seizure terminology

Seizure (Sz)
State of excessive neuronal discharge with causes that can be attributed to 1) too much excitation, 2) too little inhibition, 3) development of hyperirritable neurons that are either continuously or recurrently so close to their firing thresholds that they may discharge spontaneously. Excessive neuronal discharges that continuously or recurrently fire discharges synchronously focally or generalized.

Epilepsy
Two or more recurring seizures not directly provoked by intracranial infection, drug withdrawal, acute metabolic changes, or fevers.

Ictus
The seizure itself.

Interictal
The period between seizures.

Postictal
The period after the seizure ends when the patient may be confused. Usually, slowing is seen on the EEG. Todd’s paralysis may happen in this period where an arm or leg may be paralyzed.

Aura
A warning experienced by the patient that a seizure might be imminent; this may be a seizure or part of the coming seizure that is focal with no loss of consciousness (LOC).

Idiopathic epilepsy
The cause of their seizures is unknown.

Refractory
Also called intractable, a seizure disorder that is hard to manage or control and has failed two medications.

Paroxysmal
A well-defined onset and termination of clinical manifestation.

Electrical decremental
When the EEG gets severely attenuated; this can happen for a variety of reasons, including during a seizure instead of high voltage spike and wave.

Automatisms
Seemingly purposeful movements that occur without the patient's awareness such as lip smacking, chewing, blinking, scratching, or fumbling with clothes. (Alimentary is a word used to describe chewing or salivating during a seizure.)

Autonomic symptoms of a seizure
Rising epigastric sensation, increase in blood pressure, change in heart rate, vomiting, flushing, pupillary dilation, dizziness, etc.

Dysmnesic symptoms (dis knee zic)
Impaired memory or psychic symptoms of a seizure - distortion of memory, dreamy state, déjà vu, or flashbacks.

Dejà vu
The feeling that you have been somewhere before or done something before when you haven't. Jamais vu - familiar things are suddenly unfamiliar and confusing.

Olfactory symptoms of a seizure
Bad smells (burnt rubber or molasses); TI & T2 electrodes are used to record from the uncus area of the temporal lobe.

Auditory symptoms of a seizure
Humming, buzzing, whistling, or roaring.

Gustatory sensations of a seizure
Bad taste in mouth.

Symptoms in a motor strip seizure
Jerking of arms or legs. A patient who had turning of the head, eyes, and trunk during a seizure would have a focus in the frontal lobe on the contralateral side to the direction that the body turned.

Symptoms in a somatosensory seizure
numbness, tingling, pain, temperature change.

Electrographic (E#):
To describe a Sz as electrographic, we use the following terms: Rhythmic? Location (Focal, Lateralized, Generalized, Bilateral, Multifocal), Amplitude (High, moderate, low), Frequency (Delta, Theta, Alpha, Beta, mixed frequencies), Morphology (Spike, Spike and wave (SW), Sharp, Sharp and wave, Sharply Contoured), Evolution (Frequency, Location, Morphology), Paroxysm?

Clinical (C#):
Describe the manifestation of the patient (Pt): Drop head, Eye flutter, Shivering, Twitching (Eye, Face), Eye rolling back, Deviation of eyes (Left / Right), Tonic, Clonic, Syncope, Automatism, Gelastic, Jack knife, Lip smacking, Decrystic, Staring, Out of sleep, Bicycling, Ictal scream, Nystagmus (Eye moves rapidly back and forward), Loss of bladder, Hallucination, Hypoxic, Finger tips, Atonic, Headache, Versive (Movement opposite side of activity), Tremoring, Tic, Muscle spasm.