CONVULSION / FITTING

By

Jawad Ahmed
Aman Foundation
 GOALS
• Introduction (Definations & Causes)
• Medication
• Medical Investigation
• Mangement (PDI’s)
 INTRODUCTION
• What is a Seizure (Convuslions)?

• A seizure is a sudden change in behavior

that is the consequence of brain
dysfunction.

• It is an abnormal firing of Brain cells,

usually resulting in twitching movements.
 CAUSES
• Cardiac Arrest (anoxia-lack of oxygen)
• Diabetes (low/high blood sugar)
• Drugs (cocaine, amphetamine)
• Eclampsia (due to pregnancy)
• Epilepsy (unknown cases)
• Fever (febrile fits-in children)
• Hypoxia (inadequate oxygen)
• Meningitis (infection of brain membranes)
• Trauma
• Tumour
 FOCAL FIT
(partial seizures)
• It affect enough of the brain to cause
symptoms
• It does impair consciousness---simple
• It does not affect the whole brain---partial
• It start localized and remain localized
• It occurs at one part of the body only
• It is also known as Simple/Partial Fits
 NON-FOCAL
(complete seizure)
• Most common type in epileptic patients
• Loss of conscious is common
• It start localized then become generalized
• It usually relates with breathing issues
• It occurs on the complete body
• It is also known as Complex/Complete Fits
 Generalized tonic-clonic seizure
• Tonic phase lasts for 10-20 seconds
• Sudden LOC, loss of posture, arms flex,
eyes deviate upward
• Extension of back, neck, arms, legs
• Involuntary crying out
• Powerful contractions
 Generalized tonic-clonic seizure
• Clonic phase lasts for 90 seconds:
• Brief, violent, generalized flexor
contractions alternating with progressively
longer muscle relaxation
• Cyanosis
• Cheek or tongue biting, salivation
• Loss of bowel, bladder control
 FEBRILE FIT
• Generalized tonic clonic convulsions which
occasionally occur at the onset of acute extra-
cranial infections
• It occurs in 3-5% of all children between
6months-5years
• It occurs because of severe fever
• The risk of Death from a febrile fit is ZERO
 EPILEPSY
• It is the various neurological disorders
characterized by sudden recurring attacks of
motor, sensory, or psychic malfunction with or
without loss of consciousness or convulsive
seizures

It is common in males as compair to females

Common age 6months to 6years
 CAUSES
• Hyper / Hypothyroidism
• Tonsillitis
• Family History
• Unknown causes
• Metebolic disease
• Neurologic disease
 IMPORTANT TERMS
• Atonic (lack of muscle tone)

• Myoclonic (sudden twitching of muscles without any

rhythm or pattern, occurring in various brain disorders)

• Grand Mal (Tonic-Clonic)

• Psychomotor (activity of muscles control by Motor

Nerves)
 MEDICATIONS
• Carbamazepine 10-20 mg/kg
• Phenytoin 4-8 mg/kg
• Valproate 10-20 mg/kg
• Phenobarbitone 3-5 mg/kg
• Ativan 2mg
• Fosphenytoin 20mg/kg
• Valium (Diazepam) 0.2-0.4 mg/kg
 MEDICAL INVESTIGATION
• Lumber Puncture (CSF analysis)
• EEG (ElectroEncephaloGraph)
 PDI’s (Home Points)
• Stay online with the Caller
• If patient is still fitting / starts again to fits:
 don’t do resuscitation
 don’t hold down or force anything in
mouth
 move dangerous objects away
 PDI’s (Home Points)
• If patients stops fitting:
 check breathing status
 turn gently on one side
 if patients gets awake, tell not to get up or
walk around
 THANK YOU

ANY QUESTIONS?