Rural Emergency Medicine

This is part of the Med in Small Doses series, which aims to give you a snapshot of a disease or disorder. For information about the series, or common abbreviations click here.

Abnormal high frequency discharge from a group of CNS Neurons. Not a Dx but a series of SSx.

Partial (Focal) Seizures
  • Simple partial: 5-10s, < 1 min, clonic ± tonic, Ø LoC
  • Complex partial: ictal 30 sec -3 min, behavioural arrest, Δ in consciousness
  • Partial + 2O Generalised: Aura (partial) → Convulsive (general) [commonly in frontal lobe]
Generalised Seizures
  • Absence (Petit Mal): brief LoC, w/o posture loss
  • Myoclonic: Ø LoC, brief contraction of part/all body
  • Tonic-clonic (Grand Mal): 10% epileptics. LoC, violent muscle contractions, ~incontinence
  • Tonic: ↑ muscle tone
  • Atonic (Drop Attack): brief LoC, loss of postural tone (1-2s)

FBC, Blood glucose & electrolytes, ABGs, drug screen (amphetamines, cocaine, etc)

Rx (in general): Na+ Channel Blockers
General Seizures = Valproate
Partial Seizures = Carbamazepine

Seizure Types & Treatments
Military General Attacked Weary Fighters Pronouncing, ‘Veni, Vedi, Veci’ After Crushing Enemies
Myoclonic        Valproate
Grand Mal         Valproate
Atonic             Valproate
West Syndrome        ACTH
Focal            Carbamazepine
Petit Mal        Ethosuximide

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