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Epilepsy notes > 1a > Flashcards

1a Flashcards

1
Q

ictal headache localizes to

A

ipsilateral temporal/occipital

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1
Q

Ictal fear/cry localizes to?

A

amygdala, cingulate

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2
Q

gustatory aura (metal/rubber taste) localizes to?

A

insular region, rolandic operculum, parietal region

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3
Q

olfactory aura localizes to?

A

anterior mesial temporal/uncinate

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4
Q

deja vu localizes to?

A

mesiotemporal (no side)

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5
Q

orgasmic aura

A

non dominant mesiotemporal or parasagittal regions

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6
Q

ictal autoscopy (out of body sensation)?

A

non dominant parietal lobe

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7
Q

forced and sustained head and eye version?

A

94% PPV for contralateral temporal or frontal (frontal eye fields) rising to 100% if accompanied by neck extension and followed by generalization

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8
Q

head and eye deviation AFTER generalization?

A

ipsilateral focus (FEF)

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9
Q

fencing position

A

contralateral frontal lobe of the raised arm

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10
Q

sign of 4?

A

contralateral temporal lobe of the extended arm

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11
Q

Y sign

A

supplementary sensori-motor area

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12
Q

hyperkinetic seizre

A

frontal lobe

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13
Q

ictal smile

A

nondominant parietal

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14
Q

ictal pouting/frown

A

“chapeaux de gendarme”, frontal lobe (mesial frontal, anterior cingulate)

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15
Q

manipulative unilateral limb automatism

A

ispilateral

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16
Q

nonmanipulative unilateral limb automatism

A

contralateral

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17
Q

oral automatisms (smacking,sucking, swallowing)

A

temporal lobe/inferomesial/hippocampal

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18
Q

ictal cough

A

dominant hemisphere

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19
Q

post-ictal cough

A

nondominant temporal

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20
Q

unilateral eye blink

A

ipsilateral hemisphere

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21
Q

bilateral eye blink

A

occipital

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22
Q

gelastic epilepsy

A

hypothalamic, mesial temporal, frontal cingulate

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23
Q

ictal weeping/crying

A

mesiotemporal/mesiofrontal

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24
Q

genital automatisms

A

ipsilateral hemisphere

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25
Q

ictal/postictal drinking

A

nondominant temporal lobe

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26
Q

ictal nystagmus

A

contralateral frontal/occipital lobe

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27
Q

ictal spitting

A

nondominant temporal

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28
Q

post-ictal nose wiping

A

ipsilateral temporal lobe (90% PPV)

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29
Q

ictal tachycardia and bradycardia

A

no value, sometimes brady can be assoc with medial temporal lobe

30
Q

ictal dyspnea

A

insula

31
Q

ictal emesis

A

nondominant temporal lobe/anterior insula

32
Q

ictal urinary urge

A

nondominant temporal

33
Q

piloerection

A

ipsilateral temporal (dominant hemisphere)

34
Q

vertigo

A

insular-temporal-parietal junction

35
Q

epigastric rising

A

temporal>orbitofrontal>cingulate

36
Q

ictal speech arrest

A

dominant temporal

37
Q

postictal aphasia

A

dominant temporal

38
Q

ictal speech preservation or ictal prosody change

A

nondominant temporal

39
Q

guttural vocalizations (moaning, grunting)

A

frontal lobe (orbitofrontal/parasagittal)

40
Q

ictal humming or singing

A

temporal or pre-frontal (no clear side)

41
Q

mesial vs lateral temporal lobe seizures?

A

mesial: earlier age, rising epigastric, fear, olfactory feeling, autonomic changes (flushing, dyspnea), contralateral dystonic hand posture, ipsilateral manual automatisms, oral automatisms.

Lateral: older age, vertigo/auditory/visual aura, early evolution into unilateral clonic activity and head turn

42
Q

insular seizures?

A

laryngeal discomfort, vomiting, hypersalivation, perioral warmth, dysarthria/dysphonia

43
Q

When describing focal slowing, want to include?

A
  • location
  • abundance (rare, intermittent, frequent, continuous)
  • frequency in Hz
  • Pattern(poly/monomorphic)
44
Q

Which RDA is associated with focal seizures?

A

TIRDA; high PPV for TLE

45
Q

OIRDA is assoc with

A

childhood absence epilepsy or other genetic generalized epilepsy syndromes

46
Q

Photoparoxysmal response is assoc with?

A

75% have a generalized epilepsy syndrome

47
Q

hypsarythmia is characterized by

A

chaotic pattern, high amplitude, slow, abundant multifocal spikes, +/- electrodecrements

48
Q

nystagmus/saccadic eye movements?

A

PARIETAL eye fields (contralateral)

49
Q

Abdominal/gustatory/olfactory auras: symp zone/EZ?

A

insula/MT Lobe

50
Q

Ictal apnea: symp zone?

A

amygdala/HC
MT lobe

51
Q

ictal piloerection/goosebumps: symp zone?

A

amygdala
MT lobe

52
Q

Deja vu/ Jamais-vu: symp zone/EZ?

A

entorhinal/perirhinal coretx:
MT lobe

53
Q

Experiential aura: symp zone/EZ?

A

mesio/basal/limbic cortex
MT Lobe

54
Q

fear aura : symp zone/EZ?

A

amygdala
MT lobe

55
Q

Auditory illusions/halluciniation: symp zone/EZ?

A

lateral neocortex/STG
Lateral temporal lobe

56
Q

Visual illusions/hallucinations: symp zone/EZ?

A

lateral neocortex/temporo-occipital junction

57
Q

alteration of size (macropsia/micropsia)/color (dyschromatopsia) /shape (metamorphopsia)/ movement (kinetopsia): symp zone/EZ?

A

lateral neocortex of the temporal lobe

58
Q

Most automatisms do not have lateralizing value: unless : unilateral ictal automatism associated with contralateral dystonic hand?

A

usually contralateral to the side of the dystonic hand, and suggestive of MTLE (because part of the focus propogates to the ipsilateral insula which contracts the other limb)

59
Q

Oroalimentory aura: consists of swallowing, lip smacking, kissing/tongue movements?

A

usually lateral temporal lobe

60
Q

When someone is dialeptic during a seizure this means?

A

Complete LOA: unable to follow commands + unable to recall

Can be dom or nondom temporal lobe

61
Q

When someone has preserved awareness?

A

Able to follow commands/talk + unable to recall

Highly lateralizing to the nondominant temporal lobe

62
Q

ictal vomiting

A

usually nodom temp lobe

62
Q

nose wiping?

A

must be less than 60 seconds after the sz.

usually MTLE and ipsilateral to the hand

63
Q

ictal or peri-ictal cough?

A

no lateralizing value, but assoc with temporal lobe epilepsy

64
Q

ictal blinking if unilateral

A

ipsilateral to the epileptic zone, temp lobe epilepsy

65
Q

peri ictal water drinking?

A

EZ non dominant temporal lobe epilepsy

66
Q

gelastic seizure?

A

no lateralizing value
assoc with HH, frontal and temporal lobe

67
Q

aphasic seizure?

A

usually lateralizes to dominant hemisphere, temporal lobe

68
Q

there is a negative motor area on the dominant hemisphere, slightly anterior to Brocas. It is anterior to the SSMA

A

just know.

69
Q

bilateral asymmetric tonic seizure: Abduction/elevation of the arms and flexion at the elbow

A

BILATERAL WITH preserved awareness which is rare
SZ: supplementary sensory motor area
EZ: mesial frontal, basal frontal or mesial parietal.

70
Q

areas associated with hyperkinetic seizures?

A

anterior cingulate, frontopolar, orbitofrontal, opercular insular

Basically the whole frontal lobe.

71
Q
A

Epilepsy notes (5 decks)

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