0071643192.pdf

Seizures are classified based on behavioral, electrophysiologic, and clinical

features of the seizure rather than on anatomic or pathophysiologic features.

They can generally be broken down into partial and generalized seizures.

Partial (Focal) Seizures

Partial seizures begin in localized area of the brain.

SYMPTOMS/EXAM

■ Simple partial

■ Brief event without alteration of consciousness

■ If involving motor neurons →unilateral focal clonic movements.

■ May also manifest as isolated sensory, autonomic, or psychic symptoms

■ Complex partial (temporal lobe or psychomotor)

■ Partial seizure with impairmentof consciousness and postictal state

■ Commonly manifests as mental and psychological symptoms, includ-

ing changes in affect, confusion, hallucinations, automatisms (eg, lip

smacking)

■ Secondary generalized: Partial seizure that spreads to both hemispheres

(eg, generalized seizure preceded by aura)

NEUROLOGY

TABLE 15.5. Secondary Causes of Seizures

Metabolic derangement

Hypoglycemia

Hyponatremia

Hypocalcemia

Drugs and toxins

Anticholinergics/cholinergics

Antidepressants

Mushrooms (Gyrometrasp.)

Sympathomimetics

Toxic alcohols

Isoniazid

Withdrawal syndromes

CNS infection

CNS lesion or event

Neurocysticercosis

Hemorrhage

Tumors

Stroke

Vasculitis

Hydrocephalus

Febrile seizure (pediatrics)

Trauma

Eclampsia

Consciousness remains

normal with simple partial

seizures.

Consciousness is impaired

with complex partial seizures.

Consciousness is lost with

generalized seizures.

Neurocysticercosis

(CNS Taenia soliumlarvae

infection) is the most common

cause of secondary seizures

in the developing world.