Seizure

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Health & Fitness, Science, Education, Medicine, Life Sciences

4.9 • 816 Ratings

🗓️ 27 August 2017

⏱️ 9 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Basic Approach

* Step 1: Describe the seizure* Did patient have an aura? * Was there loss of consciousness?* What did the movements look like?* Did they have postictal phase? * Did they have a trauma as well?* Step 2: Ask about TIME (mnemonic)* Tongue biting* Usually occurs on the lateral sides of tongue* Incontinence* Medication changes/adjustments* Ethanol use* Step 3: Do a FULL neurologic examination* Mental Status* Cranial nerves* Visual fields* Speech* Cerebellar (finger-nose)* Motor* Sensation* Reflexes* Gait* Step 4: Testing plan* Glucose* Pregnancy Test* CBC* Electrolyte panel* Urine drug screen* Drug levels of anti-epileptic agents* Step 5: Simple seizures (<5 minutes) do not require immediate treatment* Roll them on side* Suction

Additional Reading

* Approach to Status Epilepticus (EM Clerkship)

Transcript

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0:00.0	Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of
0:07.1	endless charting once you become a doctor? Do you think that doctors should be spending more
0:11.9	time with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a
0:20.4	secure, hippocompliant scribe that anybody can use.
0:24.7	Focus your energy on what matters, providing good patient care.
0:29.5	Use coupon code EM50 to save 50% the first month you try it,
0:34.1	and you can cancel at any time if you decide it's not right for you. You can learn more
0:38.9	at www.gitfreed.a.i. Hello, med students. My name is Zach Olson and thank you for downloading
0:51.3	this week's episode of the EM Clerkship Podcast.
0:57.2	Core neurology topic today, here is your case.
1:07.9	Okay, this is Nikita, 27-year-old, had a seizure at a local urgent care.
1:13.4	Vital signs are post-65, respiration is 12.
1:17.3	BP 110 over 80, 8, febrile.
1:19.9	We do have line established.
1:22.0	We didn't give any benzo.
1:23.0	She's been post-tickable the whole time she's been with us.
1:25.3	Had a boyfriend with her.
1:27.6	It does have a past history of epilepsy.
1:30.3	It is on Kepra, Zonagran, Carbatrol, and Anfee generally presents as Petit Mall,
1:35.1	but this was a grand mall seizure.
1:37.0	No history of alcohol, tobacco, or drugs.
1:39.1	Glucose was 124.
	...

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