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EM week 12
Seizures
Question | Answer |
---|---|
List 2 types of seizure disorders: | 1. Partial seizures 2. Generalized seizures |
List 2 types of Generalized seizures: | 1. Generalized Tonic-Clonic Seizure 2. Absence Seizures |
What is the most common seizure? | Generalized Tonic-Clonic Seizure (Grand mal epilepsy) |
Define Absence Seizures: | Patient can have many small seizures, abrupt onset (petit mall epilepsy) |
What percent of diagnosed epilepsy is Generalized Tonic-Clonic Seizures, and what is the percent for Absence Seizures? | 1. 90% 2. 20% |
Define Status Epilepticus: | A seizure that persists for more than 1 hour or repeated seizures that produce a fixed and enduring epileptic condition for more than 1 hour |
Define Convulsion: | Intense, involuntary muscular contraction or a series of such contractions |
Define Epilepsy: | A neurological disorder characterized by sudden, convulsive seizures, with or without the loss of consciousness |
Define Tonic: | Continuous tension or contraction of muscles, as a convulsion or spasm |
Define Clonic: | Movement marked by relaxations of a muscle, after convulsion occurring in rapid succession |
Define Stertorous: | A heavy snoring inspiratory sound occurring in coma or deep sleep |
Define Ictus: | It is the actual seizure itself |
List 4 characteristics of a tonic-clonic seizure: | 1. Loss of consciousness 2. Tonic-Cloic phase 3. Stops in 5-15min. 4. Presence of an aura |
List 4 characteristics of an Absence seizure: | 1. Brief change in level of consciousness 2. Non-convulsive 3. 1-10 or 5-30sec. 4. Common in children |
What is the most common seizure in children? | Absence |
List 3 causes of seizures: | 1. Congenital 2. Trauma or Injury 3. Diseases |
What is a Nonepileptic cause for a patient to have a seizure? | Local anesthetic overdose is the most likely |
What is the stipulation for a patient that has well controlled seizures to be considered an ASA II? | No acute seizures within the past 3 months |
If a patient has well controlled seizures by medication, but has had a seizure within 1 month, what ASA class are they placed in? | ASA III |
What is the ASA classification for a patient with a history of status epilepticus? | ASA III-IV |
List the 3 reasons a patient with seizures would be classified as ASA IV: | 1. History of seizure activity 2. Poorly controlled by medication 3. Acute seizures within one week |
List 2 types of Partial Seizures: | 1. Simple partial 2. Complex partial |
Define Simple Partial: | Involve in One hemisphere |
Define Complex Partial: | Spreads to the opposite hemisphere |
What are the 3 phases of Generalized Tonic-Clonic Seizures? | 1. Prodromal phase (aura) 2. Ictal phase (Toni, Clonic) 3. Postictal phase (recovery) |
What type of Seizure is Life Threatening? | Tonic-Clonic status epilepticus |
Management: Absence and Partial Seizures- Step1: Recognition Step2: Stop Tx (List the last 4 Steps) | Step3: Doc Stat Step4: Position(little time to modify) Step5: Reassure the Pt. Step6: Discharge patient and subsequent dental care |
When should you summon medical assistance if a patient is have a seizure? | After a seizure has lasted for 5 or more minutes |
(Fill in the blanks) Management: Generalized Tonic-Clonic- Step1: Stop Tx Step2: Doc Stat Step3: Position(on floor if possible) Step4:________ Step5: A-B-C Step6: Definitive care, -A:______ -B:______ -C:______ | Step4: Consider summoning EMS-seek help from family member to evaluate seizure –A: Prevention of injury –B: Administration of oxygen –C: Monitor vitals |
What position should a patient be placed in during the postictal phase: | Supine |