- Generalized Seizures
-
Generalized Tonic-Clonic Seizure
- Generalized convulsive activity
- Myoclonic Seizure
- Rhythmic jerking of arms (may involve head and neck)
- Atonic Seizure (e.g. drop attack)
- Sudden, brief loss of Muscle tone
- Tonic Seizure
- Brief (<1 minute), bilateral increased extremity motor tone
-
Absence Seizure
- Non-motor Seizure
- Idiopathic
- Congenital cerebral lesion
- Posttraumatic cerebral scar
- Brain Tumor
- Aura (may precede Seizure)
- Irritability
- Apathy
- Giddiness
- Headache
- Scintillating scotomata
- Nausea
- Choking Sensation
- Paresthesia
- Myalgia
- Sudden Loss of consciousness
- Tonic Phase
- Muscular rigidity with Opisthotonos
- Adduction and flexion of arms
- Extension of legs
- Clonic Phase
- Generalized body musculature jerking
- Flaccid coma
- Loss of postural tone
- Loss of Deep Tendon Reflexes
- Unconsciousness
- Apnea, Cyanosis
- Associated findings
- Tongue or lip biting
- Urinary or Fecal Incontinence on awakening
-
Complete Blood Count (CBC)
- Postictal Leukocytosis in peripheral blood
-
Prolactin
- Elevated following Seizure
-
Electroencephalogram (EEG)
- Paroxysmal diffuse outbursts of high voltage
- Many spikes in fast rhythm
- Level C evidence
- Carbamazepine (Tegretol)
- Phenobarbital
- Phenytoin (Dilantin)
- Topiramate (Topamax) - also Level D evidence for use in Myoclonic Seizures
- Valproic Acid (Depakene) - also Level D evidence for use in Myoclonic Seizures
- Level D evidence
- Prophylaxis for both GTCS and Myoclonic Seizures in Younger Adults (age >16 years)
- Level C evidence
- Level D evidence