Convulsive disorders Flashcards
(44 cards)
Epilepsy:
occasional sudden excessive rapid and local discharge of gray matter
any disorder characterized by recurrent unprovoked seizures
Where are rates of epilepsy higher?
third world countries
Is epilepsy controllable?
yes, 60-70% of epileptics have well controlled seizures on current meds
Who has a higher incidence of epilepsy, when does it occur?
men, higher incidence at the beginning and end of our lives
What are the types of epilepsy?
genetic
structural/metabolic
unknown
What are the causes of genetic epilepsies?
inherited in autosomal dominant fashion
channelopathies
What are the causes of structural/metabolic epilepsies?
head trauma tumors vascular infectious degenerative metabolic disorders
What are the classifications of seizures?
focal onset
generalizes onset
What are the subtypes of focal onset?
no alteration of consciousness (simple partial)- aura, motor, sensory, autonomic, “psychomotor”
altered consciousness (complex partial)
What are the subtypes of generalized onset?
tonic clonic atonic myoclonic absence
Partial seizures: Onset
single focus giving rise to abnormal discharges
symptoms are very specific and can help localize the lesion/source
no loss of consciousness
Simple partial seizure:
Twitching
sensory- abnormal sensations, paresthesias, abnormal vision, sounds or smells, distortions of perception
autonomic- flushing, tingling nausea
“march” to different parts of the body
Complex partial seizure:
aura- about 50%, which is a warning for the seizure, typically a familiar feeling (deja vu), nausea, heat or tingling, or distortion of sensory perceptions
automatism- lip smaking, picking at clothes, walking around aimlessly or saying nonsense phrases over and over again
staring and black out for a few seconds to minutes
Generalized seizure: Onset
start all over the brain at once
Absence seizure:
impairment of consciousness usually in childhood, cease by the 20 yo starts with staring spells able to resume activities onset and termination are abrupt
Typical EEG - 3hz spike and wave
Generalized Tonic-Clonic Seizures (Grand mal)
sudden loss of consciousness and tonic activity (stiffening)
followed by clonic activity (rhythmic jerking) of limbs
eyes may roll up
lasts 1-3 min
postictal phase- sluggish, sleepy and confused
Atonic seizures
drop attacks
children or adults with wide spread brain injuries
suddenly become limp and may fall to the ground
Myoclonic seizure:
brief unsustained jerk or series of jerks
Tonic seizures
stiffening of muscles as the primary seizure manifestation
consciousness may or may not be lost
What is the breakdown of adult seizure types?
complex partial- 40%
simple partial- 20%
primary gen tonic clonic- 20%
What is the most common seizure in kids?
absence
What is the rate of re occurrence after a first unprovoked seizure?
30-50%
What are causes of epilepsy?
alteration of seizure threshold, acquired or inherited
specific epileptogenic disturbances- metabolic disturbances, anoxia, trauma, vascular malformation, tumor and infection
What is the first aid for a tonic clonic seizure?
turn person on side with head inclined toward ground to keep airway open, protect from near hazards
DO NOT PUT RIGID OBJECT IN MOUTH OR RESTRAIN
