Seizure
| Seizure | |
| ICD-10 | G40, I64, P90, R56 |
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| DiseasesDB | 19011 |
| MeSH | D012640 |
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Seizure Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Seizure On the Web |
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American Roentgen Ray Society Images of Seizure |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Diagnosis
Determining whether a seizure occurred
Investigation of underlying cause
Additional diagnostic methods include CT Scanning and MRI imaging or angiography. These may show structural lesions within the brain, but the majority of those with epilepsy show nothing unusual.
As seizures have a differential diagnosis, it is common for patients to be simultaneously investigated for cardiac and endocrine causes. Checking glucose levels, for example, is a mandatory action in the management of seizures as hypoglycemia may cause seizures, and failure to administer glucose would be harmful to the patient. Other causes typically considered are syncope and cardiac arrhythmias, and occasionally panic attacks and cataplexy. For more information, see non-epileptic seizures.
Management
The first aid for a seizure depends on the type of seizure occurring. Generalized seizures will cause the person to fall, which may result in injury. A tonic-clonic seizure results in violent movements that cannot and should not be suppressed. The person should never be restrained, nor should there be any attempt to put something in the mouth. Potentially sharp or dangerous objects should also be moved from the vicinity, so that the individual is not hurt. After the seizure if the person is not fully conscious and alert, they should be placed in the recovery position.
It is not necessary to call an ambulance if the person is known to have epilepsy, if the seizure is shorter than five minutes and is typical for them, if it is not immediately followed by another seizure, and if the person is uninjured. Otherwise, or if in any doubt, medical assistance should be sought.
A seizure longer than five minutes is a medical emergency. Relatives and other caregivers of those known to have epilepsy often carry medicine such as rectal diazepam or buccal midazolam in order to rapidly end the seizure.
Safety
A sudden fall can lead to broken bones and other injuries. Children who are affected by frequent drop seizures may wear helmets to protect the head during a fall.
The unusual behavior resulting from the chaotic brain activity of a seizure can be misinterpreted as an aggressive act. This may invoke a hostile response or police involvement, where there was no intention to cause harm or trouble. During a prolonged seizure, the person is defenseless and may become a victim of theft.
A seizure response dog can be trained to summon help or ensure personal safety when a seizure occurs. These are not suitable for everybody. Rarely, a dog may develop the ability to sense a seizure before it occurs.[1]