DRG Category: 100

Mean LOS: 6.1 days

Description MEDICAL: Seizures with Major CC

classification section:



Epilepsy is a paroxysmal neurological disorder and is characterized by recurrent episodes of convulsive movements or other motor activity, loss of consciousness, sensory disturbances, and other behavioral abnormalities. Because epilepsy occurs in more than 50 diseases, it is considered a syndrome rather than a disease. Approximately 1% of the U.S. population (2 to 3 million people) has been diagnosed with epilepsy. Each year, approximately 180,000 new cases of epilepsy occur.

Convulsive seizures are the most common forms of attacks of epilepsy. Seizures occur with abnormal electrical discharges from brain cells, and these discharges are caused by the movement of ions across the cell membrane. Although seizures are the dominant manifestation of epilepsy, patients can have a seizure and not have epilepsy. The current classification for seizures that is commonly used was redefined in the 1980s (Table 1). The characteristics of the seizure vary and depend on the focus or location of brain involvement. Seizures can vary from almost imperceptible alterations in the level of consciousness to a sudden loss of consciousness with tonic-clonic convulsions of all extremities accompanied by urinal and fecal incontinence and amnesia for the event.

Classification of Seizures

• Partial (focal, local) seizures • Simple partial seizures: No impairment of consciousness • Complex partial seizures: Impaired consciousness, frequently include automatisms • Partial seizures that secondarily generalize • Generalized seizures: All have impairment of consciousness • Absence (previously known as petit mal) of "blank stare"; generally in children • Myoclonic seizures: Short, abrupt muscular contractions • Clonic seizures: Muscle contraction and relaxation • Tonic seizures: Abrupt increase in muscle tone • Tonic-clonic seizures (previously known as grand mal): Quick, bilateral, severe jerking movements • Atonic seizures (drop attacks): Abrupt loss of muscle • Unclassified epileptic seizures: Inadequate or incomplete data to identify classification

Status epilepticus is defined as more than 30 minutes of unconsciousness with continuous or intermittent convulsive seizure activity. Usually, status epilepticus results when more than six seizures occur in 24 hours or when the patient progresses from one seizure to the next without resolution of the postictal period. Pseudoseizures are the physical appearance of seizure activity without the cerebral electrical activity.