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Seizure Disorders

Sahil Mullick, FAAFP, MD and Keithstone Young Kim, Medical Doctorate Reviewed 05/2023
 


BASICS

DESCRIPTION

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

  • Epilepsy: two or more unprovoked seizures ap...

DIAGNOSIS

Conventional classification of seizures 
  • Generalized seizures

    • Tonic–clonic: tonic phase: sudden loss of consciousness; clonic phase: sustained contraction followed by rhythmic contractions of ...

TREATMENT

  • Older adults are more sensitive to side effects from AEDs; use lower initial dosing  (3).

  • After an initial unprovoked seizure, 21–45% will have a recurrence within 2 years  (4).

  • Starting antie...

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] ...

SEE ALSO

Seizures, Febrile; Status Epilepticus 

CODES

ICD10

  • G40.B1 Juvenile myoclonic epilepsy, intractable

  • G40.804 Other epilepsy, intractable, without status epilepticus

  • G40.A0 Absence epileptic syndrome, not intractable

  • G40.A1 Absence epileptic synd...

CLINICAL PEARLS

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

  • Semiology of event is very important for diagnosis of seiz...

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