SEIZURE

S
BY : Ainul Arina Madhiah

DEFINITION OF SEIZURE AND

EPILEPSY
SEIZURE :

A PAROXYSMAL STEREOTYPE DISTURBANCE OF CONSCIOUSNESS,

MOTOR FUNCTION, SENSATION, EMOTION, BEHAVIOUR OR PERCEPTION THAT ON CLINICAL

GROUND RESULT FROM CORTICAL NEURONAL DISCHARGE

EPILEPSY : RECURRENCE, USUALLY UNPROVOKED EPILEPTIC SEIZURE THAT

RESULTED FROM FROM EXCESSIVE SYNCHRONOUS AND ABNORMAL FIRING PATTERN OF
CEREBRAL CORTICAL NEURONS.

TYPE OF SEIZURES

EEG
( electroencephalography)

DIFFERENTIAL
DIAGNOSIS
OF SEIZURE

Differential
Diagnosis
Of epileptic
seizure

SYNCOPE VS EPILEPSY

CARDIAC SYNCOPE VS EPILEPSY

Clear precipitating stimulus or

situation
- prolonged standing
- frightening
- emotional or unpleasant
scenes
- painful stimuli
- vasalva maneuvers
Prodromal symptoms
Brief period of unconsciousness
Rapid recovery
Absence of any true post ictal
phase
Sx : pallor, rapid pulse, profuse
sweating, nausea, vision blurs,
losses of muscle tone

Palpitation
Chest pain
SOB
Attacks with little relation to
posture, position or specific
triggers
Bradyarrythmias /
tachyarrhythmias

Both syncope can be

accompanied by :
Brief myoclonic twitches of
extremities
Urinary incontinence
Tongue bitting
Thus, mislead people to think it

Non epileptic attack disorder

(NEAD)
Distinguish by clinically + EEG
Triggers (frustration)
Duration (usually very prolonged)
Erratic movement (flailing, pelvic
thrusting)
Remaining pink and breathing
Resisting eye opening n eye
contact
Often prompt recovery
More commoner in :
- female
- adolescene
- early childhood

INVESTIGATION OF
SEIZURE

Aim of investigation :

Investigation :

History
Clinical examination
Renal profile
Liver function test
Blood glucose
Serum calcium and
magnesium
ABG

CSF
EEG
ECG
CXR
ECHO
Infective Screening

MANAGEMENT OF
SEIZURE

Send pt to hospital
if :
Persistent
seizure >5m
Not regain
consciousness
>30 m
Serious injury
significant fever
Increase
frequency of
seizure

Remove harmful
object

Initial
supportive
mx
gather information and pt bavkground
of epilepsy
Stay with patient until
they recover

Left lateral position and

place head over soft
support
Put on smooth
surfaces

Loosen tight
clothing

Dont put anything in pts

mouth

Post-ictal care in uncomplicated case

(hospital)
put on
oxygen

Check
reflo

Take all blood

investigation
check
ABG

Treatment of Prolonged
Seizure
Monitor all vital sign and ECG
Continue in left lateral position
ABC
( airway , breathing, circulation )
Oxygen support
If hypoglycemic , give IV 50cc 50%
glucose
If Wernickes enceph suspected :
thiamine 100mg
Antiepilepsy drug (AED) can be
started

SEIZURE > 5 MINUTES

When do we start our treatment ?

SINGLE
SEIZURE :

RECURRENT SEIZURE :

THANK YOU ~