ICA1
1. Seizures
2. Bleeding disorders
3. Acute hepatitis
4. Neuropathy
5. Cardiomyopathy
6. ACS
7. Pneumonia
8. Meningitis and encephalitis
9. Valvular heart disease
10. Chronic hepatitis
Seizure Disorders
- Seizures:
● are abnormal, excessive and synchronized discharges of neurons in cerebral
cortex
● Self limiting, intermittent, random, loss of consciousness, loss of muscle tone,
inattentiveness
● Electroencephalography
- Epilepsy:
● 2 more more unprovoked seizures occurring more than 24 hours apart
● OR 1 unprovoked seizure and probabilities of further seizures
● Provoked seizures are not called epilepsy unless they have a probability to
reoccur like hyponatremia, CNS infection, traumatic brain injury
- Seen more in males
- Focal partial S common in all age groups
- Generalized S common in kids
- Focal > Generalized > Absence > Myoclonic
- Etiology:
● VITAMINS
● Vascular, infections, trauma, autoimmune, metabolic, idiopathic, neoplasm,
psychiatry
- Drugs that induce seizures:
● Antibiotics- penicillin, metronidazole
● Anti diabetic- insulin
● Hormonal- prednisolone, oxytocin
● Cardiac- lidocaine
● Antimalarial- chloroquine
- Trigger factors:
, ● Sleep deprivation
● Missed dose of anti epileptic drugs
● Alcohol
● Physical and mental exhaustion
- Above case: must have taken some drugs like cns stimulants and alcohol since she
went to a party.
- Treatment: Lorazepam
,- Scenarios:
● 1- Cause: metabolic syndrome or hyponatremia. Rx: Loop diuretics
● 2- Cause: hypoglycemia
● 3- Cause: hepatic encephalopathy
- Neurotransmitters involved in seizures:
● GABA
● Acetylcholine
● Aspartate
● Glutamate
● Abnormalities in ion channels (Na, K, Ca)
● Increased excitation
, - Generalized seizures:
● Bilateral clinical and electrographic events without any detectable focal onset
- Absence seizures:
● 30 seconds+
● Kids
● Can occur 100 times a day hehe
● Impaired consciousness, Unresponsive, Rapid blinking of eyelids, Chewing
movements, no confusion, fatigue, hyperventilation
● Begins in childhood
● EEG: bilateral regular 3 Hz spike
● DDX: daydreaming, inattentiveness
- Myoclonic seizures:
● Sudden and brief muscle contraction that may involve one part of the body or the
entire body
● Seen in metabolic disorders, CNS diseases, brain injury
● Unaffected consciousness
● Jerks in UL and LL
● Occurs in series
● Kids
● 1-5 seconds
● EEG: polyspike, sharp or slow waves
1. Seizures
2. Bleeding disorders
3. Acute hepatitis
4. Neuropathy
5. Cardiomyopathy
6. ACS
7. Pneumonia
8. Meningitis and encephalitis
9. Valvular heart disease
10. Chronic hepatitis
Seizure Disorders
- Seizures:
● are abnormal, excessive and synchronized discharges of neurons in cerebral
cortex
● Self limiting, intermittent, random, loss of consciousness, loss of muscle tone,
inattentiveness
● Electroencephalography
- Epilepsy:
● 2 more more unprovoked seizures occurring more than 24 hours apart
● OR 1 unprovoked seizure and probabilities of further seizures
● Provoked seizures are not called epilepsy unless they have a probability to
reoccur like hyponatremia, CNS infection, traumatic brain injury
- Seen more in males
- Focal partial S common in all age groups
- Generalized S common in kids
- Focal > Generalized > Absence > Myoclonic
- Etiology:
● VITAMINS
● Vascular, infections, trauma, autoimmune, metabolic, idiopathic, neoplasm,
psychiatry
- Drugs that induce seizures:
● Antibiotics- penicillin, metronidazole
● Anti diabetic- insulin
● Hormonal- prednisolone, oxytocin
● Cardiac- lidocaine
● Antimalarial- chloroquine
- Trigger factors:
, ● Sleep deprivation
● Missed dose of anti epileptic drugs
● Alcohol
● Physical and mental exhaustion
- Above case: must have taken some drugs like cns stimulants and alcohol since she
went to a party.
- Treatment: Lorazepam
,- Scenarios:
● 1- Cause: metabolic syndrome or hyponatremia. Rx: Loop diuretics
● 2- Cause: hypoglycemia
● 3- Cause: hepatic encephalopathy
- Neurotransmitters involved in seizures:
● GABA
● Acetylcholine
● Aspartate
● Glutamate
● Abnormalities in ion channels (Na, K, Ca)
● Increased excitation
, - Generalized seizures:
● Bilateral clinical and electrographic events without any detectable focal onset
- Absence seizures:
● 30 seconds+
● Kids
● Can occur 100 times a day hehe
● Impaired consciousness, Unresponsive, Rapid blinking of eyelids, Chewing
movements, no confusion, fatigue, hyperventilation
● Begins in childhood
● EEG: bilateral regular 3 Hz spike
● DDX: daydreaming, inattentiveness
- Myoclonic seizures:
● Sudden and brief muscle contraction that may involve one part of the body or the
entire body
● Seen in metabolic disorders, CNS diseases, brain injury
● Unaffected consciousness
● Jerks in UL and LL
● Occurs in series
● Kids
● 1-5 seconds
● EEG: polyspike, sharp or slow waves
