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Epilepsy and Seizure

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20 views35 pages

Epilepsy and Seizure

Uploaded by

rexocek216
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Amoud University

College of Health Sciences (ACHS)


Eplipsy and seizures
Group 5
Group members
1. Sakerie Sh. Dahir Hussien

2.Saleban Osman Ahmed

3. Salma Ibrahim Dahir

4. Sundus Ahmed Yusuf

5. Yousuf Ismail Suleiman

6. Abdiqadir Mohamed Awil


7. Huda Abdillahi lsmail
Objectives
1. Understand the definition of seizure, epilepsy and status epilepticus.

2. Differentiae between a seizure and syncope using semiology and

historical clues.

3. Know the subtypes (generalized, partial, etc) and causes of seizures.

4. Know the role of investigations (EEG, MRI, etc) in a patient with a

seizure.

5. Master the steps in the management of status epilepticus.

6. Know how to counsel a patient with a seizure (including triggers,


precautions, etc).
Understanding The definition
Cont.d
Causes of seizure
Differentiae between a
seizure and syncope using
semiology
and historical clues
Treatment
Master the steps in the management of status
epilepticus.
Cont.d
Cont’d
Cont’d
Management of refractory status epilepticus
- Intubation, IV access.

- Continuous EEG monitoring.

- Medication Coma (phenobarbital, midazolam, propofol).


- General anesthesia with halothane and neuromuscular blockade (to avoid rhabdomyolysis)
Cont’d
General recommendations: Complications

- Benzodiazepines should be given as emergent initial therapy. - Cardiac: HTN, tachycardia, arrhythmia.
- Lorazepam is the drug of choice for IV administration, while
midazolam for IM - Pulmonary: apnea, hypoxia, respiratory failure.
administration. - Hyperthermia.
- Rectal diazepam is available when there is no IV access or IM
midazolam is - Metabolic derangement.
contraindicated. - Cerebral: neuronal damage.
- Urgent control AED therapy recommendations include IV
fosphenytoin/phenytoin,
- Death.
valproate. Sodium, or levetiracetam.
Major threat to life
- Aspiration of gastric content if the airway is not protected.

- Head injury.

- Lactic acidosis, hypoxia, hyperthermia, rhabdomyolysis, cerebral edema, or

hypotension from a prolonged seizure.

- Patient should be positioned in the lateral decubitus position, to prevent aspiration of


gastric contents
Teratogenic risk profiles of antiepileptic medication:

1. Valproic acid

2. Phenytoin, phenobarbital, topiramate

3. Carbamazepine
4. Lamotrigine (first line), Levetiracetam (second line)
Steven’s Johnson syndrome
Spina bifida (NTD) caused by valproate
Gingival hyperplasia induced
by phenytoin
Know how to counsel a patient with a seizure (including
triggers, precautions, etc).
1. Acknowledging the event.

2. Explanation of what a seizure is (and is not).

3. Possible etiology and prognosis.

4. Purpose and limitations of tests.

5. Lifestyle considerations (safety, occupation,

seizure threshold).

6. Driving.
7. Seizure first aid.
Cont’d
8. Role of medication.

9. Medication action and side effects (if

appropriate).

10. Psychological implications.


11. Next steps and when to call for help.
Life style
First seizure to avoid the triggers. As we mentioned before While people with epilepsy should be

encouraged to lead lives as unrestricted as reasonably possible, though with simple safety measures, such as:

1. Avoiding swimming and dangerous sports such as rock climbing.

2. Leaving bathroom and lavatory doors unlocked.

3. Taking showers rather than baths.

4. Avoid epilepsy triggers such as: sleep deprivation, excess alcohol and drugs.
5. Patients should be asked to stop driving after a seizure, and inform the regulatory authorities if they hold a
driving licence.
Epilepsy in women
● The overall risk of birth defects in babies with mothers who takes AED is around 7%.

● Counselling before conception is essential.

● The risk of teratogenicity is well known 5% especially with valproates, but withdrawing drug

therapy in pregnancy is more risky than continuation.


● All antiepileptic medications are not safe, however lamotrigine is the safest.

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