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48-year-old male (2 short episodes of generalized tonic-clonic seizures…
48-year-old male
2 short episodes of generalized tonic-clonic seizures
Seizure
Generalized
Provoked
Endogenous
CNS
Trauma
Hemorrhage
Subarachnoid
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Subdural hematoma
Gait disturbance, hemiparesis, headaches, confusion, incontinence. focal neurologic deficits, bradycardia, hypertension, irregular respirations
Epidural hematoma
Vascular lesion
Aneursym
Arteriovenous malformation
Infection
Meningitis
Meningoencephalitis
petechiae, palpable purpura, Neck stiffness, photophobia, Kernig's sign, Brudzinski's sign
Encephalitis
altered mental status, focal neurological deficits
Abscess
Subdural empyema
Malignancy
Neoplasm
Neurodegenerative disease
Alzheimer disease
Congenital brain abnormalities
Hypertensive encephalopathy
headache, vomiting, trouble with balance, and confusion
Stroke
Ischemic
aphasia, apraxia, vision loss, gaze deviation, neglect
Anoxic encephalopathy
Cardiac arrest
Hypoxemia
Metabolic disturbances
Hyperthyroidism
warm skin, sweating, tremors of hands and fingers, tachycardia or palpitations,
Hepatic failure
DM
Hypoglycemia
excessive amounts of insulin, agitation, tremor, hunger, weakness, palpitation, nausea, irritability, sweating, tachycardia
Hyperglycemia
focal motor seizures
Hypocalcemia
Renal failure
Hypoparathyroidism
Pancreatitis
papilledema, arrhythmias, hypotension,myalgias, muscle spasm
Uremia
Renal failure
myoclonic seizures
Hyponatremia
lethargy, hyporeflexia, altered mental status, edema, skin turgor changes, confusion, agitation, muscle twitching, nausea
Hypomagnesemia
irritability, agitation, confusion, myoclonus, tetany,convulsions
Hypernatremia
Exogenous
Drugs/toxins
Withdrawal
Drugs
hypnotic and anxiolytic agents
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Alchohol
diaphoresis, palpitations, visual hallucinations
Overdose/Intoxication
Opioids
altered mental status, miotic pupils, decreased bowel sounds, bradycardia, hypoglycemia, hypotension, respiratory depression
Antidepressants
Xanthines
Salicylates
Alcohol
Unprovoked
Idiopathic cause
Focal
Partial seizure
secondarily generalized
postictal lethargy
Epilepsy
Status epilepticus
Convulsive
Non-convulsive
prolonged postictal period, twitching, blinking, eye deviation
Seizure mimic
Syncope
Transient LOC resulting in loss of postural tone; prodrome of lightheadedness, sweating, palpitations, pallor; myoclonic jerks. No postictal sx
Psychogenic Seizure
Response to emotional upset/witness present. side to side head trashing, rhythmic pelvic thrust and alternating clonic extremity motion. No postictal confusion
Panic disorder/Conversion disorder/Psychosis
Hyperventilation syndrome
Gradual onset of attack + dyspnea, anxiety, perioral numbness, progress to involuntary spasm of extremeties & LOC. Postical sx rare.
Migraine
Preceded by aura (visual/sensory); followed by headache
Movement disorders
Dystonia, chorea, myoclonic jerks, tremors, tics
Consciousness preserved
Transient global Amnesia
anterograde amnesia,disoriented in time, asking repetitive question, other cognitive and motor functions spared
Transient Ischemic attack
weakness, numbness, aphasia, visual loss); intensity is usually maximal at onset; consciousness usually preserved
Narcolepsy with cataplexy
previously well, 15 mins prior to being found unresponsive on the floor
rare under 50
Extra-axial
Intra-axial
Due to
12-48 hours after
Recurrent
Predispose