Seizures are defined as sudden alteration of behavior, characterized by a sensory perception or motor activity without or with change in awareness or consciousness, due to aberrant cortical electrical activity. Partial seizures begin locally without impairment of consciousness, and with complex symptoms (with impairment of consciousness). Generalized seizures occur bilaterally, symmetrically and are without local onset. A third classification of seizures are unclassified epileptic seizures.
focal motor - convulsive jerking
somatosensory - parasthesias or tingling
Jacksonian - spread or march to different area
sensory - flashing lights, bad smells, buzzing, voices, songs
autonomic - flushing, sweating, epigastric sensation, arrhythmia
psychic - deja vu (familiarity), jamais vu (un-familiarity), fear, pleasure, anger
Partial seizures are confined to one part of the brain
simple partial seizures are limited to one part of the body, or one aspect of behavior
complex partial seizures have symptoms that change during the attack, loss of consciousness.
Generalized seizures involve neuronal discharge in both sides of the brain and may evolve from partial seizures. Characteristic - usually an alteration or loss of consciousness.
An absence seizure usually begins between ages 2-12, often with a positive family history.
A simple absence seizures usually lasts 1-2 seconds, and is characterized by a blank stare.
A complex absence seizure usually lasts 15-20 seconds. The head drops and arms jerk.
Causes of seizures include: Brain tumor, Cerebral hypoxia (breath holding, carbon monoxide poisoning, anesthesia), Cerebrovascular accident (infarct or hemorrhage), Convulsive or toxic agents (lead, alcohol, cocaine, camphor, chloraquine, pentylenetetrazol, picrotoxin, strychnine), Eclampsia (during pregnancy), Exogenous factors (sound, light, cutaneous stimulation), Head injury, Hyperpyrexia (acute infection, heat stroke), Metabolic disturbances (hypoglycemia, hypoparathyroidism, phenylketonuria, uremia, hepatic failure, electrolyte abnormality) or Anaphylaxis (foreign serum or drug allergy).
Convulsions may also occur as a withdrawal symptom after chronic use of alcohol, hypnotics, or tranquilizers.
Conventional lab tests include serum tests for glucose, sodium, potassium, calcium, phosphorus, magnesium, BUN, and ammonia; Anticonvulsant levels (inadequate level of anticonvulsant medication is the most common cause of recurrent seizures in children, and many adults); Drug and toxic screens (including alcohol); and a complete blood count (which may be helpful in evaluating infection).
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