Seizure physical examination: Difference between revisions
Jump to navigation
Jump to search
Kiran Singh (talk | contribs) |
No edit summary |
||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Seizure}} | {{Seizure}} | ||
{{CMG}} {{AE}} {{SHA}} | |||
{{CMG}} | |||
==Physical Examination== | ==Physical Examination== | ||
===Vital Signs=== | ===Vital Signs=== | ||
Many seizures, especially in children, are preceded by [[tachycardia]] that frequently persists throughout the seizure. This early increase in heart rate may supplement an aura as a physiological warning sign of an imminent seizure. | Many seizures, especially in children, are preceded by [[tachycardia]] that frequently persists throughout the seizure. This early increase in heart rate may supplement an aura as a physiological warning sign of an imminent seizure. | ||
=== | |||
A small study found that finding a bite to the side of the tongue was very helpful when present.<ref name="pmid7487261">{{cite journal |author=Benbadis SR, Wolgamuth BR, Goren H, Brener S, Fouad-Tarazi F |title=Value of tongue biting in the diagnosis of seizures |journal=Arch. Intern. Med. |volume=155 |issue=21 |pages=2346-9 |year=1995 |pmid=7487261 |doi=}}</ref> | ==Overview== | ||
* [[sensitivity (tests)|Sensitivity]] of | The [[physical examination]] of patients with seizure may reveal: lateral tongue bites, [[nuchal rigidity]] or [[asterixis]], [[bruises]] or scrapes on the body after falls, [[signs]] of a [[neurocutaneous syndrome]] associated with [[epilepsy]] on the [[skin]], [[back pain]], and transient or persistent focal [[weakness]] or asymmetry. | ||
* [[specificity (tests)|Specificity]] of 99% | |||
==Physical Examination== | |||
The [[physical examination]] of patients with seizure may reveal:<ref name="pmid28027373">{{cite journal| author=Gavvala JR, Schuele SU| title=New-Onset Seizure in Adults and Adolescents: A Review. | journal=JAMA | year= 2016 | volume= 316 | issue= 24 | pages= 2657-2668 | pmid=28027373 | doi=10.1001/jama.2016.18625 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28027373 }} </ref><ref name="pmid23041172">{{cite journal| author=Brigo F, Storti M, Lochner P, Tezzon F, Fiaschi A, Bongiovanni LG | display-authors=etal| title=Tongue biting in epileptic seizures and psychogenic events: an evidence-based perspective. | journal=Epilepsy Behav | year= 2012 | volume= 25 | issue= 2 | pages= 251-5 | pmid=23041172 | doi=10.1016/j.yebeh.2012.06.020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23041172 }} </ref><ref name="pmid11297707">{{cite journal| author=Browne TR, Holmes GL| title=Epilepsy. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 15 | pages= 1145-51 | pmid=11297707 | doi=10.1056/NEJM200104123441507 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11297707 }} </ref><ref name="pmid15101468">{{cite journal| author=Ahmed SN, Spencer SS| title=An approach to the evaluation of a patient for seizures and epilepsy. | journal=WMJ | year= 2004 | volume= 103 | issue= 1 | pages= 49-55 | pmid=15101468 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15101468 }} </ref> | |||
* Lateral tongue bites | |||
** Observed in 22% of patients with all types of epileptic seizures, but not observed in patients with [[psychogenic]] nonepileptic seizures. | |||
** A small study found that finding a bite to the side of the tongue was very helpful when present in diagnosing seizure.<ref name="pmid7487261">{{cite journal |author=Benbadis SR, Wolgamuth BR, Goren H, Brener S, Fouad-Tarazi F |title=Value of tongue biting in the diagnosis of seizures |journal=Arch. Intern. Med. |volume=155 |issue=21 |pages=2346-9 |year=1995 |pmid=7487261 |doi=}}</ref> | |||
*** [[sensitivity (tests)|Sensitivity]] of 24% | |||
*** [[specificity (tests)|Specificity]] of 99% | |||
* [[Nuchal rigidity]] or [[asterixis]] | |||
** May suggest an underlying systemic disorder | |||
* [[Bruises]] or scrapes on the body after falls | |||
* [[Signs]] of a [[neurocutaneous syndrome]] associated with [[epilepsy]] on the [[skin]] (such as [[neurofibromatosis]], [[tuberous sclerosis]], and [[Sturge-Weber syndrome]]) | |||
* [[Back pain]] | |||
** May suggest a vertebral [[compression fracture]] | |||
* Transient or persistent focal [[weakness]] or asymmetry | |||
** May suggest the area of the [[brain]] abnormality that may have caused the seizure | |||
==References== | ==References== | ||
Revision as of 13:02, 29 October 2020
|
Seizure Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Seizure physical examination On the Web |
|
American Roentgen Ray Society Images of Seizure physical examination |
|
Risk calculators and risk factors for Seizure physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Physical Examination
Vital Signs
Many seizures, especially in children, are preceded by tachycardia that frequently persists throughout the seizure. This early increase in heart rate may supplement an aura as a physiological warning sign of an imminent seizure.
Overview
The physical examination of patients with seizure may reveal: lateral tongue bites, nuchal rigidity or asterixis, bruises or scrapes on the body after falls, signs of a neurocutaneous syndrome associated with epilepsy on the skin, back pain, and transient or persistent focal weakness or asymmetry.
Physical Examination
The physical examination of patients with seizure may reveal:[1][2][3][4]
- Lateral tongue bites
- Observed in 22% of patients with all types of epileptic seizures, but not observed in patients with psychogenic nonepileptic seizures.
- A small study found that finding a bite to the side of the tongue was very helpful when present in diagnosing seizure.[5]
- Sensitivity of 24%
- Specificity of 99%
- Nuchal rigidity or asterixis
- May suggest an underlying systemic disorder
- Bruises or scrapes on the body after falls
- Signs of a neurocutaneous syndrome associated with epilepsy on the skin (such as neurofibromatosis, tuberous sclerosis, and Sturge-Weber syndrome)
- Back pain
- May suggest a vertebral compression fracture
- Transient or persistent focal weakness or asymmetry
- May suggest the area of the brain abnormality that may have caused the seizure
References
- ↑ Gavvala JR, Schuele SU (2016). "New-Onset Seizure in Adults and Adolescents: A Review". JAMA. 316 (24): 2657–2668. doi:10.1001/jama.2016.18625. PMID 28027373.
- ↑ Brigo F, Storti M, Lochner P, Tezzon F, Fiaschi A, Bongiovanni LG; et al. (2012). "Tongue biting in epileptic seizures and psychogenic events: an evidence-based perspective". Epilepsy Behav. 25 (2): 251–5. doi:10.1016/j.yebeh.2012.06.020. PMID 23041172.
- ↑ Browne TR, Holmes GL (2001). "Epilepsy". N Engl J Med. 344 (15): 1145–51. doi:10.1056/NEJM200104123441507. PMID 11297707.
- ↑ Ahmed SN, Spencer SS (2004). "An approach to the evaluation of a patient for seizures and epilepsy". WMJ. 103 (1): 49–55. PMID 15101468.
- ↑ Benbadis SR, Wolgamuth BR, Goren H, Brener S, Fouad-Tarazi F (1995). "Value of tongue biting in the diagnosis of seizures". Arch. Intern. Med. 155 (21): 2346–9. PMID 7487261.