Seizures Exam 3

Question 1

What is a seizure?

Answer 1

Sudden paroxysmal electrical
discharge of neurons in the brain
Other terms: Convulsion, fit, spell, ictus

Question 2

What can seizures be caused by?

Answer 2

Systemic distress- isolated nonrecurrent attacks like hypoxia and hypoglycemia

Question 3

Seizures can be caused by ?

Answer 3

Damage or disease of brain:
* Tumors
* Trauma
* Perinatal injuries
* Toxins
* Infectious agents
* Electrolyte imbalance
* Uremia
* Drug withdrawal
* Sedative hypnotics
* Vascular disorders

Question 4

What are the primary caused of seizure?

Answer 4

• Genetic and Idopathic

Question 5

What is epilepsy?

Answer 5

Also called seizure disorder/ disorder of the brain
Epilepsy is when a peron has two or more seizures.

Question 6

Epilepsy is most common neurological disorder in what type of patient?

Answer 6

Pediatrics

Question 7

What are the classification for seizures?

Answer 7

• Age-related onset
• Symptoms
• Anatomic localization in the brain

Question 8

What is the main etiology of seizures?

Answer 8

Cellular levels- Imbalances in neurotransmitters

Question 9

What are the Primary causes of a seizure?

Answer 9

(idiopathic)
▪ Genetic predisposition
▪ Neurologic abnormalities

Question 10

What are the secondary causes of a seizure?

Answer 10

Secondary (symptomatic)
▪ Examples:
▪ Perinatal injuries
▪ Brain tumor
▪ CVD
▪ Trauma
▪ Infection
▪ Complication of cancer

Question 11

Can secondary seizures be preventable?

Answer 11

Yes; if underlying cause is treated

Question 12

What are some potential causes of seizures in a dental setting?

Answer 12

• Hypoglycemia
• Hypoxia – secondary to syncope
• Local anesthetic toxicity
• Med hx of Epilepsy

Question 13

What is generalized seizures ?

Answer 13

Affects entire brain
- Nonconvulsive
▪ 4 sub-types
Absence (petit mal)
Atypical absence
Myoclonic
Atonic
- Convulsive
▪ 3 sub-types
Tonic-clonic (grand mal)
Tonic
Cloni

Question 14

What is partial seizures?

Answer 14

Involves only part of the brain
-Simple
No loss of consciousness
Staring
Jerking of mouth muscles
-Complex
Varying level of consciousness
Staring with confusion
Purposeless movements or actions

Question 15

What are the clinical manifestations of seizures?

Answer 15

Precipitating Factors: Psychological stress
Fatigue
Sensory stimuli
Flashing lights, noises, peculiar odors
Use or withdrawal of addictive drugs (i.e. alcohol)
Aura: Warning before a seizure
Warning → preparation

Question 16

What is tonic clonic (Grand Mal) seizures?

Answer 16

• Loss of consciousness sudden and complete
• Muscle contraction and relaxation
• Shallow or no breathing → pale, bluish color
• Tongue bitten, foamy saliva
• 1-3 minutes duration
• Longer → status epilepticus
• Phases: Preictal, ictal, postictal, Aura

Question 17

What is the absence (petit mal) seizure?

Answer 17

Begins: Loss of consciousness 5-30 secs
▪ Blank stare, posture fixed
▪ Rhythmic twitching- Eyelids, eyebrows, head, chewing
▪ Ends: Fully alert, conscious; unaware of seizure
* Most Common in children
* Rare after 20 years old

Question 18

What is the preictal phase?

Answer 18

• after aura
• Patient loses consciousness

Question 19

What is the ictal phase?

Answer 19

Tonic phase
* Muscles have sustained contraction –
patient appears rigid

Question 20

What is the icatal phase?

Answer 20

Clonic phase- Convulsions

Question 21

What is the postical phase?

Answer 21

• Movement stopped
• Patient remains unconscious

Question 22

What are febrile seizures?

Answer 22

• convulsions that can happen when a young child has a fever above 100.4°F (38°C)
• Risk of developing other seizure disorders later in life

Question 23

How do you diagnosis seizures?

Answer 23

Clinical signs and symptoms
▪ History
▪ Electroencephalography (EEG)
▪ Functional neuroimaging

Question 24

What is the treatment of patient with seizures disorders?

Answer 24

• Control of seizures with fewest side effects
• Drug therapy- Antiseizure and antiepileptic drugs

Question 25

What are the preventive strategies in dental office ?

Answer 25

• Preparing for management if a seizure should occur
• Essential information about the patient’s seizures history
• If uncontrolled post-pone until stable
• Early morning appt after meal
• Within hours of taking medication

Question 26

What are some preventivie strategies in a dental office?

Answer 26

• mouth prop and removal of dentures
• Clinician should advise patient to let him/her know if they feel onset of seizure.

Question 27

How should you treat a patient with seizures?

Answer 27

Primary task is to protect patient and try
to prevent injury before, during, and
after

Question 28

What is Status epileticus?

Answer 28

• Continuous GTCS or repetitive recuurence
• Life threatening
• May persist for hours or days
• Temperature may rise to 106°F.
• BP elevated: 200/150 mmHg