Seizures

Question 1

What is a Seizure?

Answer 1

book
Transient, uncontrolled electrical discharge of neurons in the brain that interrupts normal function.
notes
Occurs later on in life

Question 2

What is Epilepsy?

Answer 2

notes
2 unprovoked seizures occurring more than 24 hrs apart

A person has it from birth

Question 3

Types of Seizures

Answer 3

• Generalized: both sides of brain, B/L synchronous epileptic discharge in brain from onset of seizure.
  Losses consciousness.
• Focal: a.k.a partial or partial focal seizures. Involve one region of brain, in specific region of cortex.

Question 4

Subtypes of seizures

Answer 4

• only what’s in notes*
• Tonic- clonic: a.k.a grand mal. Loss of consciousness, falling to ground, upright, stiffening of body (Tonic) & subsequent jerking of extremities (clonic). Has no memory of seizure.
• Absence seizure: a.k.a Petite Mal. Occurs in children. Staring spell “daydreaming” less than 10 sec.

Question 5

What is Status Epilepticus?

Answer 5

Continuous seizure activity in rapid succession without return to consciousness between seizures.
Neurological emergency
Commonly caused by ETOH withdrawal and stopping meds

Question 6

Clinical manifestations of Generalized Seizures

Answer 6

• Preceded by an aura
• May sleep for several hours
• confused or hard to arouse
• abnormal breathing
• incontinence of bladder or bowel
• biting of lip or tongue

Question 7

Pharmacological management of Seizures

Answer 7

• Anticonvulsants: Levetiracetam (Keppra) go-to for CVA,TBI, inoperable tumor
• Hydrantoins: Phenytoin (Dilantin) therapeutic range 10-20. blood test required
• Barbiturates: Phenobarbital. Blood test required.
• Gamma- Aminobutyric Acid: Gabapentin (Neurontin). No blood test required.

Question 8

Pharmacological management of Status Epilepticus

Answer 8

• Diazepam/ Valium (Rectal)

- Lorazepam/Ativan

Question 9

MOA of Anti-Epileptic Drugs

Answer 9

Goal: suppress rapid & excessive firing of neurons that start a seizure
Goal: offer protection of brain function
- Block the movement of sodium ions into nerve cells
- suppress calcium influx
- increase action of GABA

Question 10

Important to know about Seizures

Answer 10

• 1st rule: protect patient from injury
• treat underlying cause
• ALWAYS start with lowest dose & GO slow
• control SZ with least minimal SE
• not a good Sz med if patient having a lot of SE