PT 2 - Neuro - Seizure Flashcards
(50 cards)
Seizures from systemic and metabolic problems -
If underlying condition is corrected and seizure stops
Are they seizures or not?
Not seizures
What are the metabolic problems that cause seizures?
- Acidosis
- Electrolyte imbalances
- hypoglycemia
- Hypoxemia
- Alcohol or Barbiturate withdrawal
- Dehydration to water intoxication
Extracranial disorders that may cause seizures:
- Systemic Lupus erythematosus
- Diabetes
- HTN - preeclampsia
- Sepsis
- Heart, lung, liver, or kidney diseases
Common causes of seizures during first 6 months of life:
- severe birth injury
- hypoxic injury of the brain (congenital)
- INFECTIONS
- inborn errors of metabolism
Common causes of seizures from ages 2-20 years:
- Birth injury
- Infection
- head trauma
- genetic factors
Common causes of seizures between 20-30 years
structural lesions - scarring of the brain
trauma
brain tumor
vascular disease
Common causes of seizures after 50 years:
Stroke
metastatic brain tumors
how many cases of seizures are idiopathic (don’t know why - no specific cause)
1/3 cases
Patho of seizures:
group of abnormal neurons seem to fire without a clear cause
Clinical manifestations of seizures:
Three major classes:
Generalized onset
focal onset
unknown onset
Clinical manifestations of seizures:
4 phases:
- Prodromal phase - couple hours prior
- Aural Phase - warning
- Ictal phase - seizure itself (happening)
- Postictal phase - recovery
Tonic means
rhythmic tensing - relaxation
Clonic means
Jerking
Tonic Clonic characterized by
loss of conscious and falling to the ground
cyanosis, salivation, tongue/cheek biting, incontinence
Tonic Clonic has three phases:
Tonic phase:
stiffening of muscles; loss of consciousness
Clonic Phase:
1-2 minutes of rhythmic jerking
Postictal Phase:
Confusion, sleepiness, agitation
no memory of seizure
Does lactic acids raise or lower during tonic clonic seizures?
lactic acid levels elevated (7+)
Absence Seizure—
Pause-staring-pause in time
(10-60 seconds)
blank staring
eye fluttering
lip smacking
no decreased muscle tone
in children
Focal onset seizures -
Described by the level of awareness
They start in one small area of the brain.
Symptoms depend on what part of the brain is affected.
Describe Focal Awareness Seizures
Focal Aware Seizure
Person is awake and alert.
May feel strange (like déjà vu, tingling, or a weird taste or smell).
May have uncontrolled movements of one body part (like arm or face).
Describe Focal Impaired Awareness Seizures
Focal Impaired Awareness Seizure
Person is confused or not fully aware.
May stare blankly, make repeated movements (like lip smacking or hand rubbing).
May not remember the seizure afterward.
Gold Standard of Diagnostics for:
Focal-Onset seizures
EEG
have to be actively seizing to use EEG
EEG also gold standard for epilepsy - mobile EEG
Focal Seizures with Motor Activity
These involve movement symptoms:
atonic, tonic, clonic, myoclonic, epileptic spasms
strange behavior, repetitive, purposeless actions (ticks, lip smaking)
Focal Seizures with Nonmotor Activity
No clear movement, but other signs like:
emotional manifestations
strange feelings or symptoms
Non epileptic seizures
may be misdiagnosed as seizure disorders
history of emotional, physical abuse, traumatic event may emerge
looks like real seizures - lose awareness - no brainwaves to show seizures
Proper diagnosis needs - EEG
not faking
no brainwaves show seizure
but have physical symptoms
