Seizures Flashcards
What is a seizure?
Paroxysmal abnormality of motor, sensory autonomic and/or cognitive function due to transient brain dysfunction.
What are types of seizures?
Epileptic Syncopal (anoxic) Brainstem (hydrocephalic, coning) Emotional Functional (pseudo seizures)
What is an epileptic seizure?
Abnormal excessive and hyper synchronous discharge of electrical activity in the cerbral cortex
what is a convulsion? Describe. Other type?
Seizure (epileptic or non-epileptic) with motor components Particularly stiff (tonic), massive jerk (myoclonic), jerking (clonic), trembling (vibratory), thrashing about (hyper motor.
As opposed to non-convulsive seizure with motor arrest e.g. unresponsive stare as in generalised epileptic absence seizures or drop attack as in epileptic atonic seizure
What are acute symptomatic seizures? What can cause them?
Epileptic seizures that are provoked by an acute brain injury
E.g. from acute cortical ischaemia during arterial ischaemic stroke, or from a cerebral contusion during a traumatic brain injury, or cortical inflammation during meningitis.
Do not constitute epilepsy.
What is a febrile seizure? When does this usually occur? Describe them.
Epileptic seizure accompanied by a fever in the absence of intracranial infection.
Occurs between ages of 6m and 6y.
Usually occurs early in a viral infection when the temperature is rising rapidly.
Usually brain generalised tonic-clonic seizures.
What are complex febrile seizures?
Those which are focal prolonged or repeated in the same illness
Have an increased risk fo subsequent epilepsy
Do febrile seizures cause brain damage?
Simple febrile seizures do not - similar risk of developing epilepsy to normal.
Complex febrile seizures carry increased risk.
What investigations are necessary in febrile convulsions?
Consider bacterial meningitis
Blood cultures
Urine cultures
LP for CSF
What management in febrile seizures?
Reassure patients and give advice sheets
Antipyretics may be five but do not prevent
First aid management of seizures taught to family
Rescue therapy with buccal midazolam can be supplied if hx of prolonged seizures.
Do not give oral prophylactic anti epileptics
EEG is not indicated as does not produce seizure recurrence.
What are funny turns?
Paroxysmal disorder
What are some causes of funny turns?
Blue breath-holding spells
- Upset toddlers hold breath. Leads to anoxia and briefly lose consciousness and rapidly recover fully
reflex systolic syncope
- Head trauma, cold food, fright, fever leads to child becoming very pale and falling to the floor.
Hypoxia may induce generalised tonic-clonic seizure
Episodes are due to cardiac systole from vagal inhibition
Seizure is brief and child recovers rapidly
Syncope
Child may faint in hot/stuffy environment, standing for long periods, from fear.
Clonic movements lasting a few seconds
Migraine
Paroxysmal headache involving unstreadiness
Benign paroxysmal vertigo
Prolonged QT
What is transient LOC most commonly due to?
Syncope which is caused by transient impairment of brain oxygen delivery due to impaired cerebral perfusion
