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Seizure vs Epilepsy
- Seizure: abnormal hypersynchronous discharge of cortical neurons
- Epilepsy: 2 unprovoked seizures 24 hours apart or 1 unprovoked seizure in the setting of interictal discharge (kindling model)
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Simple partial seizure
- 5-10 seconds
- aura/ premonition may occur
- consciousness preserved
- Ictus = focality motor(twitching), somatosensory (paresthesias C/L), auditory cortex(sounds), visual(hallucination)
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Complex partial seizures
- 5-30 seconds
- altered consciousness
- ictus --> focality
- postictal = confusion, drowsiness
- Pt that knocked on neighbors door without saying anything and not knowing it.
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Partial secondarily generalized
- tonic clonic 30s- 2 min
- aura premonition
- tonic clonic marching
- LOC
- postictal: confusion/. drowsiness
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Jacksonian tonic-clonic seizures
Begins in the hand up the arm to the trunk and the foot then crosses over and affects both sides.
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Tonic clonic
- no aura
- LOC
- ictus- tonic-clonic(tonic 10-15 s, clonic 30s - 2min)
- Salivation, dilated pupils, HTN, urinary incontinence
- postictal- Initially immobile & unresponsive confusion/ drowsiness
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Absence
- No aura
- LOC split seconds
- ictus- brief and repetitive
- No postictal symptoms
- EEG shows 3/sec spike and wave
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