Seizures

Definitions & clinical manifestations (Epilepsia 2017;58:522)

  • Seizure: transient neurologic symptoms due to excessive synchronous neuronal activity; may be provoked by a reversible factor lowering the seizure threshold, or unprovoked
  • Epilepsy: ≥2 unprovoked seizures occurring >24 h apart or 1 unprovoked seizure w/ ≥60% probability of further seizures over the next 10 y (see below for prognostication)
  • Generalized seizures (involves brain diffusely)
    • Tonic-clonic (grand mal):
      • Aura (sec to mins): premonition with paresthesias, focal motor contractions, abnormal smells/tastes, fear, depersonalization, déjà vu, autonomic changes, automatisms
      • Ictal period (sec to mins): lateral gaze tongue biting, urinary incontinence, pooling of secretions, incontinence