Seizures Notes

Seizures

Pathogenesis

  • definition: hypersynchronous firings of brain

  • Midbrain: ARAS responsible for consciousness

  • Consciousness can be affected by either ARAS or both cerebral cortex problems

Demographics

  • infant: glucose

  • elderly: stroke

Triggers

  • light

    • fire

    • Sun on water

  • causes: stroke, tumor, meningits, metabolic

Symptoms

  • mimic seizures

    • kids

      • breath holding, behavior staring, temper tantrums, behavioral outbursts

    • syncope

    • syncopal seizures

    • panic attack

    • psychogenic

    • complex migraine: often with basilar symptoms

  • PE: sequential events worsens

  • Important: first symptoms, second symptoms

  • syncope: global ischemia of brain and transient LOC

    • arrythmia: afib

    • reflex bradycardia from treating afib

    • outflow: stenosis

    • dysautonomia: arteries don't constrict. HR don't increase

      • Diabetes common cause

    • hypovolemia

  • Epilepsy

    • recurrent under normal conditions

  • seizures early: encephalitis

  • seizures later: meningitis

  • recurrent episodes of unexplained confuseion with spontaneous recover usually result of epileptic seizures

  • fake: flopping, have to hold down, punching (directed behaviors), vague episodes, pelvic thrusting, back arching

Focal Seizures

  • focal spikes on EEG

  • temporal lobe: deja vu (hippocampus), smell (olfactory), fear/rising sensations in stomach (amygdala), auditory (auditory cx)

  • complex partial seizures most common in adults

  • aura: simple partial seizure creating hallucinations that rest of brain perceives

Tonic Clonic

  • spikes everywhere

  • tonic: rigid, stiffen, drew up

  • clonic: jerking

  • epileptic 'cry': diaphragm contracts

  • postictal confusion

Treatment

  • ethusuxomide not used for partial

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