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Seizures Seizures Seizure Disorders

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Seizures Seizures Seizure Disorders Powered By Docstoc
					Seizures
         Seizure Disorders
A seizure is a temporary alteration in behavior or
consciousness caused by abnormal electrical
activity of one or more groups of neurons in the
brain
Incidence: 0.5% of US population, most common
is febrile
Causes: Fever, toxins, head injury, stroke, drug
OD, and unknown causes
        Types of Seizures
All seizures are pathological
– They may arise from almost any region of the
  brain and therefore have many clinical
  manifestations.
– The two most common seizure types are
  generalized and partial (focal)
     Generalized Seizures
Do not have a definable origin (focus) in
the brain, although focal seizures may
progress to a generalized seizure
Includes petit mal (absence seizures) and
grand mal (tonic-clonic) seizures
          Petit Mal Seizures
Occur most often in children between the ages
of four and 12
Characterized by brief lapses of consciousness
without loss of posture
Often there is no motor activity although some
children have:
– Eye blinking
– Lip smacking
– Isolated clonic activity
      Grand Mal Seizures
Common and associated with significant
morbidity and mortality
May be preceded by an aura (olfactory or
auditory sensation), which is often
recognized by the patient as a warning of
the imminent convulsion
        Grand Mal Seizure -
          Characteristics
Sudden loss of consciousness associated with
loss of organized muscle tone
Tonic phase
Clonic phase
Postictal phase
Grand mal seizures may be prolonged or recur
before the patient regains consciousness
– When this occurs, the patient is said to be in status
  epilepticus
         Partial Seizures
Arise from identifiable cortical lesions
May be classified as simple or complex
    Simple Partial Seizures
Result mainly from seizure activity in the
motor or sensory cortex
Simple motor seizures
Simple sensory seizures
Jacksonian seizure
Complex Partial Seizures
Arise from focal seizures in the temporal
lobe (psychomotor) and manifest primarily
as changes in behavior
Classic complex partial seizure
– Preceded by an aura
– Followed by abnormal repetitive motor behavior
  (automatisms)
– Seizures are typically brief (less than one minute)
– Patient usually regains normal mental status quickly
– May progress to a generalized tonic-clonic seizure
       Hysterical Seizures
        (Pseudoseizures)
Can mimic a true seizure, but stem from
psychological causes
– Not considered true seizures because they
  have no organic origin and do not respond to
  normal treatment modalities
Can usually be terminated by sharp
commands or painful stimuli
         Status Epilepticus
Continuous seizure activity lasting 30 minutes or
longer or a recurrent seizure without an
intervening period of consciousness
A true emergency
Causes: #1: Failure to take medication
Associated complications: Aspiration, Brain
Damage, FX of long bones, spine
      Status Epilepticus
Management:

     Management of airway and
     breathing is critical.
     Establish IV access and cardiac
     monitoring.
     Administer 25g 50% dextrose if
     hypoglycemia is present.
     Administer 5–10mg diazepam IV.
     Monitor the airway closely.
                Drugs
3 Types:
Drugs that stimulate an influx of chloride
ion, an effect associated with GABA
(Benzodiazepines, Barbituates, Misc)
Drugs that delay an influx of sodium
(phenytoin and phenytoin-like drugs)
Drugs that delay an influx of calcium
(succinimides) (Depakene: Valproic Acid;
Ethosuximide: Zarontin)
       Alcohol Withdrawal
Benzodiazepines: Valium, Librium,
Tranxene, Ativan

Phenytoin: Tegretol

				
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posted:3/15/2012
language:English
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