Presentation is loading. Please wait.

Presentation is loading. Please wait.

UNCLASSIFIED SEIZURES

Similar presentations


Presentation on theme: "UNCLASSIFIED SEIZURES"— Presentation transcript:

1 UNCLASSIFIED SEIZURES
PARTIAL SEIZURES GENERALIZED SEIZURES UNCLASSIFIED SEIZURES Simple Partial (consciousness retained) Motor Sensory Autonomic Psychic Complex Partial (consciousness impaired) -Simple partial, followed by impaired consciousness -Consciousness impaired at onset Partial seizures with secondary generalization Absences -Typical -Atypical Generalized tonic-clonic Tonic Clonic Myoclonic Atonic Infantile Spasms

2 SIMPLE PARTIAL SEIZURES (SPS)
Motor activity – most common symptom Asynchronus clonic or tonic movements Tend to involve the face, neck, and extremities Some patients complain of aura Lasts for secs Patients remain conscious and may verbalize during seizure No postictal phenomenon

3 May be confused with tics (shoulder shrugging, eye blinking, and facial grimacing and primarily involve the face and shoulders; can be briefly suppressed, but SPS cannot be controlled) EEG- spikes or sharp waves unilaterally or bilaterally or a multifocal spike pattern

4 COMPLEX PARTIAL SEIZURES (CPS)
May begin with a SPS with or without an aura, followed by impaired consciousness Aura- vague, unpleasant feeling, epigastric discomfort, or fear – 1/3 of children with SPS or CPS; indicates focal onset AUTOMATISMS- common feature of CPS in infants and children occurring in about 50-75% of cases Alimentary automatisms in infants: lip smacking, chewing, swallowing, and excessive salivation In children: semi-purposeful, incoordinated, unplanned automatisms

5 PARTIAL SEIZURES WITH SECONDARY GENERALIZATION
Secondary generalization – spreading of the epileptiform discharge Contralateral versive turning of the head, dystonic posturing, and tonic-clonic movements of the extremities and face, including eye blinking 1-2 mins EEG- anterior temporal lobe sharp waves or focal spikes and multifocal spikes

6 ABSENCE SEIZURES Sudden cessation of motor activity or speech with a blank facial expression or flickering of the eyelids More prevalent in girls before 5 years old Never associated with an aure Rarely persists longer than 30 secs Not associated with a postictal state EEG- 3/sec spike and generalized wave discharge COMPLEX ABSENCE – myoclonic movement of the face, fingers, or extremities, loss of body tone; EEG – atypical spike and wave discharges 2-2.5/sec

7 GENERALIZED TONIC-CLONIC SEIZURES
Common and may follow a partial seizure with a focal onset Maybe associated with an aura Patients suddenly lose consciousness, eyes roll back, and body musculature undergoes tonic contractions, become cyanotic Clonic phase – rhythmic clonic contractions alternating with relaxation of all muscle groups Loss of sphincter controll, particularly the bladder

8 Postictally, children are initially semicomatose and typically remain in deep sleep for 30 mins to 2 hrs

9 MYOCLONIC EPILEPSIES OF CHILDHOOD
Repetitive seizures consisting of brief, often symmetric muscular contractions with loss of body tone and falling or slumping forward BENIGN MYOCLONUS OF INFANCY TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD COMPLEX MYOCLONIC EPILEPSIES JUVENILE MYOCLONIC EPILEPSY (Janz Syndrome) PROGRESSIVE MYOCLONIC EPILEPSIES

10 INFANTILE SPASMS 4-8 months
Brief symmetric contractions of the neck, trunk, and extremities 3 types: flexor, extensor, and mixed FLEXOR: occur in clusters or volleys and consist of sudden flexion of the neck, arms, and legs onto the trunk EXTENSOR: extension of the trunk and extremities; least common MIXED: flexion in some volleys and extension in others; most common EEG- hypsarrhthmia-chaotic pattern of high voltage, bilaterally asynchronous, slow-wave activity or a modified hypsarrhythmia pattern

11 Cryptogenic or Symptomatic
CRYPTOGENIC: uneventful pregnancy and birth history as well as normal developmental milestones before onset of seizures SYMPTOMATIC: prenatal, perinatal, and postnatal risk factors

12 NEONATAL SEIZURES FOCAL – rhythmic twitching or muscle groups, particularly those of the extremities and face often associated with localized structural lesions as well as with infections and subarachnoid hemorrhage MULTIFOCAL CLONIC- similar to focal clonic but differ in that many muscle groups are involved, frequently several simultaneously

13 TONIC- rigid posturing of the extremities and trunk, sometimes associated with fixed deviation of the eyes MYOCLONIC- brief focal or generalized jerks of the extremities or body that tend to involve distal muscle groups SUBTLE- chewing motions, excessive salivation, and alterations in then respiratory rate including apnea, blinking, nystagmus, bicycling or pedaling movements, and changes in color

14 EEG CLASSIFICATION OF NEONATAL SEIZURES
CLINICAL SEIZURE WITH A CONSISTENT EEG EVENT CLINICAL SEIZURES WITH INCONSISTENT EEG EVENTS ELECTRICAL SEIZURES WITH ABSENT CLINICAL SEIZURES

15 CLINICAL SEIZURE WITH A CONSISTENT EEG EVENT
Clinical seizure occurs in relationship to seizure activity recorded on EEG Includes focal clonic, focal tonic, and some myoclonic seizures Epileptic and are like to respond to anticonvulsants

16 CLINICAL SEIZURES WITH INCONSISTENT EEG EVENTS
Observed with all generalized tonic seizures and subtle seziures and with some myoclonic seizures Infants tend to be neurologically depressed or comatose as a result of hypoxic-ischemic encephalopathy Nonepileptic origin May not require or respond to antiepileptics

17 ELECTRICAL SEIZURES WITH ABSENT CLINICAL SEIZURES
May develop in comatose infants who are not on anticonvulsants May persist in patients with focal tonic or clonic seizures without clinical signs after the introduction of an anticonvulsant


Download ppt "UNCLASSIFIED SEIZURES"

Similar presentations


Ads by Google