epilepsy Flashcards
definition of seizure?
abnormal clinical event cause by the abnormal and excessive discharge from the cerebral neurons.
etiology of seizure?
primary or idiopathic cause by mostly genetic cause or cause unknown
secondary cause by known cause like hepatic failure, hyperglycemia hypoglycemia renal failure tumors, stroke, AV malformation, congenital abnormalities, meningitis, encephalitis, abscess, vasculitis, sle, penecillin, metronidazole, lithium, antidepressant, cyclosporin, cocaine, amphetamine
classification of seizures?
partial seizure: simple, complex generalized: absence( typical and atypical) petitmal myoclonic tonic clonic grandmal atonic seizures
which causes associated with which type?
scars tumors and AV malformations can cause partial seizure
metabolic disorder and structural abnormalities may cause generalized seizures
define simple partial seizures?
conciousness is preserved, may present with sensory, motor, autonomic an psychic symptoms
partial motor( temporal and frontal type)
jacksonian march( jerky movment start from mouth include whole limb in few mintues) todd's paralysis (after jacksonian jerk there is pareis in whole limb for mintues to hour) epilepsia partialia continue ( when jacksonian continue for hours and days)
other types?
parietal cortex include tingling, numbness and paresthesia, vertigo, falling
occipital cortex include visual hallucinations
psychomotor temporal lobe: impair conciousness without failling on ground
generalized seizures types?
absence seizure in childhood less than 10 secs occur upto 20-30times/day two types typical and atypical difference between both of them is atypical arouse and terminate gradually
myoclonic( multiple jerks pt fall on ground)
atonic ( sudden loss of muscle tone)
tonic clonic start with aura then tonic followed by clonic phase.
triggering factors of seizures?
sleep deprivation, stress, mental and physical exhaustion, infection, pyrexia, drug, alcohol, flickering lights, hot bath, music, loud sound, reading
d/d of partial seizures?
TIA but this have longer duration and dont have jerky movements
panic attacks
d/d of generalized seizures?
syncope
cardiac dysrhythmias
pseudo-seizures ( there is no postictal stage, EEG is normal serum prolactin is unchanged which is changed in tonic clonic seizures
phases of tonic clonic seizures?
aura ( irritibility)
tonic phase( contraction of muscles)
clonic phase (jerking)
post ictal phase ( unconciousness, flaccidity)
investigation?
cbc serum urea createnin leukocytosis blood sugar serum ca and mg lfts lp if infection suspected EEG ( abnormal between two attacks) epilepsy show spikes or spike and waves pattern EEG with sleep deprivation PET SPECT In absence there is 3 per second spike and wave electrical activity
CT and MRI
for any structural abnormality
management?
immediate medical care: protect airway, give oxygen to reduce cerebral hypoxia, give iv diazepam 10mg, take blood for level of anticonvulsant checking. avoided triggering factors.
