Seizures Flashcards
(13 cards)
What is the definition of a seizure?
A transient episode of abnormal, excessive neuronal activity in the brain, leading to sudden motor, sensory, or cognitive dysfunction.
How do focal seizures differ from generalized seizures?
Focal seizures originate in one hemisphere, may affect awareness. Generalized seizures involve both hemispheres and cause loss of consciousness from the outset.
What are typical features of a generalized tonic-clonic seizure?
Sudden LOC, tonic stiffening, clonic jerking, tongue biting (lateral), incontinence, postictal confusion and drowsiness.
What are common triggers for seizures?
Sleep deprivation, alcohol excess or withdrawal, flashing lights (photosensitive), missed medications, electrolyte imbalances.
What are red flags in a first seizure presentation?
Focal neurological deficit, persistent altered consciousness, head trauma, new-onset seizure in older adults, or signs of infection or malignancy.
What is status epilepticus?
A seizure lasting >5 minutes or ≥2 seizures without full recovery in between; a medical emergency.
How can you differentiate a seizure from syncope?
Seizure: tonic-clonic movements, tongue biting (lateral), prolonged postictal phase. Syncope: quick recovery, often preceded by prodrome (e.g., lightheadedness).
What investigations are needed after a first seizure?
Bloods (glucose, electrolytes, calcium, magnesium), ECG, EEG, and brain imaging (MRI preferred).
When is neuroimaging indicated in seizure work-up?
In new-onset seizures, focal features, neurological signs, head trauma, or suspected structural lesion.
What does an EEG show in generalized epilepsy?
Generalized spike-and-wave discharges, especially during hyperventilation or photic stimulation.
What is the first-line treatment for generalized tonic-clonic seizures?
Sodium valproate (avoid in women of childbearing age), or lamotrigine/levetiracetam as alternatives.
What is the emergency treatment for status epilepticus?
IV lorazepam or diazepam → IV phenytoin/levetiracetam → consider intubation and anaesthesia if refractory.
What precautions should be advised to a patient with epilepsy?
Avoid driving (per DVLA rules), swimming alone, working at heights; adhere to medication; avoid triggers like alcohol and sleep deprivation.
