Pre PACES Podcast #9 Seizures
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May 23, 2021 Dr. Hamish Morrison, a neurology registrar and expert on seizures, joins to shed light on important differences between seizures and other collapses. He offers essential guidance on history-taking, highlighting prodromal signs and lifestyle advice for affected patients. Key topics include triggers for seizures, the significance of tongue biting, and the various causes ranging from genetic to autoimmune. He also covers safety tips, driving guidelines, and considerations for pregnancy, making this a must-listen for clinical candidates.
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Prodrome Patterns Differ
- Seizure prodromes often include positive phenomena like flashing lights, déjà vu, strange smells or sensory tingling.
- These differ from vasovagal prodromes (lightheadedness, sweating, tunnel vision) and help discriminate causes.
Screen For Common Triggers
- Ask about recent infections, electrolyte loss, drugs, alcohol, sleep deprivation and head trauma as seizure triggers.
- Identify provoked causes because treating the trigger may prevent further seizures.
Focus On Witnessed Features
- From witness accounts, check initial tone, duration and rhythm of shaking and presence of lateral tongue bite.
- Note that lateral tongue bites and prolonged rhythmic tonic-clonic activity favour epilepsy over syncope.