seizures Flashcards
(52 cards)
seizure
cortical events characterized by excessive or hypersynchonrnous discharge by cortical neruons
what are idiopathic sz?
usually begin bw 5-10 yrs old and have no specific cause
what are secondary sz?
may result from congenital abnormalities or pernatal injury, metabolic disorders, trauma, tumors, vascular dz, infex dz, or degenerative dz
generalized sz
sudden loss of consciousness; invovles both cerebral hemispheres w/ an alteration of consciousness
convulsive generalized
grand mal or tonic clonic; associated w. a postictal obtundation and confusion lasting for mins to hours
nonconvulsive generalized
absence; associated w/ only minor motor activity, such as blinking
absence is also called…
petit mal!
it begins in childhood, are often familial, and typically subside before adulthood
what are signs and sx of an absence sz?
brief, often unnoticable episodes of imparied consciouness, lasting only seconds and occuring up to hundreds of time sper day
**think staring spells
work up of an absence?
EEG
**3 per second generalized spike and wave tracing
how do you tx an absence sz?
ethosuximide is first line. valproic acid or zonisamide may be used
tonic clonic?
aka GRAND MAL
signs and sx of tonic clonic
begin suddenly w/ loss of consciousness and tonic extension of the back and extremities, continuing w/ 1-2 mins of repetitive, symmetric clonic movements
** classic sz incontinence and tongue biting
**pt may also appear cyanotic druing the ictal owing to poor respiratory fxn during sz
tx of grand-mal
emergent tx w/ benzo to abort thesz
-give antiepiliptics for seconary prevention-phenytoin, phenobarbital, valproate, lamotrigine, etc
partial sz
simple or complex
arise from discrete region of 1 cerebral hemisphere
simple partial sz are NOT accompanied by an impariment of consciousness- may be an isolated tonic or clonic activity of a limb or transient altered 8
pediatric partial sz tx?
treat with phenobarbital
how do you tx intractable temporal lobe sz?
surgical options include anteriro temporal lobectomy or vagal nerve
Postictal?
Todd’s paralysis= wkness or paralysis that is often unilatral and resolves over 24 hrs
status epilepticus
can be convulsive or nonconvulsinve
how is SE dx?
sz fail to cease spontaneously or recur so frequently that full consciousness is not restored between successive episodes
what are complications o SE?
possibility of permanent brain damage secondary to hyperthermia, circulatory collapse, or excitotoxic neuronal damage
how to tx SE?
Immediate management -ensure patent airway, including positioning the patient to prevent aspiration of stomach contents-Management of hyperthermia, related to increased motor activity and high levels of circulating catecholamines, may include a cooling blanket or induction of motor paralysis with a neuromuscular blocking agent-Diazepam or lorazepam is administered IV until the seizure stops; a loading dose of phenytoin or fosphenytoin is also given
EEG findings in partial sz?
focal rhythmic discharge; but sometimes, no ictal activity will be seen
EEG in complex partial?
interictal spikes or spikes associated w/ slow waves in the temporal or frontotemporal are
what will EEG of epileptic sz show>
epileptiform
