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SEIZURES/EPILEPSY

  • SEIZURES/EPILEPSY (4 most important questions to ask):

    • First: Confirm Diagnosis. History and PE are vital. Selected Tests may be needed. 
      Table 1. Conditions That Can Mimic Epileptic Seizures. NEJM 2009
    • Second: Define the type of Seizure
      • Seizure with loss of Consciousness
        • Absences
        • Complex Partial Seizure
        • Tonic-Clonic Seizure (Convulsion
      • Seizure without loss of Consciousness
        • Myoclonus
        • Aura (Simple partial subjective Seizure)
        • Simple Partial Motor Seizure
    • Third: Cause of Seizure (VITAMIN C as a mnemonic). Is it Epilepsy
    • Fourth: Treatment: AED. Do you need to start it. If yes, short term or long term. Recommend your patient not to drive based on your state. 
References
Status epileptics in adults Lancet Neurology 2015
First seizures in adults BMJ 2014
Evaluation of a First Seizure AAFP 2007
Sudden, Unexpected Death in Epilepsy NEJM 2011
Drug-Resistant Epilepsy NEJM 2011 
Initial Management of Epilepsy NEJM 2008 
Learning from Case Examples
Case 34-2011 (Limbic Encephalitis / Acquired Seizure and Cognitive Decline)
More on Pharmacology
Epilepsy (Medical Letter)










CHOOSING SEIZURE MEDICATIONS


 
Mayo Clinic Neuro Review 2013 (Orlando) 


 
Mayo Clinic Neuro Review 2013 (Orlando) 

 
Mayo Clinic Neuro Review 2013 (Orlando) 

WHO SHOULD BE TREATED AFTER FIRST SEIZURE?

 
Mayo Clinic Neuro Review 2013 (Orlando) 












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