5: Seizure Disorders Flashcards

1
Q

Recurrent, uncontrolled cerebral excitation

A

seizure

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2
Q

How are seizures initated?

A

neurons

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3
Q

Where are seizure activities?

A

adjecent areas of brain; can stay local or spread

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4
Q

cause of seizure disorders

A

often unknown in younger people; in adults it’s often secondary to a specific even (CVA, tumor, trauma, etc)

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5
Q

classify seizures according to…

A

1) extent of cerebral involvement
2) EEG activity
3) symptoms
4) etc.

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6
Q

subdivisions of seizures

A

1) focal (partial) seizures

2) generalized seizures

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7
Q

focal seizures

A

simple, complex

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8
Q

generalized seizures

A

absence; tonic-clonic; others

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9
Q

can focal become generalized?

A

yes

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10
Q

which primary subdivision affects both cerebral hemispheres?

A

generalized

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11
Q

most common seiures

A

1) complex partial

2) generalized tonic clonic

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12
Q

goal of antiseizure medications

A

SELECTIVE effect on hyperexcitable neurons

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13
Q

primary antiseizure agents- “front line”

A

1) phynytoin (Dilantin)
2) Carbamazepine (Tegretol)
3) Ethosuximide (Zarontin)
4) Valproates (Depakene, Divalproex, others)

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14
Q

other primary antisizure agents

A

benzos, barbiturates

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15
Q

most common antizeizure agent worldwide

A

barbitol

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16
Q

“second generation” antiseizure drugs

A

1) Gabapentin (Neurontin)
2) Lamotrigine (Lamictal)
3) Levetiracetam (Keppra)
4) pregabalin (lyrica)
5) Tiagabine(Gabitril)
6) Topiramate (Topamax)

17
Q

“second generation” antiseizure drugs: are they more effective than traditional agents?

A

not necessarily but they tend to have milder side effects; more predictable profile

18
Q

“second generation” antiseizure drug benefits: all more ( ) to tx seizures

A

drug combos

19
Q

“second generation” antiseizure drug benefits: used to tx what?

A

neuropathic pain (esp. Neurontin)

20
Q

primary antiseizure mechanisms: Dilantin, Tegretol, and Depakene decrease what entry into rapidly firing neurons?

A

Na+

21
Q

primary antiseizure mechanisms: Zarontin decreases what entry into thalamic neurons?

A

Ca++

22
Q

primary antiseizure mechanisms: barbs, BZDS, several newer drugs increase what inhibition?

A

GABA

23
Q

primary antiseizure mechanisms: several newer drugs decrease the release or effects of what?

A

excitatory amino acids

24
Q

antiseizure med side effects: relatively minor

A

1) sedation
2) headache
3) dizziness
4) incoordination
5) GI problems

25
Q

antiseizure med side effects: more serious

A

1) liver toxicity
2) blood dyscrasias (aplastic anemia, agranulocytosis)
3) increased risk of birth defects

26
Q

( ) % can remain seizure-free after meds are withdrawn

A

60-70%

27
Q

success in no meds are associated with: bein free of seizure for at least ( ) while on meds

A

2 years

28
Q

success in no meds are associated with: having good seizure control withing ( ) after seizures being

A

1 year

29
Q

success in no meds are associated with: having a normal ( ) prior to withdrawal

A

neurologic exam

30
Q

success in no meds are associated with: having intial seizure onset in ( )

A

childhood

31
Q

PTs should document ( ). what does this help? what population is this especially true in?

A

seizure activity; helps assess efficacy of meds; children