both turn to one side

Question 13

temporal lobe seizures

Answer 13

• strange smell or taste
• feeling of deja vu
• lip smacking or chewing movements
• memory, language or emotion changes

Question 14

parietal lobe seizures

Answer 14

• tingling in or jerking of leg, arm, face

- explained as an abnormal sensation

Question 15

occipital lobe seizures

Answer 15

• flashing lights or spots

- vomitting

Question 16

simple focal seizures

Answer 16

pt does not experience LOC

Question 17

complex focal seizures

Answer 17

pt experiences LOC

Question 18

simple focal seizures with motor signs

Answer 18

• w/o march (spreading to nearby parts of brain)
• w/ marching
• versive
• postural
• phonatory

Question 19

versive seizure

Answer 19

head turns to one side, usually opposite of seizure focus

Question 20

phonatory seizure

Answer 20

pt mumbles words that dont make sense

Question 21

simple focal seizures with sensory symptoms

Answer 21

• somato-sensory
• visual
• auditory
• olfactory
• vertiginous
• gustatory

Question 22

vertiginous seizure

Answer 22

pt feels as if they are falling in space

Question 23

gustatory seizure

Answer 23

pt tastes something specific like a metallic taste

Question 24

simple focal seizure with autonomic symptoms

Answer 24

• vomitting
• pallor
• sweating
• pupil dilation
• piloerection (goosebumps)
• incontinence (can be bladder or rectum)

Question 25

simple focal seizures with psychic symptoms

Answer 25

- dysphasia - dysmnesic - cognitive - affective - illusions - structured hallucinations

Question 26

illusions

Answer 26

misinterpret stimulus

Question 27

automatism

Answer 27

repeated movements

Question 28

types of generalized seizures

Answer 28

- absence - myoclonic - atonic - tonic-clonic

Question 29

abscence seizures

Answer 29

- sudden onset - interruption of activities - blank stare - brief upward rotation of eyes - can last a few seconds to 1/2 min - ends quickly

Question 30

tonic phase of seizure

Answer 30

- rigid violent muscle contraction - sudden contraction of respiratory muscle -> moan - fall - respiratory inhibition/ cyanosis - urinary incontinence

Question 31

clonic phase of seizure

Answer 31

- small gusts of grunting respiration - frothing of saliva - deep respiration - muscle relaxation - remains unconscious in deep sleep

Question 32

myoclonic seizures

Answer 32

- sudden, brief shock-like movement - usually near going to bed or waking up - may be exacerbated by volitional movement

Question 33

atonic seizure

Answer 33

- 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

Question 34

status epilepticus

Answer 34

- continuous seizures or reptitive descrete seizures with impaired consciousness in inter-ictal period - lasts 15-30 min

Question 35

subtypes of status epilepticus

Answer 35

- generalized convulsive status epilepticus | - non-convulsive status epilepticus

Question 36

generalized convulsive status epilepticus

Answer 36

persistent, generalized electrographic seizures, coma, and tonic-clonic movements

Question 37

nonconvulsive status epilepticus

Answer 37

absence of seizures or focal seizures with confusion or partially impaired conciousness, minimal motor abnormalitites