Epilepsy And Seizure

Muhammad Firdaus Bin Shahar

 Definition

Epileptic seizure is defined as paroxysmal

disturbance of conciousness, motor function,
sensation, emotion, behaviour or perception.
Result from cortical neuronal discharge.
Classification
DIFFERENTIAL DIAGNOSIS OF
EPILEPSY
 Misdiagnosis of epilepsy is common, and
can have major consequences.

The dilemma of making diagnosis in

patient who presented with unexplained
loss of consciousness.
 In adult, syncope is the most common
cause of altered consciousness.

Syncope refers to the transient alteration

of consciousness accompanied by loss of
muscular tone that result from an acute ,
reversible global reduction in cerebral
blood flow.
Vasovagal syncope
This is the most common attack disorder presenting to
hospital emergency departments and may be confused
with seizures particularly if there is stiffening and jerking
during the episode (convulsive syncope).

Features such as a prior history of fainting, a postural

trigger, a warning of lightheadedness and/or visual
symptoms, a brief duration of irregular jerking (less than
one minute), and a rapid recovery without postictal
confusion should raise suspician of convulsive syncope.
Cardiac syncope

This is an uncommon but important cause of

confusion with epilepsy; this diagnosis should
not be missed due to the risk of sudden death
from cardiac arrhythmia.

Collapse with syncopal features but without

warning, particularly if occurring on exercise, or
in the context of a personal or family history of
either congenital heart disease or sudden death,
should raise suspicion of cardiac syncope.
Investigation In Epilepsy
The main objective of investigating patients with epilepsy
are to :

Clarify the diagnosis of epilepsy and non-epileptic attack

Determine the nature of the seizure types and epilepsy
syndrome
Identify the laterality and localization of seizure onset
(partial seizure)
Identify the aetiology of the epilepsy
Identify concomitant problems both neurological and
general
Monitor the progression of the condition, the
consequences of the epilepsy and its treatment.
 Blood Chemistry
Random blood sugar
Renal profile
Liver profile
Serum Calcium and Magnesium

Cardiac Assessment
ECG
Echo

Electroencephalography (EEG)
Routine interictal scalp EEG
Video-EEG monitoring

Neuroimaging
Ct Brain
MRI
Emergency Treatment Of Epilepsy
Summary
Thank You