1. Symptoms
   1. after the seizure
      1. well oriented
      2. severe headache
      3. tachycardia
      4. No focal neurological deficit
2. Plan
   1. History taking
   2. P/E
   3. GCS
   4. Imaging
      1. CT scan
         1. Midline shift
         2. Obliteration of the sulci
         3. Blurring of the grey-white junction
   5. Management
      1. Epidural Hematoma
         1. Greater than 30 mL regardless of the patient’s GCS score.
         2. Acute EDH & coma (GCS score ≤8) with pupillary abnormalities.
         3. Less than 30 mL, midline shift less than 5 mm, GCS > 8, No focal deficit
            1. managed nonoperatively : serial CT and close neurologic observation
         4. Surgically evacuated
      2. Subdural Hematoma
         1. (SDH) >10 mm in thickness or associated with midline shift >5 mm
            1. surgically evacuated
      3. Anti-epileptics
         1. In patients with significant structural injury (eg, larger contusions or hematomas, brain laceration, depressed skull fracture) or a GCS score < 10
3. Assessment
   1. Epilepsy
      1. Etiology
         1. Autoimmune disorders
         2. Expanding intracranial lesions
         3. Hyperpyrexia
         4. Metabolic disturbances
         5. Pressure-related
         6. Withdrawal syndromes
   2. stages of seizure
      1. Aura stage
      2. Ictus stage
      3. Postictal stage
   3. Status epilepticus
      1. prevention
      2. management
   4. Classifications
      1. Generalized seizure
         1. Tonic-clonic seizures
         2. Absence seizures
      2. Partial seizure types
         1. Simple partial seizures
         2. Complex partial seizures
   5. Diagnosis
      1. History taking
      2. P/E
      3. Investigations
         1. Electroencephalogram (EEG)
         2. MRI
         3. CT scan
   6. Prognosis
      1. 70% remission on monotherapy
      2. 10- 15% have refractory epilepsy
   7. Psychological impact
4. Signs
   1. sudden jerk in Rt arm
   2. dropping tooth brush
   3. sudden "jumping" arms
   4. signs are on and off for several months
   5. One day
      1. fell down
         1. strange sound
         2. limbs went stiff
         3. eyes rolled upward
         4. frothy sputum
         5. wet herself
         6. lost consciousness
5. Demographics
   1. female, Amal
   2. 22 yrs old
   3. secretory
   4. engaged