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Approach to Seizures

Definition

  • A seizure is a paroxysmal event due to abnormal, excessive, hypersynchronous discharges from an aggregate of central nervous system (CNS) neurons.
  • Seizures can have various manifestations, ranging from dramatic convulsive activity to experiential phenomena not readily discernible by an observer.
  • Epilepsy describes a condition in which a person has recurrent seizures due to a chronic, underlying process.
  • Partial (or focal) seizures
    • Originate in a localized area of cortex
    • Simple-partial seizures do not affect consciousness and may have motor, sensory, autonomic, or psychiatric symptoms.
    • Complex-partial seizures include alteration in consciousness coupled with automatisms (e.g., lip smacking, chewing, aimless walking, or other complex motor activities).
  • Generalized seizures
    • Involve diffuse regions of the brain in a bilateral symmetric fashion
    • May occur as a primary disorder or may result from secondary generalization of a partial seizure
    • Tonic-clonic seizures (grand mal)
      • Sudden loss of consciousness
      • Loss of postural control
      • Tonic muscular contraction producing teeth-clenching and rigidity in extension (tonic phase), followed by rhythmic muscular jerking (clonic phase)
    • Absence seizures (petit mal)
      • Sudden, brief impairment of consciousness without loss of postural control
    • Other types of generalized seizures are atypical absence, infantile spasms, tonic, atonic, and myoclonic seizures.

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