Epilepsy

Question 1

What is it?

Answer 1

A disorder characterized by recurrent seizures (repetitive abnormal electrical discharges within brain)

Question 2

Signs and symptoms

Answer 2

• altered consciousness
• altered motor activity
• sensory phenomena
• autonomia phenomena
• cognitive phenomena

Question 3

Altered motor activity

Answer 3

• characterized by involuntary contractions of muscles; tonic activity (stiffening and rigidity of muscles); clonic activity (rhythmic jerking of extremities)

Question 4

Autonomic phenomena

Answer 4

associated with sudden attack of anxiety, tachycardia, sweating, piloerection, abnormal sensation rising up in upper abdomen and chest

Question 5

cognitive phenomena

Answer 5

sudden failure of comprehension, inability to communicate, intrusion of thought, illusions, hallucinations, affective disturbances (intense feelings of fear, anger, and hate)

Question 6

Common causes of seizures

Answer 6

• acquired brain disease or trauma, tumor, stroke
• degenerative brain disease (Alzheimers, amyloidosis)
• drug overdose
• drug withdrawal
• electrolyte disorder
• hyperthermia
• infection
• pregnancy complications: eclampsia

Question 7

Generalized seizure

Answer 7

all areas of the brain (cortex) are involved
- aka grand mal seizure

Question 8

symptoms of grand Mal seizure

Answer 8

• dramatic loss of consciousness, with stiffening, then rhythmic movements of the arms and legs; eyes are generally open; breathing is altered; loss of urine is common

Question 9

how long do grand Mal seizures last

Answer 9

typically 2-5 mins

Question 10

post grand mal seizure

Answer 10

• consciousness is gradually regained ; person typically confused, drowsy, and amnesiac after the event; may last several hours

Question 11

absence or petit mal seizure

Answer 11

• posture is maintained, repetitive blinking or other small movements may be present
• typically brief, lasting only a few seconds; may occur many times in a day

Question 12

Partial or focal seizure

Answer 12

• only one part of brain is involved; symptoms are formal

Question 13

complex partial seizure

Answer 13

person appears dazed or confused, not fully alter or unconscious

Question 14

temporal lobe seizure

Answer 14

characterized by episodic changes in behavior, with complex hallucinations; automatisms (lip smacking, chewing, pulling on clothing); altered cognitive emotional function; preceded by an aura

Question 15

secondarily generalized seizures

Answer 15

simple or complex partial seizure evolving to a generalized seizure

Question 16

status epilepticus

Answer 16

prolonged seizure or a series of seizures (lasting > 30 minutes) with very little recovery between attacks; or a seizure lasting longer than 5 minutes; may be life threatening, medical emergency

Question 17

examining/determining seizures

Answer 17

• time of onset, duration, type
• patient activity at onset, aura
• sensory elements, motor activity
• presence of tongue biting, incontinence, respiratory distress
• behavioral elements, changes in mood
• responses after seizure

Question 18

medical interventions

Answer 18

• antiepileptic drugs: phenytoin, carbamazepine, phenobarbital
• surgical intervention: lobe resection, hemispherectomy

Question 19

what to do

Answer 19

remove potentially harmful nearby objects, loosen restrictive clothing, and do not restrain limbs
- establish airway, prevent aspiration by putting them sidelying