seizures and blackouts

Question 1

differen types of generalised seizures

Answer 1

Typical absence
Myoclonic
Tonic-clonic

Question 2

Absence seizures features

Answer 2

Mainly childhood in onset
Frequent brief attacks (1 – 30 s)
Sudden loss and return of consciousness
No aura and no post-ictal state
Some involuntary movements

Question 3

myoclonus seizure

Answer 3

Sudden, brief, shock-like muscle contractions
Usually bilateral arm jerks
Often worse in the mornings
Precipitated by sleep deprivation and alcohol

Question 4

tonic clonic seizure

Answer 4

Sudden onset, gasp, fall
Tonic phase with cyanosis
Clonic phase
Post-ictal phase
Tongue bitten and incontinence
Noisy breathing after seizure
Headache and muscle pain afterwards

Question 5

focal seizure

Answer 5

Often have auras: rising feeling, deja-vu, focal jerking..
Loss of awareness with blank look
Depending brain region will have automatisms or posturing or jerking
May evolve to tonic-clonic
Temporal lobe the commonest

Question 6

Some causes of focal seizures and therefore action that needs to be taken

Answer 6

focal lesion

- need to look for one

Question 7

Features of vasovagal syncope (fainting)

What may a witness describe it like

Answer 7

it is due to drop in blood pressure and flow to the brain. Has a cause. Cause is
-posture, emotion, pain, heat, dehydration

A prodrome is typical:
-Hot, dizzy, vision fades, tinnitus, nausea, weak, sweaty

Witness: pallor, shaking, rapid recovery

Question 8

Difference between vasovagal syncope and epilepsy

Answer 8

Vasovagal syncope has a cause such as posture, emotion, pain, heat, dehydration

Question 9

Cardiac syncope (fainting) features

Answer 9

Either occurs in:

• Older age group
• Younger patient who develops this during vigorous exercise

Often no warning
Palpitations
Prompt recovery of consciousness if attack was brief
ECG abnormal

Question 10

Features of dissociative seizures (non-epileptic attacks)

Answer 10

Prolonged attacks
Some preservation of awareness in 4 limb movements
Lots of truncal movement 
Motionless unresponsiveness
Feelings of dissociation