Seizures and Epilepsy Flashcards
Define generalized seizure
Distributes bilaterally from basal ganglia
Define focal seizure
Occurs in 1 hemisphere
Define tonic seizure
Muscle stiffening frequently in a decerebrate posture
Define clonic seizure
Rhythmic synchronous limb movements
Define status epilepticus
- 5 or more mins of seizures OR
- Multiple seizures over 5 mins without return to awareness (baseline)
How many patients with seizures achieve control with meds?
About 2/3
1/3 of pts have drug resistant seizures
What is neurostimulation and what is it FDA approved for?
- Vagal nerve stimulator
- Refractory epilepsy
What is FDA approved for refractory epilepsy?
Neurostimulation
Define SUDEP
- Sudden unexpected death in epilepsy
- No identifiable cause of death in an epileptic pt
- Higher risk in refractory epileptics
Who is at higher risk for SUDEP?
Refractory epileptics
Etiology of epilepsy
- 70% idiopathic
- 30% have secondary causes (meds, alcohol, trauma, stroke, cancer)
How are seizures classified with regards to mode of onset?
- Focal onset
- Generalized onset
Types of focal onset seizures
- Simple (w/o impaired consciousness)
- Complex (w/impaired consciousness)
- Secondarily generalized
Types of generalized onset seizures
- Absence
- Tonic
- Clonic
- Tonic Clonic
- Atonic
- Myoclonic
Which types of seizures do NOT have a warning?
Generalized onset
Describe absence seizures
- Brief episodes (seconds) of impaired consciousness
- NO aura or postictal confusion
- Can happen many times per day
- May or may not have repetitive blinking
EEG hallmark of absence seizures
3 Hz generalized spike and slow wave complexes
What type of seizures are MC secondary to metabolic issues (electrolytes, renal, glucose)?
Tonic-Clonic (grand mal)
Describe tonic-clonic seizures
- Begins abruptly
- Usually secondary to metabolic issues
- Periods of muscle relaxation on muscle contractions
What type of seizures are brief and arrhythmic?
Myoclonic
Describe myoclonic seizures
- Brief (less than 1 sec), arrhythmic jerking motor movements
- May progress to tonic-clonic
- Myoclonus may occur normally when falling asleep
Which seizures cause rhythmic motor jerking?
Clonic (rhythmic)
arrhythmic = myoclonic
Describe tonic seizures
- Sudden flexion or extension of head, trunk, extremities
- Usually occur w/drowsiness
- “Beta buzz” on EEG
Describe atonic seizures
- Loss of postural tone for 1-2 secs
- Consciousness briefly impaired
