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Seizure
Seizures

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Presentation

CASE REPORT: We present the case of a 16-year-old male who presented on two separate occasions after a tonic-clonic seizure with hip pain, an antalgic gait, and marked discomfort on hip flexion. [ncbi.nlm.nih.gov]

Neurologic

  • Generalized Seizure

    They can cause some of the same physical symptoms as a generalized seizure, like convulsions or muscle slackness. [webmd.com]

    Generalized Seizures Section Generalized seizures occur when there is widespread seizure activity in the left and right hemispheres of the brain. [epilepsyontario.org]

    Atonic Loss of muscle tone Generalized seizures There are six types of generalized seizures. The most common and dramatic, and therefore the most well known, is the generalized convulsion, also called the grand-mal seizure. [medicinenet.com]

    SLIDESHOW Epilepsy: Symptoms, Causes and Treatment See Slideshow Generalized Seizures in Epilepsy Epilepsy that causes generalized seizures is more common in children than in adults. [emedicinehealth.com]

    Abnormal electrical activity involving a larger portion or the whole of the brain are referred to as generalized seizures. Examples of generalized seizure include: Absence seizure - Where a person appears inattentive for a short period. [news-medical.net]

  • Focal Seizure

    Focal Seizures Doctors break these into three groups: Simple focal seizures: They change how your senses read the world around you: They can make you smell or taste something strange, and may make your fingers, arms, or legs twitch. [webmd.com]

    Focal seizures may also be called partial seizures. With focal seizures, particularly with complex focal seizures, the child may experience an aura before the seizure occurs. [beaumont.org]

    There are two types of focal seizures: Focal seizures with retained awareness This type of focal seizure was previously known as a simple partial seizure. [epilepsyontario.org]

    Focal seizures Focal seizures occur when one area (or lobe) of the brain is affected by abnormal electrical activity. The symptoms and level of consciousness depend on the area of the brain involved. [youngepilepsy.org.uk]

    Focal Seizures Focal seizures begin with an abnormal electrical discharge restricted to one small region of the brain. [nyulangone.org]

  • Atonic Seizures

    They may start in the same part of the brain as an atonic seizure, and some people have both myoclonic and atonic seizures. Absence (or petit mal) seizures: You seem disconnected from others around you and don’t respond to them. [webmd.com]

    If this is the first observation of an absence seizure, medical evaluation is recommended. Atonic (also called a drop attack) : Atonic seizures cause loss of muscle tone. In fact, Atonic literally means “without tone” so the muscles become weak. [efepa.org]

    Atonic seizures are also called “drop attacks,” “drop seizures” or “akinetic seizures.” During an atonic seizure, a child usually remains conscious. The seizure typically lasts less than 15 seconds. [gillettechildrens.org]

    […] awaken Atonic Seizures or Drop Attacks brief seizures, short duration cause an unexpected and rapid fall to the ground can result from tonic (stiffening) or atonic (sudden loss of tone) events difficult to treat high risk of injury Disorders that Mimic [barrowneuro.org]

  • Neonatal Seizures

    The outcomes for babies who have neonatal seizures depend on the type of seizure and the underlying cause. Some neonatal seizures are mild and short-lived and therefore do not cause any lasting health problems. [ucsfbenioffchildrens.org]

    […] occur in 25 to 75% of patients who have brain contusion, skull fracture, intracranial hemorrhage, prolonged coma, or focal neurologic deficits. † Fifth day fits (benign neonatal seizures) are tonic-clonic seizures occurring between 4 and 6 days of age [msdmanuals.com]

  • Jacksonian Seizure

    A focal aware seizure may progress to a focal impaired-awareness seizure. Jacksonian seizures are a type of focal aware seizures. Symptoms start in one hand or foot, then move up the limb as the electrical activity spreads in the brain. [merckmanuals.com]

Workup

Diagnostic workup revealed a giant middle cerebral artery aneurysm without evidence of subarachnoid or intracerebral hemorrhage. [ncbi.nlm.nih.gov]

Most patients will be admitted to a telemetry floor for close monitoring, further workup, and treatment of their underlying condition. [emedicine.com]

However, every child with ASD and seizures should have a comprehensive medical workup for known medical disorders. [tacanow.org]

EEG

  • Epileptiform Activity

    Electroencephalogram (EEG) was negative for epileptiform activity. A diagnosis of seizure in the setting of dementia with Lewy bodies (DLB) was deemed probable. [ncbi.nlm.nih.gov]

    Temporal epileptiform and nonepileptiform activities, mostly unilateral, were found in both groups. Extratemporal epileptiform activities (frontal, parietal, central, occipital and generalized) were also found equally in both groups. [dx.doi.org]

    Since altered awareness occurs with even brief bursts of spike-wave paroxysms on EEG, treatment should be titrated to suppressing all epileptiform activity. The decision to start antiepileptic medication must be made with great care. [reference.medscape.com]

Treatment

RESULTS: Rapid initiation and escalation of status epilepticus treatment has been associated with shortened seizure duration and more favorable outcomes. [ncbi.nlm.nih.gov]

Prognosis

The current study aimed to perform a comprehensive meta-analysis to investigate the correlation of isocitrate-dehydrogenase 1 (IDH1), an important molecular biomarker for glioma classification and prognosis, to preoperative seizure incidence in LGG. [ncbi.nlm.nih.gov]

The management and prognosis is the same as for classical febrile convulsions. Acute Management Treat the convulsion when necessary as per Convulsions guidelines. * Reassurance is important in simple febrile convulsions. [rch.org.au]

Retrieved December 3, 2018, from https://www.uptodate.com/contents/etiology-and-prognosis-of-neonatal-seizures Neonatal Seizures. (2018, August 09). [abclawcenters.com]

Etiology

The choice of antiepileptic drug is typically based on seizure type, and there is no evidence for superior effectiveness or potential deterioration of particular antiepileptic drug in specific etiologic subgroups. [ncbi.nlm.nih.gov]

In children with TLE of different etiologies there is a wide clinico-electroencephalographic diversity 2,10-13. [dx.doi.org]

Epidemiology

The classification of seizures in old age in epidemiologic studies is rarely satisfactory. [dictionary.cambridge.org]

Epidemiology Age-adjusted incidence of epilepsy in North America ranges between 16/100,000 and 51/100,000 person-years. The age-adjusted prevalence ranges from 2.2/1000 to 41/1000 depending on the country. [ncbi.nlm.nih.gov]

The epidemiology of the epilepsies. Handbook of Clinical Neurology. 107. pp. 113–33. doi:10.1016/B978-0-444-52898-8.00006-9. ISBN 9780444528988. PMID 22938966.; Sander JW, Shorvon SD (1996). "Epidemiology of the epilepsies". [en.wikipedia.org]

Epidemiology Incidence in the United States The incidence of absence seizures in the United States is 1.9-8 cases per 100,000 population. [reference.medscape.com]

Randomized Controlled Trials - CONSORT - Consolidated Standards of Reporting Trials Observational Studies - STROBE - Strengthening the Reporting of Observational studies in Epidemiology Systematic Review of Controlled Trials - PRISMA - Preferred Reporting [elsevier.com]

Pathophysiology

This case report discusses the pathophysiology of post-ictal desaturations and breathing abnormalities during seizures and their possible association with sudden unexpected death in epilepsy. [ncbi.nlm.nih.gov]

Expression of this gene in the developing brain may help explain an age-related onset and remission in childhood absence epilepsy. [20] Pathophysiology The pathophysiology of absence seizures is not fully understood. [reference.medscape.com]

The difference in response probably reflects the different pathophysiologic mechanisms in the various types of seizure and the specific epileptic syndromes. [emedicine.medscape.com]

Pathophysiology of disease : an introduction to clinical medicine (6th ed.). New York: McGraw-Hill Medical. ISBN 978-0-07-162167-0.CS1 maint: extra text: authors list (link) ^ a b c d e Bradley, Walter G. (2012). "67". [en.wikipedia.org]

Prevention

CONCLUSION: Improved preventive care, seizure detection, and rescue medication education may advance pre-hospital management, and we propose the use of acute status epilepticus intervention teams to initiate and incorporate in-hospital interventions as [ncbi.nlm.nih.gov]

Also, preventing seizures prevents the injuries and accidents that may occur because of a seizure. [msdmanuals.com]

The main thing is to prevent them from injuring themselves. Put something soft under their head, remove any sharp or unstable objects from the area and stay with them. There is no danger they will swallow their tongue. [healthdirect.gov.au]

But someone who has recurrent seizures may need treatment with daily anti-seizure medications to control and prevent future grand mal seizures. Symptoms Grand mal seizures have two stages: Tonic phase. [mayoclinic.org]

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