SEIZURES & CONVULSIONS

What is the primary difference between seizures and convulsions? Seizures are sudden, uncontrolled electrical disturbances in the brain, while convulsions refer specifically to the involuntary muscle contractions that may occur during a seizure. What are some common causes of seizures? Causes include epilepsy, fever (in children), head injury, stroke, brain infections, low blood sugar, and drug withdrawal. What is the most common type of seizure? Focal (partial) and generalized seizures are the most common types, with focal seizures affecting one part of the brain and generalized seizures affecting both hemispheres. What should you do if you witness someone having a seizure? Keep them safe by clearing the area of dangerous objects, cushioning their head, turning them onto their side, and timing the seizure. Do not put anything in their mouth. . What is status epilepticus? A medical emergency where a seizure lasts longer than five minutes or multiple seizures occur without full recovery between them. What are absence seizures? Brief, sudden lapses in awareness, often mistaken for daydreaming, lasting only a few seconds. What is the postictal state? A period of confusion, drowsiness, or fatigue following a seizure as the brain recovers. How can epilepsy be diagnosed? Through medical history, neurological exams, EEG (electroencephalogram), MRI, and CT scans. What are common triggers for seizures? Lack of sleep, stress, flashing lights, fever, alcohol or drug withdrawal, and missed medications. Can seizures occur without epilepsy? Yes, seizures can result from high fever, head trauma, low blood sugar, or substance withdrawal. What is a febrile seizure? A seizure triggered by a high fever, usually in children between six months and five years old. What is the first-line treatment for epilepsy? Anti-epileptic drugs (AEDs) such as valproate, levetiracetam, or carbamazepine. Can a person hear or remember anything during a seizure? It depends on the type of seizure; some individuals remain aware during focal seizures, while others lose consciousness. What is a tonic-clonic seizure? A type of generalized seizure involving muscle stiffness (tonic phase) followed by jerking movements (clonic phase). Can seizures be prevented? Some can be managed with medication, lifestyle modifications, avoiding triggers, and in some cases, surgery. What role does the brain's electrical activity play in seizures? Seizures occur due to abnormal, excessive electrical discharges in the brain’s neurons. What is an aura in relation to seizures? A warning sensation before a seizure, such as a strange smell, taste, or visual disturbance. How is a non-epileptic seizure different from an epileptic seizure? Non-epileptic seizures are not caused by abnormal brain activity but may result from psychological factors, such as stress or trauma. What dietary therapy is sometimes used for seizure control? The ketogenic diet, a high-fat, low-carbohydrate diet, is used to help control seizures, particularly in drug-resistant epilepsy. What is refractory epilepsy? A form of epilepsy that does not respond to standard anti-seizure medications. Can stress and anxiety trigger seizures? Yes, stress and anxiety can lower the seizure threshold in some individuals. . What is a myoclonic seizure? A seizure characterized by sudden, brief jerking or twitching movements of muscles. Why should a person with epilepsy avoid alcohol? Alcohol can interfere with seizure medications and lower the seizure threshold, increasing the risk of seizures. Can a person die from a seizure? In rare cases, prolonged seizures (status epilepticus) or Sudden Unexpected Death in Epilepsy (SUDEP) can be fatal. . What should not be done during a seizure? Do not restrain the person, put anything in their mouth, or attempt to stop their movements. Would you like more questions added? Febrile Seizure A seizure associated with a fever in a child usually between 6 months and 5 years of age. Simple Febrile Seizure Generalized No associated neurological deficit Less than 15 minutes duration Only one within a 24 hour period Complex Febrile Seizure Any one of the following Focality Greater than 15 minutes duration Neurological Deficit Multiple in a 24 hour period Clinical Features of Febrile Seizure Seizure usually occurs within the first 24 hours of fever. Seizure is due to rapid change in body temperature, usually >39 C (102.2 F). Usually occurs in the presence of a clinically recognizable infection. Most common infectious triggers are viral URI, AOM, Roseola. 80% are simple febrile seizures, 20% are complex febrile seizures. Most often have generalized motor seizure. Less commonly have focal motor activity or may be only staring episode or eye rolling. Usually brief; only 8% last longer than 15 minutes. Approach to Child with Fever and First Seizure May be due to a febrile seizure May be due to a chronic seizure disorder triggered by fever May be due to an intracranial infection, meningitis, encephalitis, brain abscess. Meningitis and Seizures In 13-16% of children with meningitis, seizures are the presenting sign of disease. In 30-35% of these children (primarily less than 18 months old), meningeal signs are lacking. AAP Practice Guideline for First Simple Febrile Seizure recommends less than 12 months old LP should be strongly considered; 12-18 months LP should be considered.(for meningitis) Risk Factors for Abnormal CSF in Kids with Fever and Seizures Suspicious findings on physical exam Complex febrile seizures Doctor visit w/i 48 hrs before the seizure Seizing upon arrival to ED Prolonged postictal state Initial seizure after 3 years old EEG eval no predictive value Blood studies no routine serum electrolytes, calcium, phosphorus, magnesium, CBC, or blood glucose Neuroimaging no need for skull films, CT or MRI Risk of death Several large studies have not reported any deaths. Child intelligence No long term intellectual or neuro