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Seizure Disorders

Yvo A. Rodriguez, MD and Shaun O. Smart, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Seizure: sudden and transient symptoms (altered level of consciousness, motor manifestations) due to abnormal or synchronous electrical activity of neuronal networks

  • Epilepsy: endurin...

DIAGNOSIS

  • Physiologic seizures are true cortical events and may require acute intervention.

  • Psychogenic nonepileptic seizures (PNES) are also a differential diagnosis to consider.

  • Conventional classific...

TREATMENT

  • Older adults are more sensitive to side effects from AEDs; therefore, target dose should be half of dosing for younger population (3)[C].

  • After presenting with an initial unprovoked seizure, ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Maintain adequate drug therapy; ensure compliance and/or access to medication. Drug therapy withdrawal and tapering of doses may be considered after a seizure-fre...

REFERENCES

1
Perucca E, Tomson T. The pharmacological treatment of epilepsy in adults. Lancet Neurol.  2011;10(5):446–456. [View Abstract on OvidMedline]
2
Fisher RS, Acevedo C, Arzimanoglou A, et ...

ADDITIONAL READING

  • Drugs for epilepsy. Treat Guidel Med Lett.  2013;11(126):9–18. [View Abstract on OvidMedline]

  • Husain AM. Practical Epilepsy. New York City, NY: Demos Medical Publishing; 2016...

SEE ALSO

Seizures, Febrile; Status Epilepticus 

CODES

ICD10

  • R56.9 Unspecified convulsions

  • P90 Convulsions of newborn

  • G40.909 Epilepsy, unspecified, not intractable, without status epilepticus

ICD9

  • 780.39 Other convulsions

  • 779.0 Convulsions in newborn

  • 345....

CLINICAL PEARLS

  • Initiation of treatment depends on multiple variables, including type of seizure, underlying risk factors, and further risk of recurrence.

  • Semiology of event is very important for diagn...

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