Adult and Pediatric Epilepsy Flashcards
Mutation associated with GEFS+?
SCN1A
If there are GTC seizures along with absence seizures, which agents should you use?
Depakote, lamotrigine
What are meds that can aggravate absence epilepsy?
phenytoin, carbamazepine, gabapentin, lamotrigine
Dosing of topiramate that causes increase metabolism of OCP?
> 200 mmg/d
1st time therapy for benign rolandic epilepsy if you choose to treat it?
carbamazepine
PLEDs (periodic lateralized epileptiform discharges)
unilateral or bilateral, high amplitude, sharp, and slow wave complexes at 0.5 - 3 hz
*any destructive process such as anoxia, HSV encephalitis, drug toxicity, and other toxic metabolic etiologies
West syndrome triad
infantile spasms, hypsarrhythmia, psychomotor arrest/regression
Vigabatrin is associated with what ocular finding?
retinal toxicity
1st line treatment for West syndrome?
ACTH
Formula for calculating loading dose
(target total level - current total level) x (kg body weight x volume distribution)
Depakote dose what to lamotrigine’s half life?
increases half life by 24-48 hours
MOA benzos?
GABAa agonist, leads to subsequent activation of chloride channels–>hyperpolarization of the neuronal membrane and decreased neuronal excitability
Fencer’s posturing seizure localization
SMA
Seizure coming from the side of arm flexion.
head deviates towards contralateral side
Which syndrome has seizures that are sensitive to hyperthermia?
Dravet
Which syndrome is catastrophic and has burst suppression pattern that is present during wakefulness and sleep?
Ohtahara
*oooohshit that’s bad
Temporal lobe seizure lateralizing sign?
seizure arises from contralateral side to the dystonic extremity
automatisms ipsilateral to the focus
Syndrome with stimulus induced myoclonus?
Unverricht-Lundborg
*mutation in EPM1 gene
Sialidosis type 1 enzyme deficinecy?
alpha-neuraminidase
*adolescents and adults
Sialidosis type 2 enzyme defiency?
alpha-acetyl neuraminidase and beta-galactosialidase
*neonatal and second decade of life
EPM2A mutation is associated with what syndrome?
Lafora body disease
What disorder has pathology showing perivascular cuffs of lymphocytes and monocytes and glial nodules in the gray and white matter?
Rasmussen’s encephalitis
PLEDs
sharply contoured waves with various morphologies
occur every 1-2 seconds, lateralized to one hemisphere
*stroke, HSV, infection, hemorrhage, tumor
REM period normally occurs how long after sleep onset?
90 mins
Stage N1 sleep characteristics?
-slow rolling eye movements, reduction in muscle artifact, attenutation of the occipital dominant alpha and increaseing slower frequencies
- can also have vertex waves and POSTS
Stage N2 sleep?
-K complexes
-sleep spindles
REM sleep?
-alpha may be seen in occipital leads
-rapid eye movements
Stage N3 sleep?
delta activity more than 20%
OSA vs central sleep anpea?
in central sleep apnea there is transient central cessation of respiratory drive and airway obstruction does not occur
Sleep terror
-non-REM parasomnia
-slow wave or stage 3 sleep
-doesn’t recall, wake up confused
sleep walking
-non-REM parasomnia
-stage 3 sleep
what type of sleep disorder has an increased prevalence of alpha synucleinopathies?
REM sleep behavior disorder
REM parasomnia
-loss of normal atonia that happens during REM
-complex motor activity – acts out dreams, violent
Kleine-Levin syndrome
recurrent hypersomnia, can last for several days or weeks with aggresiveness, confusiong and hypersexuality
INTERMITTENT
What structure is involved in the pathophsyiology of nacroplexy with cataplexy
lateral hypothalamus
-loss of hypocretin neurons
-LOW HYPOCRETIN LEVELS
Teenager who stays up all night, wakes up tired but when they sleep in they feel fine?
delayed sleep phase syndrome
