NCMA219 W15a

• Seizures are disturbance in normal function of the brain resulting from abnormal electrical discharges which may fire as many as 500x/sec
• Seizures are the most common pediatric neurologic disorder
• 50% episodes of seizure being febrile seizure.
• Causes of Seizure

  • vascular
  • infection
  • trauma
  • AV malformation
  • metabolic
  • idiopathic
  • neoplasm
• Seizure may arise from central areas in the brain that affect consciousness
• Seizure may be restricted to one area of the cerebral cortex, producing manifestations characteristics of that particular anatomic focus
• Seizure may begin in a localized area of the cortex and spread to other portions of the brain and, if sufficiently extensive, produced generalized seizure activity

   
• Tonic-clonic seizure is characterized by loss of consciousness with stiffening of limbs (tonic phase) followed by rhythmic jerking movements (clonic phase)
• 3 classifications of seizure

  Partial, Generalized, Unclassified epileptic seizure
• Partial seizure involves only a part of the brain and therefore only a part of the body. major seizure happens on the first year of life and mostly affect the frontal, temporal, and parietal lobes.
• Two types of Partial Seizure

  1. simple partial seizure
  2. complex partial seizure
• Average duration of simple partial seizure: 10-20 seconds
• Average duration of complex partial seizure: 1-2 minutes
• In simple partial seizures, motor component is located on one portion of the body, patient remains awake, and may involve face, arms, and extremities.
• Complex partial seizure affects children from 3 years through adolescence.
• Complex partial seizure


  Characterized of altered behavior and impaired consciousness; amnesia for event, no recollection of behavior; begins with aura (visual disturbances)
• In complex seizure, ­after the seizure, child is disoriented known as “post-ictal period”
• Complex sensory phenomena (aura)


  Strange feeling in the pit of the stomach that rises toward the throat, there's visual hallucination, déjà vu, ­and in small children, emission of a cry or attempt to run for help
• Types of Generalized Seizure

  1. Tonic-clonic seizures
  2. absence seizures
  3. atonic and akinetic seizures
  4. myoclonic seizures
• Tonic – clonic seizures is formerly known as Grand Mal
• Atonic and Akinetic Seizures is also known as Drop Attacks
• Absence seizures is formerly called Petit Mal or Lapses
• Generalized seizure


  It involve both hemispheres of the brain and are without local onset
• Loss of consciousness 


  Initial sign of generalized seizure
• Tonic-Clonic Seizures

  It is the most common and most dramatic of all seizure manifestation and occur without warning
• Tonic phase lasts approx. 10-20 secs; Clonic phase lasts about 30 seconds
• True


  True or False

  In tonic phase, there's immediate loss of consciousness; stiffens (arms flexed and legs, head, neck extended); cyanotic
• Absence seizure usually last about 5-10 secs
• Absence seizure


  It suddenly develops 20 or more attacks daily and appears without warning or aura.
• onset of absence seizure usually between 4 and 12 years of age
• Its onset usually happens between 2 and 5 years of age.
• Atonic and akinetic seizure


  Its onset usually happens between 2 and 5 years of age
• Myoclonic seizure


  Brief shock-like jerks of a muscle or group of muscles. It doesn't last for more than a second or two
• Atonic and akinetic seizure events recurring frequently during the day, particularly in the morning hours and shortly after awakening
• Myoclonic seizure may be isolated as benign essential myoclanus
• unclassified epileptic seizure


  seizures that lack sufficient information to classify
• Infantlie spasms


  Also called infantile myoclonus; commonly occur during the first 6-8 months of life
• Two classifications of febrile seizure

  • Simple febrile seizure
  • complex febrile seizure
• Febrile seizure


  One of the most common neurologic conditions in childhood and is classified as simplex or complex
• Simple febrile seizure


  Consist of a general Tonic-Clonic seizure that occurs with a fever (>38.0° C) and resolves within 15 minutes with a return to alert mental status after the seizure and no further seizure occurring within a 24-hour period