Siezure Disorders by Dr.Nadeem Khawer

SEIZURE DISORDERS
NADEEM KHAWAR
What is a Seizure?
lParoxysmal, change in motor activity
and/or Behavior that results from
abnormal electrical activity in the brain

Epilepsy

Recurrent, Unprovoked Seizures
Two or more
Interval: > 24 hours apart

INCIDENCE
lEPILEPSY 0.4 % to 0.9 %

lSINGLE AFEBRILE 1 %

lFEBRILE 4 %

Classification
Partial Seizures

Generalized Seizures

Unclassified Seizures
Partial Seizures
v SIMPLE
§ (Temporal Lobe Epilepsy)

v COMPLEX

v PARTIAL GENERALISED (Jacksonian Epilepsy)
v Generalized Seizures
lABSENCES
lTYPICAL
lATYPICAL
lGENERALISED TONIC— CLONIC (grandmal)
lTONIC
lCLONIC
lMYOCLONIC
lATONIC
Unclassified
Febrile Convulsions

Infantile Spasms

Epileptic Syndromes
FEBRILE CONVULSIONS
Definition
lAGE ?—6 months …………. 5 years.

lALWAYS WITH…………?--- fever

lALWAYS EXCLUDE…………?—CNS signs.
Febrile Convulsions
TYPES
v Simple

v Complex
Treatment
Acute

Control the fit
Prevent further fits
Treat the cause of fever
Exclude CNS infection
Counsel parents

LONGTERM

lANTICONVULSANTS NEED ?
NON EPILEPTIC SEIZURES
v JITTERINESS
v BREATH HOLDING ATTACKS
v SYNCOPE
v PSYCHOGENIC
v SLEEP MYOCLONUS
v NIGHT TERROR
ASSESSMENT
lHISTORY > Clear Description onset/type/duration/frequency etc > Relevant History perinatal/development/ family/ DRUG

lEXAMINATION 1) Head size ( OFC ) 2) Dysmorphic features 3)Neurocutaneous signs 4) CNS motor 5) Fundi



lINVESTIGATION

GLUCOSE /CALCIUM / ELECTROLYTES
FBC / CREATININE / ALT
URINE METABOLIC SCREEN
ECG / ECHO
EEG
CT BRAIN



MANAGEMENT
PRINCIPALS OF A.E.D.( anti epilectic drugs)
· SELECT
· SEIZURE TYPE / COST /SIDEEFFECTS
· MONOTHERAPY
· DOSE / COMPLIANCE
· DRUG LEVEL
· DURATION
ANTICONVULSANTS
v PHENOBARBITONE
v PHENYTOIN
v VALPROATE
v CARBAMAZEPINE

v DIAZEPAM
v PARALDEHYDE
THANK YOU
HOME WORK
INFANTILE SPASMS
STATUS EPILEPTICUS