Seizures

Question 1

Types of seizures

Answer 1

Focal onset seizure
Generalized onset seizure
Non-Epileptic

*All can have Motor Onset

Question 2

Focal onset seizures

Answer 2

Seizure that begins within networks of one hemisphere of the brain

Usually arise from identifiable lesions in the motor or sensory cortex and may spread in an orderly way to surrounding areas

Divided into:
-Focal aware
-Focal impaired aware

Question 3

Focal aware

Answer 3

Patient is aware of his/her surroundings (knows something is happening); often remembers

Question 4

Focal impaired aware

Answer 4

Change in the patient’s level of awareness during the seizure; may not remember

Question 5

Non-Epileptic

Answer 5

Psychogenic non-epileptic seizures -or PNES- (formerly called pseudoseizures)

Can be difficult to distinguish from epileptic seizures and, unless the history is absolutely clear, should be treated as such

Although the origin may not be neurogenic, it doesn’t not mean the pt is doing volitionally

Epileptic and non-epileptic seizures can occur in the same patient

Question 6

Motor/Non-Motor Onset

Answer 6

-Produces a change in muscle activity, such as weakness, twitching, and stiffening of body parts

-Non-motor onset seizures can affect the senses, resulting in changes in smell, taste, and hearing; visual and/or auditory hallucinations may also arise

Question 7

Generalized onset seizure

Answer 7

Begins within both hemispheres of the brain and are divided into motor and non-motor

-Awareness is believed to be impacted in some way

May include:
-Absence seizures
-Atonic seizures
-Myoclonic seizures
-Tonic-clonic seizures

Question 8

Seizures 5 minutes or longer

Answer 8

Status Epilepticus

-Ongoing or w/out returning to normal
-Usually tonic-clonic

*Medical Emergency

Question 9

Seizure Causes

Answer 9

VASCULAR: Stroke, AV malformations, Bleeding
INFECTIONS
TRAUMA/TOXINS
AUTOIMMUNE
METABOLIC
IDIOPATHIC
NEOPLASM: CNS Tumors
OTHER

Question 10

Vascular

Answer 10

Strokes (embolic, post)
Av malformations

Question 11

Infections

Answer 11

Meningoencephalitis
Brain abscess
Cerebral malaria
Sepsis

Question 12

Trauma/Toxins

Answer 12

TBI

Drugs/etoh/prescription
Pesticides
Heavy metals

Question 13

Autoimmune

Answer 13

Lupus
Rheumatoid arthritis
Sjorgren’s syndrome
Crohn’s disease

Question 14

Metabolic

Answer 14

Hypoglycemia & HHS
Hepatic encephalopathy
Thyroid disorders
Uremia
Low Na, Ca, Mg

Question 15

Neoplasm

Answer 15

Primary & secondary

Question 16

Other

Answer 16

Sleep depravation
Eclampsia
Hydrocephalus
Congenital disorders

Question 17

Age Limits for Febrile seizures in PEDS

Answer 17

<6 Months

> 5 yrs old

Question 18

How do PEDS febrile seizures present

Answer 18

Generalized in character (Not Focal)

1 event w/in a 24hr period (Cannot be multiple)

<15 minutes in Duration