9 - Seizures

Summary

The epileptic seizures are internationally classified into simple partial seizures, complex partial seizures, partial seizures evolving to secondarily generalized seizures, generalized seizures (convulsive or nonconvulsive), myoclonic seizures, clonic seizures, tonic seizures, tonic-clonic seizures and atonic seizures (astatic seizures). The emergency department (ED) management of a patient with a seizure is commonly determined by the cause, type, severity, and frequency of the seizure. Status epilepticus (SE) can be nonconvulsive or convulsive. Convulsive SE is a medical emergency requiring prompt and focused treatment. A benzodiazepine is the first class of drug to be administered in treating SE. Alcohol withdrawal seizures are generalized tonic-clonic convulsions that usually occur within 48 hours after cessation of ethanol ingestion, with a peak incidence between 13 and 24 hours. It is important that the emergency physician knows the state's law regarding restriction of driving privileges for patients who have experienced a seizure.