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Which clue in the attack separates dissociative from epileptic seizures?
More, if you want it
Does the patient have the same attack every time?Tap a term: its definition, what you can do with it, and how often the exam asks it.
Definition: an attack that repeats the same pattern each time, with loss of awareness.
You can: Tell an epileptic seizure from a dissociative seizure by whether the attack repeats the same pattern.
Definition: a partial seizure that alters consciousness and impairs awareness.
You can: Tell a complex partial seizure from a dissociative seizure by whether awareness is impaired.
Definition: an attack that looks like epilepsy and differs from one attack to the next.
You can: Tell a dissociative seizure from a complex partial seizure by recall of the unresponsive period.
Definition: one person has both epileptic attacks and dissociative attacks.
You can: Name epilepsy with dissociative seizures when a patient with known epilepsy has new, varying attacks.
Each card is one term. The grey line is what the patient says, which is what the question stem gives.
Summary
An epileptic seizure is an attack that repeats the same pattern each time, with loss of awareness.
An epileptic seizure is an attack that repeats the same pattern each time, with loss of awareness. An attack with the same pattern every time is a stereotyped attack.
Epilepsy is a clinical diagnosis. The diagnosis rests on detailed accounts of the attack from witnesses and the patient. A generalised tonic-clonic seizure may be followed by a post-ictal phase, when the patient can be delirious.
Tom Brennan attends a first seizure clinic in Sheffield. His wife says, "He goes stiff and shakes the same way every time." Tom says, "I remember nothing until I wake up."
Impaired recall of the attack suggests epilepsy. An extensor plantar response after an attack suggests epilepsy.
The plantar reflex, also called the Babinski reflex, is a primitive reflex present at birth. The reflex normally fades in infancy. Doctors examine signs after the attack in the post-ictal phase.
5 more sections on Dissociative seizures, epileptic seizures, complex partial seizures and more
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