00:01
We also think about a
seizure review of systems
and there are a few things that we
think about in reviewing seizure systems
that can point us in the direction
of a seizure a non seizure diagnosis.
00:12
When looking at an aura we ask
about to any strange tastes,
smells or visual symptoms,
any rising nausea
or recent Deja vu,
or a sense of fear
or impending doom.
00:22
Sometimes these mini auras
will be happening repetitively,
and patients won't offer them
and asking specifically
about recurrent episodes.
00:30
With these symptoms
can be helpful
in honing in on simple partial
seizures that may be occurring.
00:37
We think about seizure mimics.
00:39
Any chest pain, dizziness,
lightheadedness,
headache or sleep symptoms
that could point towards
pre-syncope or a syncable diagnosis
or a parasomnia sleep disorder.
00:49
We think about things
that exacerbate seizures.
00:52
Fever can lower the
seizure threshold,
new medications, antibiotics like the
fluoroquinolones, which we discussed,
stress can drive or
exacerbate seizures
and sleep deprivation is one of
the most pervasive exacerbations
of seizures and can
set off seizures
in someone with
underlying epilepsy.
01:10
And then in terms of risk
factors for epilepsy,
history of seizure is a risk
factor for subsequent epilepsy
prior head trauma,
specifically with hospitalization,
or loss of consciousness
or facial fractures increases
the risk of subsequent epilepsy.
01:25
Patients with a history of meningitis
are at higher risk of epilepsy,
prior encephalitis or a brain
tumour can increase the risk
of developing epilepsy
later in life.
01:34
History of febrile seizures
also increases the risk
of developing
epilepsy late in life.
01:38
Many patients with
febrile seizures will not,
but about 3% of patients
who had febrile seizures
will develop epilepsy
later in life.