# 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
