Seizures and Epilepsy Flashcards
Classification of seizures
Partial (or focal) seizures
Simple partial seizures
With motor signs
Without impairment of consciousness.
With motor signs. With or without march. Versive. Postural. Phonation.
Classification of seizures
Partial (or focal) seizures
Simple partial seizures
With sensory symptoms
Somatic. Visual. Auditory. Olfactory. Gustatory. Vertiginous.
Classification of seizures
Partial (or focal) seizures
Simple partial seizures
With autonomic signs or sx
Epigastric sensations. Pallor. Sweating. Flushing. Piloerection. Pupillary dilation.
Classification of seizures
Partial (or focal) seizures
Simple partial seizures
With psychic sx
disturbance of higher cerebral function).
i. Dysphasic.
ii. Deja vu.
iii. Cognitive.
iv. Affective.
v. Illusions.
vi. Hallucinations.
Complex partial seizures
With automatisms
With automatisms – seizure involves a period of altered behavior for which patient is amnestic and during which patient appears to respond in a limited fashion to his environment, as if partially conscious and able to carry out coordinated motor acts.
Complex partial seizures
Clinical features
i. May have lip smacking, chewing, grimacing, swallowing. May pick at clothes; permit himself to be led; strike out if restrained but in a nondirected way; speak in jumbled or repetitive phrases; perform stereotyped behavior which is repeated with each attack; walk about in a dazed state; etc.
ii. Duration may be brief or up to five minutes long.
iii. Usually followed by several minutes of postictal confusion.
iv. May follow any of the subjective phenomena listed above for simple partial seizures.
v. Automatisms may occur in the postictal period following any severe seizure and are usually associated with confusion.
Types of partial seizures
Partial (focal) seizures
Complex partial seizures
Partial seizures evolving to secondarily generalized seizures (tonic, clonic, or tonic-clonic)
Generalized seizures
types
Absence seizures Generalized tonic-clonic seizures (“grand mal”) Generalized tonic seizures Generalized clonic seizures Myoclonic seizures Atonic seizures
Causes of seizures by age groups
Infancy (0-2 years old)
Congenital maldevelopment. Birth injury. Metabolic (hypocalcemia, hypoglycemia). Vitamin B6 deficiency. Phenylketonuria.
Causes of seizures by age groups
Childhood (2-10 yo)
Birth injury. Trauma. Infection. Thrombosis of cerebral artery or vein. Beginning of idiopathic epilepsy.
Causes of seizures by age groups
Adolescence (10-18yo)
Idiopathic epilepsy.
Trauma.
Congenital defects.
Causes of seizures by age groups
Early adulthood (18-35 yo)
Trauma. Neoplasm. Idiopathic epilepsy. Alcoholism. Drug addiction.
Causes of seizures by age groups
Middle Age (35-60 yo)
Neoplasm. Trauma. Vascular disease. Alcoholism. Drug addiction.
Causes of seizures by age groups
Late life
Vascular disease
degenerative disease
neoplasm
Seizure hx protocol
General historical questions
onset
i. When did the first attack occur?
ii. Was it precipitated by an accident or associated with an acute illness (fever)?
iii. How soon was it followed by a second
attack?