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Seizure Disorder, Partial

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Seizures occur when abnormal synchronous neuronal discharges in the brain cause transient cortical dysfunction.

  • Generalized seizures involve bilateral cerebral cortex from the seizure...

DIAGNOSIS

  • Seizure activity usually stereotyped

  • Duration: seconds to minutes, unless status epilepticus develops; status epilepticus may present as focal/generalized convulsions/altered mental status wi...

TREATMENT

GENERAL MEASURES

  • Ask the patient to maintain a seizure diary.

  • Note potential triggers, such as stress, sleep deprivation, drug use, discontinuation of alcohol/benzodiazepines, menses.

MEDICATION

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Most states have restrictions on driving for those with seizure disorders.

  • Depending on seizure manifestation, may also recommend against activities such as swimmi...

REFERENCES

1
Brigo F, Igwe SC, Erro R, et al. Postictal serum creatine kinase for the differential diagnosis of epileptic seizures and psychogenic non-epileptic seizures: a systematic review. J Neurol....

ADDITIONAL READING

  • Gavvala JR, Schuele SU. New-onset seizures in adults and adolescents: a review. JAMA.  2016;316(24):2657–2668. [View Abstract on OvidMedline]

  • Walker LE, Mirza N, Yip VL, et al....

CODES

ICD10

  • G40.109 Local-rel symptc epi w simp prt seiz,not ntrct, w/o stat epi

  • G40.209 Local-rel symptc epi w cmplx prt seiz,not ntrct,w/o stat epi

  • G40.119 Local-rel symptc epi w simple part seiz, ntrc...

CLINICAL PEARLS

  • It is controversial whether AED treatment is indicated after a first seizure. Treatment should be strongly considered when a clear structural cause is identified/risk of injury from se...

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