Seizures - Answers Abnormal electrical discharges in the brain usually accompanied by
uncontrollable muscle activity
ictus - Answers Medical term for seizure
Nervous system disorders - Answers Seizures; vestibular disease; intervertebral disk disease;
degenerative myelopathy
Epilepsy - Answers term describes recurring seizures (does not indicate cause)
Types of seizures - Answers partial and generalized
Gram mal - Answers Generalized seizures (more common)
Focal - Answers Partial seizures. Only part of the body
Phases of a seizure - Answers prodromal, aural, ictal, postictal
Aural (pre ictal phase) symptoms - Answers • altered behavior, restlessness
• precedes seizure activity
• May last seconds to hours
Ictal phase - Answers seizure activity: can be generalized or partial
• Generalized ictal phase: - Answers • Loss of consciousness
• Muscle contractions
• +/- urination, defecation, salivation
• Partial ictal phase: - Answers • Depends on area of brain affected
• Post-ictal phase: - Answers • Immediately follows seizure
,• Confusion, disorientation, lethargy, pacing, restlessness and sometimes temporary blindness
• Lasts minutes to hours
Seizure duration - Answers • A few seconds to several minutes
Prolonged seizure activity can result in hypoxemia, hyperthermia, and hypotension
Status Epilepticus - Answers seizure activity lasting longer than 5 minutes. If occurs, must
administer treatment to stop the activity
Cluster seizures - Answers - multiple seizures occurring within 24 hours
seizure causes - Answers Intra-cranial or extra-cranial
Intra-cranial causes of seizures - Answers • Idiopathic epilepsy
• Tumors
• Trauma
• Infection
Extra-cranial causes of seizures - Answers • Toxins or drugs
• Chemical imbalances
Diagnosis of seizures - Answers • History and PE
• Neurological exam
• Fundic exam
, • Blood and urine panels
• Referral to neurologist
• Brain Imaging
• CSF Evaluation
* Rule out extra-cranial causes first, then intra-cranial causes
Younger patients with seizures are more likely to have... - Answers ...epilepsy
Older patients with seizures are more likely to have... - Answers ...a tumor
Fundic exam - Answers eye drops used to dilate iris for retina examination
Blood and urine tests for seizures - Answers Helps to rule out systemic causes
Brain imaging for seizures - Answers Usually done last as it is the most expensive
CSF - Answers cerebrospinal fluid
Seizure treatment - Answers Treat with anticonvulsant medication
Anticonvulsant Medications - Answers • Treatment of seizures in progress versus chronic
seizure control
• Do not cure the seizures; prevents their occurrence by reducing electrical activity in the brain
Short term anticonvulsant - Answers diazepam IV (or rectal) aka Valium
Long term anticonvulsant - Answers Phenobarbital most common
• Potassium bromide