(42A) Epilepsy in Adults

Question 1

partial seizures emanate from …

generalized seizures emanate from …

Answer 1

partial: specific cortical region
generalized: brainstem to both hemispheres (@ same time)

Question 2

complex partial seizure vs secondary generalized

Answer 2

generalized = loss of consciousness and BILATERAL cerebral involvement

complex partial = just loss of consciousness and FOCAL cerebral involvement

Question 3

nml or abnml EEG with simple partial seizures

Answer 3

nml

Question 4

Signs and symptoms of _____ SIMPLE partial seizures:

1. motor
2. somatosensory
3. autonomic
4. psychic

Answer 4

1. movement starts in hand to arm to face
2. tingling/numbness in hand to arm then face
3. epigastric sensations, N/V
4. deja vu, fear

Question 5

what type of seizures are assc with automatisms (chewing, lip smacking, hand rubbing, picking)

Answer 5

complex partial

Question 6

if the hand automatisms are happening on the left side, what side of the cerebrum is the complex partial seizure

Answer 6

left

IPSILATERAL

Question 7

complex partial seizures emanate from what lobes…

Answer 7

temporal or frontal lobes

Question 8

when a person suffering from a complex partial seizure begins to see contralateral posturing the seizure activity has spread to the …

Answer 8

ipsilateral basal ganglia

Question 9

generalized 3 Hz spike is characteristic of what type of seizure

Answer 9

absence seizure

Question 10

Describe the classic presentation of an absence seizure

Answer 10

10-20s loss of consciousness
staring spell
subtle myoclonic movements (eye-lid flutter)
NO post ictal confusion

Question 11

What type of seizures are aura’s?

Answer 11

simple partial seizures

Question 12

cry, loss of conciousness
muscle rigidity
rhythmic jerking
bladder/bowel incontinence 
post-ictal confusion

Answer 12

tonic-clonic seizures

Question 13

conscious
brief, shock-like muscle contractions
precipitated by awakening or falling asleep

Answer 13

myoclonic seizure

Question 14

brief loss of consciousness
head drop
fall

Answer 14

atonic seizure

Question 15

goal of AED therapy

Answer 15

medical remission

Question 16

medical remission vs disease remission

Answer 16

medical = seizure free with only 1 or 2 AEDs (without side effects)

disease = seizure free off of meds

Question 17

surgical therapy with sometime lead to what type of remission

Answer 17

disease

Question 18

criteral for generalized convulsive status epilepticus

Answer 18

generalized seizure

lasts >5 mins or 2+ sequential seizures occurring w/o full recovery of consciousness

Question 19

management of GCSE

Answer 19

ABSs
labs
glc then thiamine
ativan 
Dilantin

Question 20

GCSE is considered refractory if it fails to respond to

Answer 20

lorazepam