SEIZURES/EPILEPSY

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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 22-2010: An 87-y-o-w (Alzheimer's Disease / PRES /Inflammatory cerebral amyloid antipathy)
Case 34-2011 (Limbic Encephalitis / Acquired Seizure and Cognitive Decline)