ALPHA
| Seizure type | Location | Before | During | After | Treatment |
|---|---|---|---|---|---|
| Generalised tonic-clonic seizures (grand mal) | General brain | Aura | Tonic (muscle tensing), Clonic (muscle jerking). Tonic before clonic usually. Incontinence, tongue biting, complete LOC | Post-ictal peroid - confused tired irritable and low |
Sodium valproate Women able to have children - lamotrigine or levetiracetam |
| Focal seizures (partial seizures) | Can be anywhere localised | Deja vu, strange sensations | Aware in simple partial seizure but not in complex | Lamotrigine or levetiracetam | |
| Myoclonic seizures | Sudden brief muscle contractions - jolt |
Sodium valproate Women able to have children - levetiracetam |
|||
| Tonic seizures | Sudden onset of increased muscle tone. Only last a few seconds/minutes. Patient falls if standing |
Sodium valproate Women able to have children - lamotrigine |
|||
| Atonic seizures ("drop attacks") | Sudden loss of muscle tone. Often resulting in a fall. May indicate Lennox-Gastaut syndrome | Same as tonic seizures | |||
| Absence seizures | More common in children | Becomes blank and stares into space then abruptly returns to normal. Unaware. 10-20 seconds | Usually stop with as they grow older | Ethosuximide | |
| Infantile spasms (West syndrome) | Most common in children | Hypsarrhythmia on EEG | It presents with clusters of full-body spasms | It is associated with developmental regression and has a poor prognosis. . | Treatment is with ACTH and vigabatrin |
| Febrile convulsions | Occur in children (6month - 5 year) | High fever | Not caused by epilepsy or other neurological pathology | One in three will have another febrile convulsion. They slightly increase the risk of developing epilepsy. | Reduce fever |
Levofloxacin (quinolones) lowers the seizure threshold