MEDICAL CAUSES OF SEIZURES

Seizures are commonly encountered in patients who do not have epilepsy . Factors that may provoke such seizures include organ failure, electr olyte imbalance, medication and medication withdrawal, and hypersensit ive encephalopathy. There is usually one underlying cause, which may b e reversible in some patients. A full assessment should be done to rul e out primary neurological disease. Treatment of seizures in medically ill patients is aimed at correction of the underlying cause with appr opriate short-term anticonvulsant medication. Phenytoin is ineffective in the management of seizures secondary to alcohol withdrawal, and in those due to theophylline or isoniazid toxicity. Control of blood pre ssure is important in patients with renal failure and seizures. Non-co nvulsive status epilepticus should be considered in any patient with c onfusion or coma of unclear cause, and electroencephalography should b e done at the earliest opportunity. Most ill patients with secondary s eizures do not have epilepsy, and this should be explained to patients and their families. Only those patients with recurrent seizures and u ncorrectable predisposing factors need long-term treatment with antico nvulsant medication.