China
Africa
Explore chapters and articles related to this topic
Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Seizures are classified into either generalised or focal (also called partial) seizures. The whole brain (or at least the whole of the cerebral cortex) is involved in generalised seizures, whereas focal seizures only affect part of the brain, and often, only one part of one lobe of the brain. Generalised seizures are broadly classified into ‘absence’, ‘myoclonic’, ‘atonic’, ‘tonic’, ‘clonic’ and ‘tonic-clonic’. Focal or partial seizures are classified as ‘simple’, in which consciousness is retained, or ‘complex’, in which consciousness is impaired or lost; it is possible if not likely, that this division of ‘simple’ and ‘complex’ may be dropped from future classifications of the epilepsies. Simple partial seizures with sensory, autonomic or psychic symptoms may be easily overlooked in younger children unable to describe such symptoms. Focal or partial seizures may become secondarily generalised, resulting in a tonic-clonic convulsion. The symptoms of a simple partial seizure, prior to secondary generalisation, constitute the epileptic aura. A recent diagnostic scheme proposal has been submitted to the International League Against Epilepsy (ILAE). The scheme encompasses five levels or axes: seizure description, seizure type, epilepsy syndrome, aetiology and associated physical and/or learning impairments [3].
Classification of Seizures and Epilepsy
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Almost any imaginable symptom can occur as the subjective or observable expression of a simple partial seizure, from elementary motor (“Jacksonian seizures,” adversive seizures) and sensory disturbances to complex emotional, psychoillusory, hallucinatory and dysmnesic phenomena. Simple partial seizures reflect abnormal neuronal activity occurring in a limited, and often very circumscribed, area of cortex (epileptogenic focus). Classification of a partial seizure as “simple” means that consciousness is not impaired, implying that the patient can interact normally with the environment except for those limitations imposed on specific functions by the seizure.
Practice Paper 6: Answers
Published in Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar, Get ahead! Medicine, 2016
Anthony B. Starr, Hiruni Jayasena, David Capewell
A simple partial seizure is one where consciousness is preserved. In complex partial seizures, consciousness is affected. Patients having a complex partial seizure stop what they are doing, stare blankly and may display automatisms (e.g. lip smacking). This may be preceded by complex hallucinations. After a few minutes, consciousness returns and the patient is drowsy.
Intravenous sodium valproate in status epilepticus: review and Meta-analysis
Published in International Journal of Neuroscience, 2021
Ioannis Liampas, Vasileios Siokas, Alexandros Brotis, Elias Zintzaras, Ioannis Stefanidis, Efthimios Dardiotis
Therefore, seizure cessation within 30 min of drug infusion was appraised in two studies (Figure 3A). Misra et al. (India, 1-85 years) included patients with CSE using a 10 min time-frame, while Gilad et al. (Israel, >18years) included patients with complex partial seizures, generalized tonic-clonic seizures, simple partial seizure and partial with generalized seizures according to a 30 min time-frame. In both studies, interventions were deployed as first-line AEDs according to the following administration regimens (maintenance doses were not administered in either study): Misra et al.: VPA: 30 mg/kg infused over 15 min and PHT: 18 mg/kg at a rate of 50 mg/min, Gilad et al.: VPA: 30 mg/kg and PHT: 18 mg/kg both infused over 20 min. Overall, seizure cessation was accomplished in 36/53 (67.93%) patients in the VPA group and 21/42 (50%) patients in the PHT group. According to FE model (PQ=0.25, I2=25%), no significant difference was observed regarding seizure termination between VPA and PHT when deployed as first-line AEDs [FE OR = 1.99, 95% CI = (0.83–4.75)].
The Revised Definition and Classification of Epilepsy for Neurodiagnostic Technologists
Published in The Neurodiagnostic Journal, 2018
Robert S. Fisher, Anna M. Bonner
The names of the seizures have changed in a 2017 classification that revises the 1981 classification. The primary division continues to be based upon focal origin of the seizure in one hemisphere of the brain versus generalized onset in both hemispheres. Consciousness has been maintained as an important classifier of focal seizures, but awareness is used as a more easily understood surrogate marker for consciousness. The prior term “complex partial seizure” is now a “focal impaired awareness seizure.” The prior “simple partial seizure” is now a “focal aware seizure.” Focal seizures can be further subdivided into motor and nonmotor onset categories. Generalized seizures are not classified according to awareness, since awareness is impaired for most, and are categorized as either motor or absence (nonmotor) seizures. If onset is unknown, some seizures can still be classified under the heading for unknown-onset seizures.
When the plot thickens: a rare complication of rheumatoid arthritis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Marianne Scheitel, Samuel T. Ives, Rawad Nasr, Marc W. Nolan
Shortly after admission, the patient had an episode of involuntary muscle contraction of her right extremity and right facial twitching lasting 20 seconds without loss of consciousness. Following the event, the patient had residual right arm weakness. The episode was thought to be a simple, partial seizure. The patient had multiple similar episodes during her admission, some of which had associated aphasia and involvement of the left lower extremity. She underwent further evaluation with an EEG, lumbar puncture, and additional blood testing. Patient had one spell on video EEG with no electrographic correlate.