Two Groupings of seizures:
One involves seizures with LOC and loss of postural tone, the other involves a lucid or semi-conscious patient and localized seizure activity.
What is Generalized seizures and Partial seizures.
100
When an epileptic has a seizure caused by changes in anticonvulsant levels, infection, medication interactions, decreased sleep, or increased stress the seizure is called _______
What is a breakthrough seizure
100
high levels in the blood of these drugs can lower the seizure threshold.
What are anti-convulsants.
100
According to Cowlitz County EMS protocols:
If a seizure has persisted more than 3-5 minutes or if repetitive: This drug and dosing is first indicated (adults and peds)
Lorazepam 2mg IV or IM q min until termination of seizure or 8mg is reached. Child- 0.1mg/kg may repeat q 5min X 2.
100
The most common differential for seizures, may also involve a brief period of seizure like activity.
What is Syncope.
Preceding symptoms of syncope may include Nausea, light headedness or diaphoresis.
200
a fixed condition of the brain responsible for recurrent seizures
What is epilepsy
200
Hypomagnesmia is the cause of this type of seizure. Multiple seizures are common once they reach the seizure threshold.
What is Alcohol withdrawal seizure.
200
This pre-hospital drug is poorly absorbed IM.
What is valium
200
If no IV access is available these two meds and routes are indicated.
What is Lorazepam IM or Valium 0.5mg/kg Rectal.
Rectal dose is administered with insulin syringe and IV catheter.
200
usually occurs when witnesses are present, and secondary incontinence and or injuries are very rare.
What are pseudoseizures
300
A type that is in the grouping of generalized but involves no loss of postural tone. Episodes are usually very brief and pt resumes normal activity after cessation.
What is an absence seizure
300
Although many street drugs may cause seizures, this is common.
What is Cocaine
300
Clonazepam, Gabapentin, lamictal, Keppra, Tegretol, Enoxaparin, Dilantin, Topamax, Depakote. ---------One is not used for seizures.
What is Enoxaparin (anticoagulant- Lovenox)
300
This drug has a faster onset than ativan but is shorter acting.
What is Versed
300
A more common differential Dx of stroke, may present with hemiparesis, hemianopsia and a preceding aura.
What are migraines.
400
a complex partial seizure is a focal seizure where _______ is affected.
What is consciousness
These types of seizures are commonly misdiagnosed as psych issues. These types my present with the patient staring off and having odd motor movements such as lip smacking, hand gestures or others. The pt will not remember the aura or event and bystanders may not be aware it took place.
400
These types of infections in the brain and CNS can cause secondary seizures.
What are encephalitis and meningitis.
400
Phase when a pt has ridgid trunk, extended ext's, and pt also may be apneic, cyanotic and incontinent.
What is the Tonic phase.
400
Phenytoin is ________channel blocker that is commonly used in the hospital setting as a second line drug for seizures. It has a slow onset and long duration
What is sodium
400
Pt has lip smacking and staring off similar to a complex partial seizure. A family member states he just started a new med. The med list is as follows :
Lisinopril,
Atenolol,
Oxycodone,
Senna,
Paxil,
Compazine;
This differential diagnosis is suspect.
What is Dystonic reaction.
500
This type of seizure involves a sudden loss of postural tone without an aura.
What is Atonic or "Drop" seizure.
500
When this occurs after cardiac arrest or stroke, seizures are common and may be refractory to anticonvulsants. General anesthesia may be indicated along with continued anticonvulsant infusions.
What is anoxic ischemic injury
500
A form of epilepsy, these seizures may be self limiting or spread from the hands or feet to more proximal areas and become generalized.
What are Jacksonian Seizures
500
RSI may be considered for _________ __________ and if used a ________ ________ paralytic should be used.
What is "prolonged seizures" and "short acting"
500
Condition that presents with preceding symptoms including SOB, anxiety and extension/contraction of ext's. Pt may have involuntary spasms during episode. In severe cases pt may lose consciousness.