Seizures

Seizures include tonic clonic, abscence and status epileptics. Simple partial and complex partial as well.  

Simple and complex partial seizures can be treated with medical drugs.  

Seizure pharmacology part II. Mnemonic to remember epilepsy drug treatments.  

 

A seizure is a neurological event where there is a synchronous discharge of many neurons. Each individual has a ‘threshold’ at which their neurons will begin to do this. It is thought that this threshold is at least partly genetically determined. This threshold can be affected by: External stimulation – e.g. flashing lights Cerebral injury  

In 85% of patients, the diagnosis comes from the history; blood tests, electrocardiography, electroencephalography, and sometimes magnetic resonance imaging are important for classification and risk prediction  

In 85% of patients, the diagnosis comes from the history; blood tests, electrocardiography, electroencephalography, and sometimes magnetic resonance imaging are important for classification and risk prediction  

Stream How to manage the first seizure in an adult by BMJ talk medicine from desktop or your mobile device  

In 85% of patients, the diagnosis comes from the history; blood tests, electrocardiography, electroencephalography, and sometimes magnetic resonance imaging are important for classification and risk prediction  

Focal epilepsies are caused by abnormal electrical discharges in specific (localised) parts of the brain. In most people the resulting epileptic seizures can be controlled with medication. In up to 30% of people these seizures are not controlled by medication. If the site of origin of these signals (the epileptogenic zone) can be located from the description of the seizures, or from magnetic resonance imaging (MRI) (a medical imaging scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body) and electroencephalography (EEG) findings (recording of electrical activity along the scalp) the person should be offered the chance of having the epileptogenic zone removed. We studied the factors (characteristics of the people undergoing surgery and details of surgery type) that might be linked to the best chance of surgical cure of epileptic seizures.  

Traumatic head injury is a frequent event and can injure the brain. This severe injury is often followed by seizures (fits), which may worsen the damage and can lead to chronic epilepsy, a neurologic disorder characterized by frequent recurrent seizures. Antiepileptic drugs are usually given to suppress already diagnosed seizures. Their role in curing the disease and preventing the development of epilepsy in people who are considered at risk for seizures after any brain injury, including head trauma, is not well understood.  

Paul Offit likes to tell a story about how his wife, pediatrician Bonnie Offit, was about to give a child a vaccination when the kid was struck by a seizure. Ha…  

Experts recommend clinicians approach patients on an individualized basis in terms of whether to treat with an antiepileptic drug following a first unprovoked seizure.  

A small study has trialled a marijuana extract in people with severe epilepsy. Seizures decreased among the participants, though 6% stopped taking the drug after side effects.  

In the latest Case Record of the Massachusetts General Hospital, a 9-year-old girl presented to the emergency department with loss of consciousness and a seizure. She had returned from a trip to Puerto Rico 3 weeks earlier. Unilateral inguinal lymphadenopathy was present, and rapidly progressive encephalopathy developed.  

You are on your PEM shift overnight when a 9 year old boy with history of behavior disorder, BIBEMS only moments (<30min) after witnessed ingestion of 500mg of his grandmother’s amitriptyline. On arrival, ABC’s intact, and the patient is sleepy but easily arousable. Normal vitals for his age. An EKG is performed, which appears normal. QRS 92 and the terminal R wave in aVR is <3mm. You are just about to given charcoal when the patient has a tonic-clonic seizure.  

Lacosamide is an antiepileptic drug that can be added along with others to treat people who have certain types of epileptic seizures. This drug may be beneficial for people who are taking other antiepileptic medication but continue to have seizures. This review looked at how well lacosamide works when added to a patient's daily medication and also looked at some of the harms or side effects of the drug.  

Your patient arrives by ambulance having a seizure.  EMS administered ativan 10 minutes ago.  You give a second dose but the seizure continues.  What should you do?  

 

Epilepsy is a common neurological disorder in which recurrent seizures are caused by abnormal electrical discharges from the brain. We studied two types of epileptic seizures in this review; generalised onset seizures in which electrical discharges begin in one part of the brain and move throughout the brain, and partial onset seizures in which the seizure is generated in, and affects one part of the brain (the whole hemisphere of the brain or part of a lobe of the brain). For around 70% of people with epilepsy, generalised onset or partial onset seizures can be controlled by a single antiepileptic drug. Worldwide, phenytoin and carbamazepine are commonly used antiepileptic drugs, however carbamazepine is used more commonly in the USA and Europe due to concerns over side effects associated with phenytoin. Phenytoin is still commonly used in developing countries in Africa, Asia and South America due to the low cost of the drug.