1(E): Seizure

Question 1

Define Seizure

Answer 1

Irregular electrical activity in the brain due to hyper excitability of neutrons

Question 2

How are seizures classified

Answer 2

• Aetiology

- Clinical Presentation

Question 3

What are unprovoked seizures

Answer 3

Epileptic seizures

Question 4

What can predispose to unprovoked seizures

Answer 4

Hypoxic-Ischaemic Injury

Genetic

Question 5

What are provoked seizures

Answer 5

Dur to underlying cause

Question 6

What are commonest cause of seizures in neonates

Answer 6

• Hypoxic Injury
• Metabolic
• Congenital

Question 7

What are common causes of seizures in infants

Answer 7

• Febrile
• Infection
• TBI

Question 8

What are common causes of seizures in adolescents

Answer 8

• Infection
• TBI
• Illicit drug-use

Question 9

What are common causes of seizures in young-adults

Answer 9

• TBI
• Alcohol withdrawal
• Illicit drug-use

Question 10

What are common causes of seizures in adults

Answer 10

• Alcohol withdrawal
• Stroke
• SOL
• Metabolic abnormalities

Question 11

How are seizures classified

Answer 11

• Focal
• Generalised
• Unknown

Question 12

What are focal seizures

Answer 12

• Occur in one hemisphere

Question 13

Where do focal seizures with impaired consciousness present

Answer 13

• Temporal Lobe Seizure (80%)

Question 14

If a seizure originates in frontal lobe what are 5 key features

Answer 14

• Peddling legs
• Jacksonian march
• Behavioural disturbance
• Dysphasia

Question 15

If seizure originates in parietal lobe what are the features

Answer 15

Sensory

Question 16

If seizure originates in occipital lobe what are the features

Answer 16

Visual

Question 17

Where do focal seizures with impaired awareness arise

Answer 17

Temporal lobe (80%)

Question 18

What is a classical feature of temporal lobe seizures before it occurs

Answer 18

Aura - visual, auditory or gustatory hallucinations

Question 19

What are features during the seizure that are characteristic of temporal lobe seizures

Answer 19

• Deja Vu
• Jamais Vu
• Automatisms
• Epigastric rising
• Emotion
• Bizarre associations
• LOC
• Delusions

Question 20

What is post-ictal state of temporal lobe seizures

Answer 20

Post-Ictal Confusion

Question 21

What is an acronym to remember seizure causes

Answer 21

HEAD

Hallucinations
Epigastric rising, Emotion
Automatisms
Deja vu, Delusions

Question 22

What are generalised seizures

Answer 22

Start in both hemispheres

Question 23

What are four-types of absence seizures

Answer 23

• Atonic
• Generalised T-C
• Myoclonic
• Absence

Question 24

What are absence seizures

Answer 24

Brief pauses for 10s

Question 25

When are absence seizures more common

Answer 25

Childhood

Question 26

Explain tonic-clonic seizures

Answer 26

Individual goes stiff and then jerks uncontrollably. Associated with LOC, Tongue-biting, Incontinence. Post-Ictal Confusion.

Question 27

What is myoclonic seizure

Answer 27

Violent disobedient jerking limb or face

Question 28

What are atonic seizures

Answer 28

Sudden loss of muscle tone

Question 29

What is sheldon's questionnaire

Answer 29

Used to determine if likely seizure. More than one indicates seizure, less than one indicates syncope.

Question 30

What should be ordered in seizures

Answer 30

- FBC, Blood Culture - U+E - Toxicology - ECG - MRI