Week 4- seizures

Question 1

What is the difference in mortality rate for less than and over an hour?

Answer 1

Under an hours 2%

over an hour 30%

Question 2

How many people world wide have epilepsy?

Answer 2

50 million world wide

3/4 not treated in low and middle income countires

Question 3

How many people respond to treatment for epilepsy?

Answer 3

70% siezure free with treatment

Question 4

How many people in australia have epilepsy?

Answer 4

250,000 living with epilepsy
25,000 diagnosed every year
3-3.5% of austrlian’s will experence epilepsy

Question 5

What are the increased risks of death associated with epilepsy?

Answer 5

Increased risk of death due to
-underlying brain disease, siezures in dangerous positions, prolonged seizures, sudden unexplained causes, cardiac arrest and suicide

Question 6

What is thought to be causative of seizures?

Answer 6

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

Question 7

What things might trigger seizures?

Answer 7

Hypoxia, hypothermia, hypoglycemia, hyponatrimia, brain injuries or certain drugs

Question 8

What is the definition of a seizure?

Answer 8

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.

Question 9

What is the definition of a seizure?

Answer 9

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.

Question 10

what are some every day triggers for seizures?

Answer 10

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

Question 11

What is a partial siezure?

Answer 11

Begin focally in a unilateral cortical site

- Affect part of the body controlled by that part of the brain

Question 12

what are the main causes of a partial seizure?

Answer 12

• stroke
  tumor
  head injury

Question 13

What is a simple patrial sizure?

Answer 13

Where there is no alteration in concious state

- involving a limb, unplesant taste/smell, cant remember, lasts a few minutes

Question 14

What is a complex partial sizure?

Answer 14

starts in temporal/frontal lobe, appears dazed, last up to 7 minutes, pt appares dazzed for minutes/hours with no recall of incident

Question 15

What are the types of genralised seizures?

Answer 15

Absence, atonic, myclonic, tonic, tonic-clonic

Question 16

What is an absence sizure?

Answer 16

Awearness and responsivness are impared. Pt stares/eyes toll back, starts suddenly and cant be interupted, lasts a few seconds and stops suddenly

Question 17

What is an atonic sizure?

Answer 17

known as drop attacks, remains conscious, recover quiet quickly

Question 18

What is a myoclonic seizure?

Answer 18

Brief, shock like jerks of a muscle group
lasting a second or two
can be one or many in a short time frame

Question 19

What is a tonic seizure?

Answer 19

Muscle tone is greatly increased
body, arms or legs make sudden stiffening movments
often occurs in clusters
duration <20 seconds
remain concious

Question 20

What is a tonic-clonic sizure?

Answer 20

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

Question 21

What happens after a tonic-clonic seizure?

Answer 21

ongoing confusion, drowsy agitated or depressed
may have headache/want to sleep
drowsiness last for hours

Question 22

What is a secondary generalised seizure?

Answer 22

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

Question 23

what are the phases of generalised seizures?

Answer 23

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)

Question 24

What is status epilepticus?

Answer 24

Neurological emergency charcterised by seris of convusions rapidly repeated without intervals of conciousness

Question 25

What is our definition?

Answer 25

seizure lasting > 5 mintes or multiple seizures without full recovory of conciousness between seizures

Question 26

What are some signs that it is psychogenic status epilepticus?

Answer 26

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

Question 27

What drugs are given as anti-convulsants and what are their effects?

Answer 27

Benzodizapeines

- anxiolytic, muscle relaxants, anticonvulsant, hypnotic, memory imparement

Question 28

What is the mechanism of action of anticonvulsants?

Answer 28

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

Question 29

What are the adverse affacts of Benzos?

Answer 29

RElated CNS depression- hypotnesion, resp depressm drosiness- dependence

Question 30

What is a febril convulsive seizure?

Answer 30

seizure associated with fever in the absense of CNS infection or electrolyte imbalcne between6months and 6 years

last <10 minutes

Question 31

what is the second line treatment for seizures?

Answer 31

Anti-convulsants
Phenytoin- dilantin
valproate- epilim
levetiracetam- keppa