Seizures & Epilepsy Flashcards
causes of seizures?
Vascular (stroke, AVM) Infection Trauma Autoimmune (vasculitis) Metabolic (hypoMg, Na, Ca, gluc, O2; hyperNa; drugs) Idiopathic Neoplasm pSychiatric = pseudo-seizure
post-seizure tests (to dx cause of seizure)
- CT
- MRI
- O2 sat
- metabolic panel
- toxin screen
- trauma Hx
-EEG –> if all others are negative
drugs that cause seizures
- cocaine
- benzodiazepine/barbituate withdrawal
- alcohol toxicity or withdrawal
- phenylcyclidine toxicity
pseudo-seizure dx
-normal EEG
seizure vs syncope
- posi-ictal confusion, muscle aches, somnolence; incontinence; tongue biting; long time to regain consciousness
- no post-ictal period, no incontinence/tongue biting, recover conscious quickly (minutes)
causes of gradual loss of consciousness
- hypoxia
- hypoglycemia
- metabolic abnormalities
- vasovagal
causes of sudden loss of consciousness
- cardiac (sudden regain of consciousness) –MS, AS, HOCM
- neurological (gradual regain of consciousness)
partial seizure types?
-simple = no loss of consciousness
-complex = loss of consciousness + automatisms + aura
(chewing, lip smacking)
-partial seizure with secondary generalization
= loss of consciousness + tonic-clonic activity
generalized seizure types?
- tonic clonic (grand mal)
- absence (petit mal)
status epilepticus tx
- benzodiazepines (lorazepam) = best initial
- phenytoin(anti arrhythmic) or fosphenytoin
- barbiturates (phenobarbital)
- anesthesia (propofol or midazolam)
phenytoin SE
- gingivial hyperplasia
- vertigo
- ataxia
- vertical nystagmus
- hypotension, bradycardia
only tx first time seizure pt if…
- was in status epileptics
- abnormal EEG
- strong FHx of seizure disorder
absence seizure tx
ethosuxamide
or valproic acid
seizure tx options
not absence seizures
- valproic acid
- phenytoin
- carbamazepine
- lamotragine
lamotragine SE
Stevens Johnson syndrome
toxic epidermal necrolysis
