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CH: EXAM 2: Seizure types
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Terms in this set (21)
what is a seizure ?
A seizure is uncontrolled brain activity that results in an abrupt change in sensory perception or motor activity.
what are the 3 classifications of seizures?
Seizures are classified as partial, generalized, and unclassified, and can range from simple to complex.
list the four types of generalized seizures.
types of generalized seizures include tonic clonic, absence, myoclonic, and atonic or akinetic.
list the two types of partial seizures.
types of partial seizures include, simple partial and complex partial. this type of seizure arises from a specific area of the brain and cause limited symptoms
explain infantile spasms
Infantile spasms involve spasms of the neck, arms, legs or trunk. This type of seizure can involve brief loss of consciousness and tends to occur in children between 4 to 8 months old when they are asleep or waking up. these can be benign however the majority of children who have infantile spasms, who also had complicated births or pregnancies, go on to develop west's syndrome and may eventually develop partial or generalized seizures.
arms legs neck or truck loss of consciousness
happens during sleep
4-8 months of age
most develop seizure disorders
expalain febrile seizures.
Febrile seizures occur in children between 9 months and 5 years of age. They can be simple or complex, clonic or tonic clonic. Simple febrile seizures last less than 15 minutes, and don't recur in 24-hours. complex febrile seizures have focal attributes, last longer than 15 minutes ,and recur on the same day.
fever causes seizure
9 months to 5 years old
simple = less than 15 mins
complex =more than 15 mins and reoccurs in 24
what is an unprovoked first seizure?
unprovoked first seizure is a seizure that occurs without a known cause. most of these children will have a second seizure. Laboratory testing may include glucose, electrolytes, toxicology screening, or metabolic testing. A lumbar puncture is only considered if meningeal signs, such as stiff neck or headache, are present. An EEG may be helpful in determining the presence of focal abnormalities.
no know cause
most have another seizure
lab testing will look at glucose,metabolism, toxins, electrolytes
lumbar puncture if they have stiff neck and head ache
EEG to determine where the seizure is coming from
explain epileptic seizures in children.
epileptic seizures are defined as the presence of more than one unprovoked seizure that occur at least 24 hours apart. Childhood epilepsy is usually considered a benign condition that is attributed to CNS immaturity. Most children who experience epileptic seizures will be free of seizure activity and can discontinue medication by 23 years of age.Factors that contribute to a poorer prognosis include onset of seizures in infancy or adolescence, difficulty in managing seizure activity, and presence of a developmental disorder such as cerebral palsy.
more than 1 seizure more than 24 hours apart
attributed to CNS immaturity
most stop having seizures and do not need meds by 23 years old .
cerebral palsy, difficult to manage seizures, infant or adolescent onset have a poor prognosis
what is an epileptogenic focus?
the epileptogenic focus is the area of the brain a seizure originates from. the location of the Focus determines the nature of the seizures
what is status epilepticus?
Status epilepticus is a prolonged seizure or series of convulsions where loss of consciousness occurs for at least 30 minutes. it is an emergency.
Refractory seizures last more than 60 minutes.
what is epilepsy ?
Epilepsy refers to a chronic seizure disorder often associated with central nervous system pathology.
Partial seizures will have symptoms associated with the area of the brain affected. movements are asynchronous involve only the face, neck, or extremities . Consciousness is maintained and patients may be able to talk through the seizure
explain a simple partial seizure
simple partial seizures can be manifested at any age. movements numbness, tingling, or painful sensations start in a specific location like the fingers on one hand and march through adjacent muscle groups toward the body. The child may have sensory hallucinations involving sight, sound, smell and taste. The child may also report feeling emotional or anxious.
seizure begins in very specific area and marches up
movements involve one extremity or head and eyes
seizure can be movements or paralysis
conscious during seizure
hallucinations and emotions experienced during siezure
explain complex partial seizures
complex partial seizures can occur from 3 years of age through adolescence. Children report feelings of anxiety, fear, deja vu, abdominal pain, or sensory hallucinations. child will not lose consciousness but appear confused or dazed, stares into space, and performs automatisms. seizure is followed by postictal period where child experiences drowsiness is aphasic, or has sensory or motor deficits and they do not remember the seizure
has an aura before seizure
conscious during seizure but confused
does not remember
what are automatisms?
automatisms are repeated non-purposeful actions, such as lip smacking, chewing, sucking, or uttering the same word over and over, wander aimlessly, or remove clothing.
what is a general seizure?
general seizures arise from both hemispheres, can occur anytime and last seconds to hours. They are not preceded by an aura like partial seizures. There is always loss of consciousness. movements involve bilateral and symmetrical spasms. There are four types of generalized siezures: tonic clonic, absence, myoclonic, and akinetic. children who have these before age 4 tend to have behavior, learning, and developmental delays.
both sides of brain
loss of consciousness
4 types: tonic clonic, absence, myoclonic, and akinetic
explain what happens in a tonic clonic seizure.
tonic clonic seizures were formerly referred to as grand mal seizures. they can occur at any age. Onset is usually abrupt. child loses consciousness and falls to the ground. the tonic phase is first, it lasts 10 to 30 seconds and involves intense muscle contractions. The airway, oxygenation and ventilation are compromised. The neck and legs extend while the arms flex. The eyes roll upward or deviate to one side, the pupils dilate, and there may also be bladder or bowel incontinence. During the clonic phase, jerking movements are produced. salivation causes breathing difficulty and partial airway obstruction. Bladder and bowel incontinence are not uncommon. Clonic spasms dissipate can last from 30 seconds to 30 minutes after onset of the seizure
loss of consciousness occurs
starts with tonic 10-30 seconds
ends with clonic 30 seconds to 30 minutes
tonic is intense muscle contraction
clonic is jerking
airway, oxygenation and ventilation are compromised
incontinence may occur
postictal period can last minutes to hours
child has no memory of the event
may have poor coordination, slurred speech, and fatigue
what are absence seizures?
absence seizures were formerly called petit mal seizures. most begin between ages 4 to 8,but they can begin in adolescence. transient loss of consciousness appears as cessation of current activity. The child seems to stare into space or the eyes may roll upward with ptosis or fluttering of the lids. There also may be lip smacking or a loss of muscle tone causing the head to droop or any objects in the hands to be dropped. absence seizures last from 5 to 10 seconds and can occur hundreds of times per day. Children with this type of seizure are often accused of daydreaming and being inattentive in school. Absence seizures respond well to medication and usually spontaneously resolve during adolescence
mostly ages 4-8 onset
brief loss of consciousness looks like daydreaming
occurs hundreds of times a day
lasts 5-10 seconds
responds well to medication
what are myoclonic seizures?
myoclonic seizures are sudden repeated contractions of the muscles of the head, extremities, or torso. These seizures can begin as young as 6 months, in early childhood, or adolescence, and occur when the child is drowsy and just falling asleep, or just waking up. There is no loss of consciousness, no postictal period, and the child recovers quickly. Complex and progressive myoclonic epilepsy have poor outcomes. They can result in cognitive and development delays, and can be difficult to control.
sudden repeated contraction of muscles
can begin anytime between 6 months to adolescence
occur when child is sleeping or waking up
no loss of consciousness no postictal period
what are atonic or akineteic seizures?
akinetic seizures occur between ages 2 and 5 years of age. akinetic seizures present as a sudden loss of muscle tone with the head dropping forward for a few seconds. In some seizures the child may exhibit only a head drop or nod. others they may lose consciousness and fall to the ground face first. In either case, amnesia follows. These seizures often cause repetitive head injuries if the child is not protected by wearing a football or hockey helmet. Many have underlying brain abnormalities and are mentally retarded.
2-5 years of age
sudden loss of muscle tone head nod or falls face first
no memory of seizure
repetitive head injuries must wear helmet
typically underlying brain issues
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