Seizures Exam 3 Flashcards
What is a seizure?
Sudden paroxysmal electrical
discharge of neurons in the brain
Other terms: Convulsion, fit, spell, ictus
What can seizures be caused by?
Systemic distress- isolated nonrecurrent attacks like hypoxia and hypoglycemia
Seizures can be caused by ?
Damage or disease of brain:
* Tumors
* Trauma
* Perinatal injuries
* Toxins
* Infectious agents
* Electrolyte imbalance
* Uremia
* Drug withdrawal
* Sedative hypnotics
* Vascular disorders
What are the primary caused of seizure?
- Genetic and Idopathic
What is epilepsy?
Also called seizure disorder/ disorder of the brain
Epilepsy is when a peron has two or more seizures.
Epilepsy is most common neurological disorder in what type of patient?
Pediatrics
What are the classification for seizures?
- Age-related onset
- Symptoms
- Anatomic localization in the brain
What is the main etiology of seizures?
Cellular levels- Imbalances in neurotransmitters
What are the Primary causes of a seizure?
(idiopathic)
▪ Genetic predisposition
▪ Neurologic abnormalities
What are the secondary causes of a seizure?
Secondary (symptomatic)
▪ Examples:
▪ Perinatal injuries
▪ Brain tumor
▪ CVD
▪ Trauma
▪ Infection
▪ Complication of cancer
Can secondary seizures be preventable?
Yes; if underlying cause is treated
What are some potential causes of seizures in a dental setting?
- Hypoglycemia
- Hypoxia – secondary to syncope
- Local anesthetic toxicity
- Med hx of Epilepsy
What is generalized seizures ?
Affects entire brain
- Nonconvulsive
▪ 4 sub-types
Absence (petit mal)
Atypical absence
Myoclonic
Atonic
- Convulsive
▪ 3 sub-types
Tonic-clonic (grand mal)
Tonic
Cloni
What is partial seizures?
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
What are the clinical manifestations of seizures?
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
What is tonic clonic (Grand Mal) seizures?
- 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
What is the absence (petit mal) seizure?
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
What is the preictal phase?
- after aura
- Patient loses consciousness
What is the ictal phase?
Tonic phase
* Muscles have sustained contraction –
patient appears rigid
What is the icatal phase?
Clonic phase- Convulsions
What is the postical phase?
- Movement stopped
- Patient remains unconscious
What are febrile seizures?
- 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
How do you diagnosis seizures?
Clinical signs and symptoms
▪ History
▪ Electroencephalography (EEG)
▪ Functional neuroimaging
What is the treatment of patient with seizures disorders?
- Control of seizures with fewest side effects
- Drug therapy- Antiseizure and antiepileptic drugs
What are the preventive strategies in dental office ?
- 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
What are some preventivie strategies in a dental office?
- mouth prop and removal of dentures
- Clinician should advise patient to let him/her know if they feel onset of seizure.
How should you treat a patient with seizures?
Primary task is to protect patient and try
to prevent injury before, during, and
after
What is Status epileticus?
- Continuous GTCS or repetitive recuurence
- Life threatening
- May persist for hours or days
- Temperature may rise to 106°F.
- BP elevated: 200/150 mmHg
