Week 4- seizures Flashcards
What is the difference in mortality rate for less than and over an hour?
Under an hours 2%
over an hour 30%
How many people world wide have epilepsy?
50 million world wide
3/4 not treated in low and middle income countires
How many people respond to treatment for epilepsy?
70% siezure free with treatment
How many people in australia have epilepsy?
250,000 living with epilepsy
25,000 diagnosed every year
3-3.5% of austrlian’s will experence epilepsy
What are the increased risks of death associated with epilepsy?
Increased risk of death due to
-underlying brain disease, siezures in dangerous positions, prolonged seizures, sudden unexplained causes, cardiac arrest and suicide
What is thought to be causative of seizures?
Focus at a group of neurons due to changes in cell membrane potential. It may be caused by the GABA inhibitory system or abnormality in excitatory transmission
What things might trigger seizures?
Hypoxia, hypothermia, hypoglycemia, hyponatrimia, brain injuries or certain drugs
What is the definition of a seizure?
Results from widespread uncoordinated dishcharge of the CNS neurons. Characterised by a sudden, transiet alteration in brain function usually invovling motor, ensory, autonomic or physic clinical manifestations and an altered level of conciousness.
What is the definition of a seizure?
Results from widespread uncoordinated dishcharge of the CNS neurons. Characterised by a sudden, transiet alteration in brain function usually invovling motor, ensory, autonomic or physic clinical manifestations and an altered level of conciousness.
what are some every day triggers for seizures?
Alcohol- reduces effects of med diet- caffiene, low BGL infection/inless- hogh temp lack of sleep menstration smells, sounds other drugs stress photosensitivity severe temp change
What is a partial siezure?
Begin focally in a unilateral cortical site
- Affect part of the body controlled by that part of the brain
what are the main causes of a partial seizure?
- stroke
tumor
head injury
What is a simple patrial sizure?
Where there is no alteration in concious state
- involving a limb, unplesant taste/smell, cant remember, lasts a few minutes
What is a complex partial sizure?
starts in temporal/frontal lobe, appears dazed, last up to 7 minutes, pt appares dazzed for minutes/hours with no recall of incident
What are the types of genralised seizures?
Absence, atonic, myclonic, tonic, tonic-clonic
What is an absence sizure?
Awearness and responsivness are impared. Pt stares/eyes toll back, starts suddenly and cant be interupted, lasts a few seconds and stops suddenly
What is an atonic sizure?
known as drop attacks, remains conscious, recover quiet quickly
What is a myoclonic seizure?
Brief, shock like jerks of a muscle group
lasting a second or two
can be one or many in a short time frame
What is a tonic seizure?
Muscle tone is greatly increased body, arms or legs make sudden stiffening movments often occurs in clusters duration <20 seconds remain concious
What is a tonic-clonic sizure?
Body stiffens and fall to the ground (tonic phase)
may cry or groan
limbs begin jerking in a strong, symmetrical, rythmic movements (clonic phase)
pt may dribble, facial cynocis/red, loss of bladder or bowels
lasts 1 to 3 minutes
What happens after a tonic-clonic seizure?
ongoing confusion, drowsy agitated or depressed
may have headache/want to sleep
drowsiness last for hours
What is a secondary generalised seizure?
seizure activity spreads from focal point across both sides- intially partal sizure
episode breif and no recall
lasts 1-3 minutes
similar to primary generalisde seizures
what are the phases of generalised seizures?
Preictal phase- period before sizure- pts feel aura, restlessness, nervousness, wandering
Ictal phase- seizure perios lasting seconds to minutes
Postictal- period after seizure (disorientation, confusion, salivation, unresponsivness, incoherent)
What is status epilepticus?
Neurological emergency charcterised by seris of convusions rapidly repeated without intervals of conciousness
What is our definition?
seizure lasting > 5 mintes or multiple seizures without full recovory of conciousness between seizures
What are some signs that it is psychogenic status epilepticus?
onset gradual
back arching, thrashing, head rolling, in middle of seizure sobbing/cryong, eyes held shut tightly, limb withdrwal to painful stimuli, active resistance if hand fall over face
What drugs are given as anti-convulsants and what are their effects?
Benzodizapeines
- anxiolytic, muscle relaxants, anticonvulsant, hypnotic, memory imparement
What is the mechanism of action of anticonvulsants?
enhance GABA transmission by increasing frequency of opening GABA channels, increase opening time and increased receptor affinity for GABA
GABA is the main CNS inhibitory CNS transmitter
What are the adverse affacts of Benzos?
RElated CNS depression- hypotnesion, resp depressm drosiness- dependence
What is a febril convulsive seizure?
seizure associated with fever in the absense of CNS infection or electrolyte imbalcne between6months and 6 years
last <10 minutes
what is the second line treatment for seizures?
Anti-convulsants
Phenytoin- dilantin
valproate- epilim
levetiracetam- keppa
