The following paragraph was taken from UpToDate on 2013/01/23:
Postictal state —Manifestations typically include confusion and suppressed alertness; focal neurologic deficits may also be present. The postictal state may last from seconds to minutes to hours, depending upon several factors including which part(s) of the brain were affected by the seizure, the length of the seizure, whether the individual was on AEDs, and age.
As an example, young adults with partial seizures of frontal lobe origin may have postictal states that last only several seconds, while elderly patients with secondarily generalized seizures may have postictal confusion and sleepiness that persists for as long as several days to a week, particularly if there is underlying brain dysfunction. If a person had a CPS or a convulsion, his or her level of awareness gradually improves during the postictal period, much like a person waking up from anesthesia after an operation.
The ictal and postictal manifestations are different between complex partial seizure and generalized tonic-clonic seizure:
1. Complex partial seizures typically last less than three minutes and may be immediately preceded by a simple partial seizure. Afterward, the patient enters the postictal phase, often characterized by somnolence, confusion, and headache for up to several hours. The patient has no memory of what took place during the seizure other than, perhaps, the aura.
2. A generalized tonic-clonic seizure (also called grand mal seizure, major motor seizure, or convulsion) is the most dramatic type of seizure. It begins with an abrupt loss of consciousness, often in association with a scream or shriek. All of the muscles of the arms and legs as well as the chest and back then become stiff. The patient may begin to appear cyanotic during this tonic phase. After approximately one minute, the muscles begin to jerk and twitch for an additional one to two minutes. During this clonic phase the tongue can be bitten, and frothy and bloody sputum may be seen coming out of the mouth. The postictal phase begins once the twitching movements end. The patient is initially in a deep sleep, breathing deeply, and then gradually wakes up, often complaining of a headache.
End Note: please remember the following sentence…
In some cases, the postictal symptoms may be the presenting clinical feature, when the seizure itself is very brief and/or unwitnessed.
2013年1月23日 星期三
訂閱:
張貼留言 (Atom)
Thrombolytic therapy
Intra-arterial therapy (IAT) has been used for three decades to promote recanalisation after stroke. Whereas results of the Prolyse in Acute...
-
Primary progressive aphasia (PPA) 這個名詞是由Mesulam所提出來的。Mesulam在2007年底寫過一篇文章,回溯PPA的發現及發展的經過。故事得要從1975年說起。當時Norman Geschwind離開Boston City Hospit...
-
Semantic dementia 這個名詞雖是由 Snowden,Goulding及Neary等人於1989年共同提出,但故事通常得由 Elizabeth Warrington 談起。 Warrington 於1975年以 “selective impairment of se...
-
The following paragraph was taken from UpToDate on 2013/01/23: Postictal state —Manifestations typically include confusion and suppressed ...
沒有留言:
張貼留言