Presentation
A clonal lymphoplasmocytic proliferation, e.g. plasmacytoma, is present in the majority of cases. Here we report on a 19-year-old male who presented with generalized seizures and an enhancing white matter lesion on MRI scans. [ncbi.nlm.nih.gov]
Entire Body System
- Falling
Please obtain help should the individual fall and injure him/herself. [edmontonepilepsy.org]
The present findings confirm that the main indication for callosotomy is the occurrence of generalized seizures with fall. [ncbi.nlm.nih.gov]
Generalized Grand Mal seizures are physically violent and could result in falls and injury. If you are witnessing such a grand mal event, it is important to lay the patient on a flat surface and place them on his or her side. [my.clevelandclinic.org]
These seizures may cause a person to drop what they were holding or fall off a chair. What it is not: Clumsiness or poor coordination VII. [epilepsy-ohio.org]
- Fever
If a child has seizures with a fever, but also has seizures without a fever, this is not considered to be febrile seizures; this is considered to be epilepsy, or a seizure disorder. [swedish.org]
If your child has a fever, the pediatrician will check to see if there is an infection. [healthychildren.org]
Symptoms, including seizures often accompanied by a high fever, generally begin in the first year of life. [dravetsyndromenews.com]
Severe illnesses/infections and high fevers: Seizures should improve once these issues resolve. [verywellhealth.com]
You have a high fever. You're experiencing heat exhaustion. You're pregnant. You have diabetes. You've injured yourself during the seizure. If you experience a seizure for the first time, seek medical advice. [mayoclinic.org]
- Hypothermia
Low body temperature (hypothermia): drop in your body temperature to less than 95º F, feeling tired, confusion, coma. [depakote.com]
Cardiovascular
- Hypertension
Typical symptoms include the following: Drowsiness Confusion Memory loss Nausea General malaise Body soreness Difficulty finding names or words Headaches/migraines Thirst Arm or leg weakness Hypertension Feelings of fear, embarrassment, or sadness Reviewed [cureepilepsy.org]
Uremia: BUN usually between 90–120 dl% when seizures occur Following rapid osmotic shifts (post dialysis) Need to rule out intracranial blood: Uremic platelet dysfunction Hypertensive hemorrhage from the uremic state Incomplete reversal of anticoagulation [neurodiffdx.com]
The seizure threshold can be altered by fatigue, malnutrition, lack of sleep or rest, hypertension, stress, diabetes, the presence of strobe-flashes or simple light/dark patterns, raised estrogen levels at ovulation, fluorescent lighting, rapid motion [en.wikipedia.org]
Unequal pupils and Cushing’s Triad (hypertension, bradycardia, abnormal respirations) may suggest increased intracranial pressure due to, for example, intracranial hemorrhage (ICH) and resulting cerebral herniation. [jems.com]
Stroke Abnormalities present or occurring at birth, including genetic disorders Birth defect Hereditary metabolic disorders, such as Tay-Sachs disease or phenylketonuria Injury during birth Fluid accumulation in the brain (cerebral edema) Eclampsia Hypertensive [merckmanuals.com]
- Tachycardia
Ictal hypoxemia occurred in 25% of seizures and was associated with normal MRI (p=0.01), longer seizure duration (p=0.049), and ictal tachycardia (p=0.003). Such findings may have implications for understanding the pathogenesis of SUDEP. [ncbi.nlm.nih.gov]
Complications of SE When early benzodiazepine therapy doesn’t terminate the seizure, providers must be prepared to manage various serious complications, including hyperthermia, tachycardia, systemic and pulmonary hypertension, pulmonary edema, cardiac [jems.com]
There is usually autonomic upset - pupils large, hyperthermia, tachycardia, salivation, often emptying of bladder. It is terminated by inhibitory transmitters that result in postictal period of dense stupor or coma. 22-6. [dartmouth.edu]
Skin
- Flushing
Children who experience an autonomic seizure will experience dramatic changes in breathing and heart rate accompanied by sweating, and a flushed appearance or goose bumps. [dellchildrens.net]
They may experience a variety of symptoms, including but not limited to: Confusion Memory lapses Distractedness Sense of detachment Eye or head twitching movement in one direction Inability to move or speak Loss of bladder and/or bowel control Pale/flushed [cureepilepsy.org]
Other symptoms can include tingling, numbness, unusual head movements, flushed face or nausea. A generalized seizure affects both hemispheres of the brain at once. [nm.org]
[…] groups Sensory and psychiatric symptoms Visual (e.g., hallucinations, micropsia, macropsia) Somatic (e.g., paresthesias) Position (e.g., vertigo) Hearing (e.g., hearing complex sounds) Olfactory (e.g., unusual or intense smells) Autonomic symptoms (e.g. flushing [amboss.com]
Simple partial seizures may also cause abdominal discomfort, an increase in heart rate or blood pressure, flushing of the face, feelings of fear, or sensations of déjà vu, depending on where they occur in the brain. [massgeneral.org]
Neurologic
- Seizure
For different seizure types, focal to bilateral tonic-clonic seizures (P = 0.020) and myoclonic-atonic seizures (P = 0.002) might correlate with unfavourable outcomes. [ncbi.nlm.nih.gov]
- Confusion
During this time, the child may be confused, in a "fighting" mood, or hard to wake up or he may sleep for several hours. [nationwidechildrens.org]
[…] hand Complex partial epileptic seizures confined to a larger region of the brain than simple partial seizures impaired level awareness about surroundings usually involves the temporal lobe symptoms: glassy stare and lack of response inappropriate or confused [barrowneuro.org]
The most common symptoms of a prodrome include confusion, anxiety, irritability, headache, tremor, and anger or other mood disturbances (Besag & Vasey, 2018). [cureepilepsy.org]
Because they happen so quickly, it’s very easy not to notice simple absence seizures — or to confuse them with daydreaming or not paying attention. [epilepsynewengland.org]
Afterwards, it is common for the person to feel confused, tired or weak. Seizures that last five minutes or longer or recur rapidly require emergency medical attention. Call 9-1-1 for the fastest response. [barnesjewish.org]
- Generalized Tonic-Clonic Seizure
Abstract Are "generalized" seizures truly generalized? Generalized tonic-clonic seizures are classified as either secondarily generalized with local onset or primarily generalized, without known focal onset. [ncbi.nlm.nih.gov]
[…] cause a generalized tonic clonic seizure. [en.wikipedia.org]
Generalized tonic-clonic seizure Definition Generalized tonic-clonic seizure is a type of seizure that involves the entire body. It is also called grand mal seizure. [pennstatehershey.adam.com]
- Meningism
Other conditions may also cause these seizures, such as: Serious head injury Stroke Brain tumor Brain infection (meningitis or encephalitis) Alzheimer's disease Loss of oxygen at birth Hardening of the brain's arteries Patients with a family history of [cedars-sinai.org]
Seizures can happen after a stroke, a closed head injury, an infection such as meningitis or another illness. Many times, though, the cause of a seizure is unknown. [mayoclinic.org]
[…] occurs with infections that spread to the arachnoid and pia mater Cortical stroke is caused by: Tuberculosis (endarteritis, meningeal involvement) Cryptococcosis (meningeal) Mucormycosis (sinus spread) Aspergillus (venous spread); often lung abscess [neurodiffdx.com]
Medical conditions other than epilepsy, such as brain tumors and meningitis, can also cause epileptic seizures. Recurrent seizures can be a sign of epilepsy, and these seizures can take various forms. [barnesjewish.org]
If a serious infection such as meningitis is responsible for the seizure, your child will have to be hospitalized for further treatment. [healthychildren.org]
- Amnesia
[…] urine or stool control (incontinence) Stopped breathing or difficulty breathing Blue skin color After the seizure, the person may have: Confusion Drowsiness or sleepiness that lasts for 1 hour or longer (called the post-ictal state) Loss of memory (amnesia [medlineplus.gov]
[…] disorientation, fear, vertigo, and visual, acoustic, olfactory, or gustatory hallucinations) Sudden behavioral arrest (e.g., staring without moving) Impaired consciousness Automatisms (e.g., fumbling, lip smacking, chewing, swallowing) Confusion Anterograde amnesia [amboss.com]
Confusion and total amnesia upon regaining consciousness are also usually experienced and slowly wear off as the patient becomes gradually aware that a seizure occurred and remembers their identity and location. [en.wikipedia.org]
Workup
With these data, the current American College of Emergency Physicians (ACEP) guidelines on the workup of new-onset seizures were applied to determine whether they could safely be used in patients with AIDS. [ncbi.nlm.nih.gov]
The awake EEG of patients with generalized tonic-clonic seizure may be normal; however, certain specific interictal EEG patterns can be distinctive of generalized epilepsy syndromes (see Workup). [emedicine.medscape.com]
Treatment
OBJECTIVE: To evaluate safety, tolerability, seizure frequency, and regional variations in treatment responses with the AMPA antagonist, perampanel, in a large extension study during up to 3 years of treatment. [ncbi.nlm.nih.gov]
Treatment Correct treatment can help reduce or prevent seizures. In some cases, treatment can help patients to remain free of seizures for the rest of their lives. [cedars-sinai.org]
It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. [dravetsyndromenews.com]
Prognosis
All preoperative evaluation data correlated to generalized seizures and postoperative prognosis were collected and analysed. [ncbi.nlm.nih.gov]
What is the prognosis of epilepsy? 60% to 70% of people with epilepsy will respond satisfactorily to the first AED used. Prognosis is highly dependent on the cause of epilepsy and seizure type. [aesnet.org]
Many types of seizures are described, each attributed to a certain demon or departed spirit and given a prognosis. References Template:WH Template:WS [wikidoc.org]
Confirm a seizure Exclude an underlying condition Differential diagnoses Treatment Acute management First seizure Recurrent seizures Complications Status epilepticus General complications of seizures and epilepsy Prognosis Risk of seizure recurrence [amboss.com]
Implications of Seizure Type Seizure type may suggest a particular treatment, prognosis, restriction of an activity like driving, or an underlying disease process. [mdedge.com]
Etiology
The purpose of this investigation was to determine the relative importance of this medication as the etiology of new-onset seizures relative to other drugs and new-onset seizures in general. The study design was a retrospective case series. [ncbi.nlm.nih.gov]
Etiology Epilepsy Although these seizures are referred to as unprovoked, they may be triggered by certain provocative factors! [amboss.com]
Epidemiology
The Epidemiology of Epilepsy. Neuroepidemiology. 2020;54(2):185-191. [PubMed: 31852003] 5. McGee RE, Sajatovic M, Quarells RC, Johnson EK, Liu H, Spruill TM, Fraser RT, Janevic M, Escoffery C, Thompson NJ. [ncbi.nlm.nih.gov]
Definition References:[1][2][3][4][5] Epidemiology References:[6] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Epidemiology The age-adjusted incidence of epilepsy (ie, recurrent unprovoked seizures) ranges from 24-53 per 100,000 population per year. Approximately 20-25% of cases are classified as generalized seizures. [emedicine.medscape.com]
Shobi Sivathamboo, Piero Perucca, Dennis Velakoulis, Nigel C Jones, Jeremy Goldin, Patrick Kwan, Terence J O’Brien, Sleep-disordered breathing in epilepsy: epidemiology, mechanisms, and treatment, Sleep, 10.1093/sleep/zsy015, 41, 4, (2018). [onlinelibrary.wiley.com]
Seizure Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Seizure from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis [wikidoc.org]
Pathophysiology
Recognition and characterization of individual diurnal seizure patterns offer new diagnostic and therapeutic options, including EEG or long-term video EEG monitoring scheduling, differential (day/night) medication dosing, and a better understanding of pathophysiologic [ncbi.nlm.nih.gov]
The ILAE task force initially was interested in developing an entirely new seizure classification based anatomy, brain networks, or pathophysiology. “But we quickly realized that we just did not know enough about the underlying science,” Dr. [mdedge.com]
International classification of seizure types (1981) This classification is based on observation (clinical and EEG) rather than the underlying pathophysiology or anatomy. [wikidoc.org]
Pathophysiology Generalized epilepsy is thought to be initiated by 3 different mechanisms: Abnormal response of hyperexcitable cortex to initially normal thalamic input Primary subcortical trigger Abnormal cortical innervation from subcortical structures [emedicine.medscape.com]
Prevention
Treatment and Prevention Tonic-clonic seizure treatment is primarily focused on prevention, however, in some situations such as with prolonged seizures, treatment will be needed acutely. [verywellhealth.com]
There’s no specific way to prevent developing epilepsy. If you have epilepsy, following a healthy lifestyle by getting plenty of sleep and eating well can decrease the chances of triggering a seizure. [healthline.com]
Management[edit] For a person experiencing a tonic–clonic seizure, first-aid treatment includes rolling the person over into the recovery position, which can prevent asphyxiation by preventing fluid from entering the lungs.[12] Other general actions to [en.wikipedia.org]
This uses a device to monitor brain activity and respond with electronic stimulation if it detects a seizure is about to take place.[16] Generalized seizure prevention Idiopathic epilepsy can not be prevented. [ada.com]
Sometimes, changing the diet of a child with epilepsy can help prevent seizures. [mountsinai.org]