This document presents a case study on seizures. It discusses the presentation of seizures including signs and symptoms, risk factors, classification, pathophysiology, standard treatment, and lifestyle modifications. Specifically, it describes how seizures occur due to altered neuronal cell membrane integrity leading to increased and amplified neuronal firing that spreads to other neurons. It then details the subjective and objective findings, assessment, plan, medications, and discharge instructions for a 50-year-old male patient admitted with two seizure episodes associated with fever.

1. CASE PRESENTATION ON SEIZURES
PRESENTATION BY
V.VENNELA
PHARM - D 2nd YEAR
201K1T0030
SREE CHAITANYA INSTITUTE OF
PHARMACEUTICAL SCIENCES
THIMMUPUR, KARIMNAGAR

2. 1. Introduction
2. Disease
3. Pathophysiology
4. Standard Treatment
5. Subjective Findings
6. Objective Findings
7. Etiology
8. Assessment
9. Plan
10. Lab Findings
11. Discharge Summary
12. Life Style Modification

3.  Seizures: seizures are sudden, abnormal electrical discharges from the brain
that result in sensation, behavior, movements, perception or consciousness.
 Epilepsy is a chronic disorder of recurrent seizures.
 An isolated, single seizues does not constitute epilepsy.
 Signs and Symptoms:
• Stiffening of the body.
• Loss of consciousess.
• Breathing problems.
• Loss of bowel or bladder control.
• Staring.
• Jerking movements of arms and legs.
• Appearing confused.
• During seizures, your lips may become tined blue.

4. RISK FACTORS
 Age.
 Family history.
 Brain infection.
 Head injuries.
 Stroke and other vascular diseases, leads to brain
damage that may trigger seizers.
 Seizures at childhood, if a child has a long fever
associated seizure that increase the risk of epilepsy.
 Alocohol withdrawal.

5. CLASSIFICATION OF SEIZURES
Generalized Focal Unknown
 Tonic-clonic o Without impairment of O Epileptic spasms
 Absence consciousness or awareness
 Myoclonic o With impairment of
 Atonic consciousness or awareness
 Clonic o Evolving to bilateral
 Tonic convulsive seizures

6. • Seizures that appear to involve all are of the brain are called generalized seizures.
Different types of generalized seizures include:
• Absence seizures: Involves sudden lapse in consciousness and starting blankly into
space. The episodes last less than 15 seconds.
• Tonic seizures: Tonic seizures cause stiffening of your muscle. These seizures usually
affect muscle in your back, arms and legs and may cause fall to the ground.
• Atonic seizures: Atonic seizures also known as drop seizures, cause a loss of muscle
control, which may cause sudden collapse or fall down.

7. CONT
• Clonic seizuers: Clonic seizuers are associated with repeated or rhythmic, jerking
muscle movements. These seizures usually affect the neck, face and arms.
• Myoclonic seizuers: Myoclonic seizues usually appear as sudden brief jerks or
twitches of arms and legs.
• Tonic-clonic seizuers: Tonic-clonic seizures, previously known as grand mal seizuers,
are the most dramatic type of epileptic seizures and can cause an abrupt loss of
consciousness, body stiffening and shaking, and somethings loss of bladder control or
biting of tonque.

8. Due to etiological factors
The integrity of the nuronal cell membrane is altered
The cell begins firing with increas frequency & amplitude
When the intensity of the discharges reaches the threshold the neuronal
firing spreads to adjancent neurons
Ultimately resulting in a seizure

9. 1. Phenytoin 50mg/ml/BD
2. Fosphenytoin 15 to 20mg/kg/BD
3. Phenobarbital 200mg/ml/TID
4. Diazepam 5mg/ml/BD
5. Lorazepam 2mg/ml/OD
6. Gabapentin 300,400,600,800mg/TID
7. valproic acid 100mg/ml/BD

10.  Chief complaints: A male patient of 50 years of age
admitted in acute medical care unit with
IP NO:19012/202 on 19/12/2021
 2 Episodes of seizures on 19/12/2021 at 10:30AM
 Fever since 2 days

11. Objective evidence
• CT-Scan : CT- Brain Detection of structural lesion.
Fever on D1-103degreeF
D2-100degreeF
• Etiology: As patient has an habit of smoking and consumption
of alcohol. So, the patient may have chances of getting seizures.
• Alcohol- 90ml since 10years.
• Smoking- 2 cigrattes/day since 10years.

12. ASSESSMENT:
• Based on subjective and objective evidence the diagnosis was made to be
SEIZURES

13. PLAN:
SNO: BRAND NAME
GENERIC
NAME
ROA
DOSE Frequency DA DS
1. Inj Eptoin Phenytoin IV 500mg BD D1 D2
2. Tab Monocef Cefopodoxime PO 500mg BD D1 D7
3. Tab PCM Acetaminophen PO 650mg TID D1 D7
4. Inj PAN Pantoprazole IV 400mg OD D1 D2
5.
IVF DNS/RL/NS Dextrose
nornmal saline/
Ringer’s lactate/
Normal saline
IV 1 pint OD D1 D2

14. Discharge medication:

15. Lab Investigation:

16. 1. Acetaminophen+Phenytoin
• Using acetaminophen together with phenytoin may alter the effects
of acetaminophen and cause serious side effects that may affect
your liver.

17.  Alocohol and smoking should be avoided.
 Food allergies: Food allergies may provide seizures in childrens who also have
migraine headaches, hyperactive behaviour.
 Inadequate or fragmented sleepcan set off seizures in many people.
 Dietary measures: All patients should maintain a healthy diet, including plenty of
whole grains fresh vegetables and fruits.
 Fasting has been used to prevent seizures since ancient times.
 In 1920, A high-fat, no-sugar, low protien diet, known as a ketogenic diet, was used
to prevent seizures.

18. THANKYOU