16. Epilepsy & Other Seizure Disorders

Question 0

An intense paroxysm of involuntary repetitive muscular contractions

Answer 0

Convulsion

Question 1

A condition of recurrent unprovoked seizures

Answer 1

Epilepsy

Question 2

Type of seizure in which a focal or localized onset can be discerned

Answer 2

Partial seizure

Question 3

Type of seizure in which the seizures appear to begin bilaterally

Answer 3

Generalized seizures

Question 4

Characterized by a 2.5-4Hz bifrontally predominant spikes or polyspike-&-slow-wave discharges that arise without underlying structural abnormalities; a genetic component underlies many of these disorders

Answer 4

Primary generalized seizure/epilepsy

Question 5

Seizures that begin locally & evolve into generalized tonic-clonic seizures; generally have no genetic component & are usually the result of underlying brain disease

Answer 5

Secondarily generalized seizure

Question 6

Partial seizure without loss of consciousness or alteration in psychic function

Answer 6

Simple partial seizure

Question 7

Partial seizure with impaired consciousness

Answer 7

Complex partial seizure

Question 8

Characteristic EEG of absence seizure

Answer 8

3-per-second spike-&-wave pattern

Question 9

Onset between 2 & 6 y/o; characterized by atonic or astatic seizures (falling attacks) often succeeded by various combinations of minor motor, tonic clonic, or partial seizures & by progressive intellectual impairment in association w/ a distinctive slow (1- to 2-Hz) spike-&-wave EEG pattern

Answer 9

Lennox-Gastaut syndrome

Question 10

Characterized by a triad of: (1) progressive dementia; (2) myoclonus; & (3) episodes of generalized seizures

Answer 10

Lafora disease

Question 11

Most common form of idiopathic generalized epilepsy in older children & young adults; characteristic bursts of 4- to 6-Hz irregular polyspike activity

Answer 11

Juvenile myoclonic epilepsy

Question 12

Begins with a tonic contraction of the fingers on one hand, the face on one side, or the muscles of one foot. This transforms into clonic movements in these parts.

Answer 12

Jacksonian motor seizure

Question 13

A transient paralysis of the affected limbs following convulsions that have a prominent focal motor signature

Answer 13

Todd paralysis

Question 14

Localization: Jacksonian/focal motor seizure

Answer 14

Precentral gyrus/ BA 4

Question 15

Localization: Contraversive seizure (forceful sustained deviation of face & eyes contralateral to site of lesion)

Answer 15

Frontal/ BA 8

Question 16

Localization: somatosensory seizure

Answer 16

Contralateral postcentral

Question 17

Localization: visual seizure

Answer 17

Occipital

Question 18

Localization: auditory seizure

Answer 18

Transverse temporal gyri of Heschl

Question 19

Localization: vertiginous symptoms

Answer 19

Superoposterior temporal region

Question 20

Localization: olfactory hallucinations

Answer 20

Medial temporal

Question 21

Localization: gustatory hallucination

Answer 21

Insula

Question 22

Localization: visceral sensation

Answer 22

Temporal

Question 23

Appears during the 1st yr of life; characterized by recurrent, single or brief episodes of gross flexion movements of the trunk & limbs & less frequently by extension movements; hypsarrythmia on EEG

Answer 23

Infantile spasm/ West syndrome

Question 24

Specific to infants & children between 6 months & 5 yrs of age w/ a strong inherited tendency; takes the form of a single generalized motor seizure occurring as the patient's core temperature rises/ reaches its peak

Answer 24

Benign febrile seizure

Question 25

A febrile acute encephalitic or encephalopathic state causes focal or prolonged seizures, generalized or focal EEG abnormalities, & repeated episodes of febrile convulsions during a febrile illness

Answer 25

Complex febrile seizure

Question 26

Seizures that can be evoked by a discrete physiologic or psychologic stimulus

Answer 26

Reflex seizure

Question 27

T/F: Lacunar infarcts produce convulsions.

Answer 27

False

Question 28

1st line tx: tonic-clonic

Answer 28

Carbamazepine, valproate, phenytoin

Question 29

2nd line tx: tonic-clonic

Answer 29

Lamotrigine, oxcarbazepine

Question 30

1st line tx: myoclonic

Answer 30

Valproate

Question 31

2nd line tx: myoclonic

Answer 31

Topiramate, leviteracetam, zonisamide

Question 32

1st line tx: partial

Answer 32

Carbamazepine, phenytoin

Question 33

2nd line tx: partial

Answer 33

Valproate, lamotrigine, oxcarbazepine, leviteracetam

Question 34

1st line tx: absence

Answer 34

Valproate

Question 35

2nd line tx: absence

Answer 35

Ethosuximide, lamotrigine

Question 36

1st line tx: unclassifiable

Answer 36

Valproate

Question 37

2nd line tx: unclassifiable

Answer 37

Lamotrigine

Question 38

Best choice of medication for a woman with seizure disorder that has been off epilepsy medications for some time before pregnant, & seizes during pregnancy

Answer 38

Phenytoin

Question 39

Most common idiosyncratic reaction to anti-epileptic drugs

Answer 39

Rash

Question 40

Preferred drug for seizure control in infancy

Answer 40

Phenobarbital

Question 41

Drug for immediate suppression of convulsions

Answer 41

Diazepam IV 2mg/min until convulsions stop or a total of 20 mg is given

Question 42

Drug for initiation or reloading of anticonvulsants

Answer 42

Phenytoin 20 mg/kg in freely running with NSS at a rate not exceeding 50 mg/min as LD (Monitor: BP & ECG)