seizure¶

imbalance in the excitation and inhibitory neuronal synapses in the cerebral cortex or limbic system.

Epilepsy¶

lower seizure threshold and an inherently higher risk of recurrent seizures in a lifetime.

Tonic¶

Muscles become stiff and rigid, often leading to falls.

clonic¶

involve repeated, rhythmic jerking or twitching movements

Status epilepticus¶

Status epilepticus is a single seizure ≥5 minutes in length or two or more seizures without recovery of consciousness between seizures

Refractory Seizures¶

Refractory status epilepticus is defined as persistent seizure activity despite the IV administration of adequate amounts of two antiepileptic agents and usually exceeds 60 minutes

Causes¶

fever + seizure = meningoencephalitis
tachycardia and hypertension + seizure = Symphomimetic intoxication
hypertension and bradycardia[ cushing triad ] + Seizure = Brain Herniation syndromes

Classification of Seizures based on Region and Symptoms¶

History taking for future saftey of Seizure¶

-abrupt onset - Aura + ,triggers,drugs, medication non-adherence ,sleep - duration - Seizures rarely last longer than 60 to 120,excpet status epilepticis - Alteration of consciousness - concious usuallay in focal seizures - unconcious in Generalised seizures - Purposeless, stereotypic, and nonsuppressible - Automatisms and undirected tonic-clonic movements with gentle attempt to suppress clonic activity dxd from Tremors vs Seizures -

DXD seizures¶

1. able to stop clonic activity of limb = nonepileptic spells or movement disorders 2. persistent mydriasis = anticholinergic or sympathomimetic toxicity

Seizure Algo¶

Signs of CNS emergency¶

Diagnosis¶

NOTHING is 100% diagnosis of Seizure
Convulsive syncope = when cerebral perfusion block ,leads to tonic extension of trunk and myoclonic jerky extermities