1. Seizures Flashcards
Transient loss of consciousness and postural tone due to brain hypo-perfusion; lasts ONLY SECONDS
Syncope
Cardiogenic causes of Syncope
MI
Arrhythmias
Valvular Outflow Obstruction
Orthostatic causes of Syncope
Autonomic failure (spinal cord injury, diabetic neuropathy) Volume depletion (dehydration, blood loss) Medications (anti-hypertensives, antidepressants)
Vasovagal causes of Syncope
Micturition (urination)/Defecation/Cough
Carotid Sinus Hypersensitivity
Noxious stimulus (blood, needles, gore, bad news, fear)
Most common cause of Syncope
Vasovagal (micturition, carotid sinus hypersensitivity, noxious stimulus, etc.)
Paroxysmal pathological discharge of neurons which results in a stereotypical behavior or sensation; it’s s a SYMPTOM
Seizure
CHRONIC condition of recurrent unprovoked epileptic seizures; is a DISEASE
Epilepsy
Continuous seizures for >5 minutes or 3+ seizures without complete recovery; EMERGENCY; high morbidity and mortality
Status Epilepticus
Syncope usually occurs in a _________________ position and is relieved with…
standing; lying down
Types of Focal Onset Seizures (2 types)
- abnormal discharges start in one place with or w/o subsequently spreading
- Aware = simple partial seizure
- motor or sensory - Impaired Awareness =complex partial seizure
Types of Generalized Onset Seizures (5 types)
- all the cortical neurons begin to have abnormal discharges simultaneously
Absence Tonic-Clonic Atonic Myoclonic Infantile Spasms
Any Focal Onset seizure can secondarily Generalize (True or False)
True (i.e. Focal seizure evolving into a Tonic-Clonic seizure)
Common causes of Epilepsy
Metabolic (glucose or electrolytes) Toxins (prescription or illicit drugs) Withdrawal (from alcohol, benzodiazepines) Tumors Infections Genetic Idiopathic
Type of seizure; MOST COMMON; only in small children; ONLY occur with fevers
Febrile Seizures
Type of seizure; occur in both children and adults; display a “staring” spell then immediately back to normal; EEG shows 3Hz spike and wave
Absence (Petit-Mal) Epilepsy
Very common form of epilepsy; arise from Hippocampus-Amygdala region; usually either
- focal awareness with sensory abnormalities (deja-vu, sense of fear, olfactory hallucinations)
OR
- focal impaired awareness without sensations and followed by staring and AMNESIA of event
Temporal Lobe Epilepsy
Gold standard for EPILEPSY Evaluation/Management
EEG
Treatment for Epilepsy
Chronic anticonvulsants
Surgery (rarely)
A primary generalized epilepsy that occurs in infants; sudden symmetric, synchronous spasms/movement (crunching of arms and legs); is associated with DEVELOPMENTAL REGRESSION
Infantile Spasms
Tx for Infantile spasms
ACTH
A primary generalized epilepsy that occurs in children; multiple types of seizures; is associated with DEVELOPMENTAL REGRESSION
Lennox-Gastaut Syndrome (LGS)
A primary generalized epilepsy that occurs in adolescents; triad of seizures (myoclonic, tonic-clonic, absence); NORMAL development
Juvenile Myoclonic Epilepsy
Tx for Juvenile Myoclonic Epilepsy
Valproate, Lamotrigine
SPECT scan shows postictal (period after epileptic seizure) hyperperfusion in what region in a patient with left mesial temporal lobe epilepsy?
Left amygdala
