Dr Trowers

Seizures

Sudden uncoordinated electrical activity in the brain

Generalized Seizures

• Petit mal, most common in ages 4-12, rarely after 20. typically less than 15 seconds, no postictal phase.
• Grad Mal – tonic/conic – often  preceded by aura, can occur at any age, typically followed by postictal phase. Can progress to status epilepticus (seizure lasting longer than 5 minutes or back to back seizures with no return to consciousness)

• Tonic – body wide rigidity
• Clonic – rhythmic contraction of major muscle groups,

Partial Seizures (Focal)

• Simple partial seizure – Jacksonian March seizure – tonic/clonic active localized to one part of the body – may spread and progress to a generalized seizure – No aura or LOC
• Complex partial seizure – mood changes, abrupt rage , often preceded by aura, 1-2 minutes, no postictal phase.

Seizure Management

• Protect from injury
• maintain airway
• provide oxygen
• establish vascular access
• emotional support and transport
• Meds (NYC REMAC Protocols)

• dextrose 25gm IVP (50% Solution)

• (Peds: glucagon 1mg IM, dextrose 0.5gm/kg IVP – > one month old use 10% solution, 25% for patients 1 month to 14 years)

• (Peds: Medical Control option: 0.05mg/kg IV/IN over two minutes)

• (Peds: Medical Control option: 0.1mg/kg IV/IO over two minutes, if no IV 0.5mg/kg via rectum)

• (Peds: if no IV 0.1mg/kg IM/IN max dose 5mg)