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Epilepsy, Light-headedness and Syncope

Epilepsy, Light-headedness and Syncope. Dr Mohamad Shehadeh Agha MD MRCP(UK) د. محمد شحاده آغا. To define the story inquire about Pre-attack Attack Post-attack. WITNESS.

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Epilepsy, Light-headedness and Syncope

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  1. Epilepsy, Light-headedness and Syncope Dr Mohamad Shehadeh Agha MD MRCP(UK) د. محمد شحاده آغا

  2. To define the story inquire aboutPre-attackAttackPost-attack

  3. WITNESS

  4. SeizuresPre-attack: no warning or auraAttack:tonic phase the respiration ceases, cyanosisClonic phase jerking all four limbs tongue biting+/- incontinencePost attack: deep sleep diffuse bodily aching or stiffness

  5. SyncopePre-attack: nausea ,dizziness, sweating,…Attack: gradual, fall, pale, occasionally shivering, if prolonged may progress to GTCPost-attack: rapid return to consciousness when flat on floor

  6. Psychogenic attackOccurs in front of peopleNo injuryProlonged attackRed in faceAttempt to open the eyes may lead to voluntary contractions of the orbicularis oculi and upward deviation of the eyes.Allowing the limp hand to fall on the face may be resisted.

  7. Epilepsy It is the consequence of focal or generalized epileptogenic discharges in the brain.

  8. Classification of Epilepsy Generalized seizures 1. Absence attacks (petit mal) 2. Myoclonus 3. Clonic 4. Tonic 5. Tonic-Clonic (grand mal) 6. Atonic

  9. Partial seizures A. Simple Partial (consciousness preserved) 1. Motor symptoms 2. Somatosensory symptoms 3. Autonomic 4. Psychic 5. Mixed forms

  10. Partial seizures B. Complex Partial (consciousness impaired) 1. Motor symptoms 2. Somtosensory symptoms 3. Autonomic 4. Psychic 5. Mixed forms 6. Impaired consciousness alone

  11. Partial seizures C. Partial seizures with secondary generalization

  12. Syncope It is caused by sudden drop in blood flow to the brain.

  13. This may lead to abrupt loss of consciousness either without any warning or with preceding symptoms.

  14. Without any warningSyncope due to aortic stenosis or complete heart block.

  15. Preceding symptoms Feeling of faintness Lightheadedness Dizziness Bilateral dimming or loss of vision General weakness Nausea Hot or cold feeling Sweating Sounds seem distant

  16. Causes of syncope Vasovagal syncope Postural hypotension Cardiac arrhythmia Valsalva maneuver Structural cardiac disorders Acute circulatory failure Micturation syncope Cough syncope

  17. Psychogenic attacks Panic attacks Functional overbreathing Pseudoseizures Agoraphobia

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