Wednesday, December 26, 2018

Are you fitting well?

In a seizure/epilepsy long case, there are 3 essential clinical questions to ask:

1) Is it truly a seizure?
2) What is the cause of the seizure(s)?
3) what triggered this current seizure?

Could it be anything else other than seizure. Consider hypoglycaemic attack, cardiac and vasovagal syncope, transient ischaemic attacks etc etc.
Causes of seizure include epileptic seizures(epilepsy), meningoencephalitis, autoimmune encephalitis, electrolytes imbalances particularly hyponatraemia, cerebral venous thrombosis, uraemia, hepatic encephalopathy etc etc.
Examples of triggers are insomnia, alcohol, drugs, stress and metabolic derangements.

Ask if there was any video recording during an episode of seizure.

Consider Juvenile Myoclonic Epilepsy in young adults.

International League Against Epilepsy(ILAE) 2017
Image result for 2017 ilae seizure classification

Image result for 2017 ilae seizure classification

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