Seizure

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PRODROMAL PHASE:

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subjective feeling or sensation that may serve as a warning sign of seizure onset for those who experience it

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AURAL PHASE

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considered an early part of the seizure

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ICTAL PHASE

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most people are familiar with and would identify as a seizure which manifests in different ways for each person with epilepsy

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POST ICTAL PHASE

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recovery period following a seizure where some people recover immediately, while others may require minutes, hours or days to feel like they’re back at their baseline.

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Simple Partial Seizure

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No impairment of consciousness. Usually last for 20-60 sec

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Complex Partial Seizure

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Most common and consciousness may be impaired. Usually last for 30 sec–2 min

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Partial w/ Secondarily Generalized Seizure

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Simple or complex that may evolve in generalize seizures

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TONIC

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Sudden stiffness or tension in the muscles of the arms, legs or trunk that lasts about 20 second

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CLONIC

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Repeated jerking movements of the arms and legs on one or both sides of the body, sometimes with numbness or tingling

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Tonic-Clonic (Grand Mal)

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Characterized by sudden loss of consciousness followed by sustained contraction of muscles (tonic – 1 min) then series of jerks (clonic-2-4min)

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ATONIC DROP ATTACKS

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Characterized by sudden loss of postural tone and head drops for few seconds or drop to ground.

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EPILEPTIC SPASMS

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sudden flexion, extension or mixed flexion-extension of proximal and truncal muscles, lasting 1-2 seconds

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ABSENCE SEIZURES

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Brief episodes of unconsciousness (4–20 seconds, usually <10 seconds) with no warning and immediate resumption of consciousness (no postictal abnormality).

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GENERALIZED SEIURES (general onset)

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Affects the whole brain.

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Partial seizures ( focal brain region)

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Begin foscally in the cortex

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Epilepsy

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common neurologic disorder affecting -0.5-1% of the population worldwide. • Characterized by recurrent seizures often accompanied by episodes of unconsciousness and / or amnesia.

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Seizure

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transcient alteration in behaviour because of disordered firing of groups od brain neurons.

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Convulsion

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involuntary, violent and spasmodic / prolonged contraction of the skeletetal muscle

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Behavior arrest

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characterized by a decrease in amplitude and/or rate or arrest of ongoing motor activity during the seizure. Because brief _________ is common and difficult to identify at the start of many seizures, the arrest must be persistent and dominant through the entire seizure.

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Status epilepticus

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Abnormal electrical activity in the brain that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes is called

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Convulsive status epilictus

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Status epilepticus with convulsions may be more likely to lead to long-term injury. Convulsions may involve jerking motions, grunting sounds, drooling, and rapid eye movements.

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Nonconvulsive status epilictus

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People with this type may appear confused or look like they're daydreaming. They may be unable to speak and may be behaving in an irrational way.

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LENNOX-GASTAUT SYNDROME

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A type of epilepsy with multiple different types of seizures, particularly tonic (stiffening) and atonic (drop) seizures.

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LENNOX-GASTAUT SYNDROME

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Intellectual development is usually delayed and often worsens over time. Behavioral problems, including hyperactivity, agitation, aggression and autism, are common.

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Lennox-gastaut syndrome

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is a type of “epileptic encephalopathy.”

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Lennox-gastaut syndrome

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Accounts for only 2 to 5% of childhood epilepsies.

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Dravet syndrome

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(Severe myoclonic epilepsy of infancy) is a rare genetic epileptic encephalopathy characterized by diverse generalized and focal seizure types, including myoclonic seizures, tonic-clonic seizures, absence seizures, atonic seizures, and one-sided hemi-convulsive and focal seizures.

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Dravet's syndrome

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are caused by mutation in the SCN1A gene, which is required for the proper function of brain cells.

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Mild seizures

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use of a single drug is preferred ( Monotherapy)

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Hard-To-Control Seizures

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multiple drugs are usually used simultaneously (Multidrug therapy) • Treatment is Palliative

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temporal lobe resection

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The most commonly performed epilepsy surgery is ___________ for mesial temporal lobe epilepsy; extratemporal cortical resection, when indicated, is less successful.

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Convulsive status epilepticus

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consisting of repeated generalized tonic-clonic seizures with persistent postictal depression of neurologic function between seizures

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Nonconvulsive status epilepticus

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persistent change in behavior or mental processes with continuous epileptiform EEG but without major motor signs

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Focal status epilepticus

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with or without altered awareness

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IV Diazepam/Lorazepam is the DOC

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For Absence Seizures going into status epilepticus:

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Teratogenicity

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Most women with epilepsy who become pregnant require continued antiseizure drug therapy for seizure control.