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BRAIN BATTACK > CH15: EPILEPSY > Flashcards

CH15: EPILEPSY Flashcards

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1
Q

how many percent of patients with absence are completely motionless during the attack (p. 336)

A

10%

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2
Q

For absence, rarely seizures begin before 4 years of age or after puberty (p. 336)

A

TRUE

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3
Q

Difference between childhood and adolescence absence seizure (p. 336)

A

Persistence into adulthood

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4
Q

EEG finding in absence seizur (p. 336)

A

Generalized 3 per second spike and wave

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5
Q

EEG finding in atypical absence seizure (p. 337)

A

Long runs of slow spike and wave activity

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6
Q

EEG finding in Lennox- Gestaut syndrome (p. 337)

A

1-2 Jz spike and wave

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7
Q

Lennox Gastaut preceded by this condition in early life (p. 337)

A

Hypsarrhythmia

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8
Q

Hypsarrhythmia+ mental development arrest + hypsarrhythmia (p. 337)

A

West syndrome

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9
Q

most common form of idiopathic generalized epilepsy in older children and young adults (p. 337)

A

Juvenile Myoclonic Epilepsy

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10
Q

EEG findings in JME (p. 337)

A

4-6 Hz irregular polyspike activity

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11
Q

JME impairs intelligence (p. 337)

A

FALSE

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12
Q

Drug of choice for JME (p. 337)

A

Valproic Acid

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13
Q

Drug of choice for JME, but child- bearing age (p. 337)

A

Levetiracetam, Lamotrigine

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14
Q

Drugs that exaggerate seizures in JME (p. 337)

A

Carbamazepine and Phenytoin

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15
Q

Olfactory hallucination localization (p.339)

A

Inferior and medial part, temporal lobe

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16
Q

Gustatory hallucination localization (p.339)

A

Insula and parietal operculum

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17
Q

Most frequent reported color during visual seizure (p. 339)

A

Red

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18
Q

Auditory hallucination localization (p. 339)

A

Superior temporal convulsion

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19
Q

Vertiginous sensation localization (p. 339)

A

Superoposterior temporal region

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20
Q

pathologic findings of Infantile spasms (p. 343)

A

Cortical dysgenesis

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21
Q

common precipitant of Febrile seizure beacause of its tendency to cause high fever (p. 344)

A

Herpesvirus 6

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22
Q

EEG findings in epilepsia partialis continue (p. 345)

A

repetitive slow- wave or sharp waves or spikes over the central areas of the contralateral hemisphere

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23
Q

EPC- resistant or not to treatment? (p. 345)

A

RESISTANT TO TREATMENT

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24
Q

EPC + progressive hemiparesis (p. 345)

A

Rasmussen Syndrome

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25
Q

Antibodies in Rasmussen encephalitis (p. 345)

A

Anti- GluR3

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26
Q

A single EEG tracing obtained during the interictal state is abnormal to some degree in what percentage of patients (p. 348)

A

30% to 50%

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27
Q

gross and microscopic CNS findings in brains of patients with epilepsy (p. 349)

A

NORMAL

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28
Q

loss of neurons in what part of the hippocampus in MTS (p. 349)

A

CA1

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29
Q

overall concordance of primary epilepsies (p. 349)

A

70% monozugotic, 30% dizygotic

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30
Q

problematic channel in AD nocturnal frontal lobe epilepsy (p. 350)

A

nicotinic acetalcholine receptor subinit

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31
Q

problematic channel in generalized epiilepsy with febrile seizures plus (p. 350)

A

neuronal sodium channel

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32
Q

problematic channel in benign familial neonatal convulsions (p. 350)

A

two different potassium channels

33
Q

problemattic hcannel in JME and childhood absence (p. 350)

A

brain GABA

34
Q

progressive myoclonic epilepsy, problematic cystatin B (p. 350)

A

Unverricht- Lundborg disease

35
Q

progressive myoclonic epilepsy, tyrosine phophate B (p. 350)

A

Lafora body disease

36
Q

sudden myoclonic jerk of the head and arms leading to flexion or extension of the body (p. 353)

A

Infantile spasms

37
Q

bilateral slow waves and multifocal spikes in EEG (p. 354)

A

West syndrome

38
Q

myoclonic focal seizures, loss of function mutation in SCN1A in most cases (p. 354)

A

Dravet Syndrome

39
Q

most common lesions underlying status epilepticus in late adult life (p. 355)

A

Previous infarcts

40
Q

seizure from advanced Alzheimers (p. 355)

A

10%

41
Q

Most common metallic poison causing seizures: childhood (p. 356)

A

Lead

42
Q

Most common metallic poison causing seizures: adulthood (p. 356)

A

Mercury

43
Q

cephalosporin if excessive dosage can cause status epilepticus (p 356)

A

Cefipime

44
Q

2 drugs induced unheralded single convulsion if administered too quicklu or in excessive doses (p. 356)

A

Lidocaine and Aminophylline

45
Q

Anticonvulsant but causes myoclonic phenomena upon withdrawal (p. 356)

A

Propofol

46
Q

Rate of seizures post stroke (p. 357)

A

3%

47
Q

how many percent of women who became pregnant have no change in seizure frequency (p. 357)

A

2/3

48
Q

Safe drugs in breast feeding (p. 357)

A

Carbamazepine, Phenytoin, VPA

49
Q

Drugs increased in breast milk (p. 357)

A

Pb, Primidone, Ethosoxumide, Zonisamide, BZD

50
Q

Vitamin K given at 8th month or before birth due to coagulopathy due to this AED (p. 357)

A

Phenobarbital

51
Q

Most common teratogenic effect of AED (p. 357)

A

Cleft lip and palate

52
Q

General risk of major copngenital effect with AED vs no AED (p. 357)

A

4-5% from 2-3%

53
Q

shortened nose, philtrum or inner canthal distance (p. 357)

A

midface hypoplasia

54
Q

decrease in IQ by 9 points (p. 358)

A

Valproate

55
Q

highest risk and significant dose effect for an individual for fetal malformation (p. 358)

A

Polytherapy

56
Q

AED for patient not having AED for a long time but had seizure during pregnancy (p. 358)

A

PHY LEV

57
Q

induce hepatic enzymes, if on pills should be given higher doses (p. 358)

A

PHY, CBZ, TPR

58
Q

dose of magnesium in patients with eclampsia (p. 358)

A

10gm IM, 5g IM q4

59
Q

percent of patients controlled seizures on one drug (p. 359)

A

70%

60
Q

drug that will not have linear kinetics once concentration exceeds 10mg/ml (p. 361)

A

PHY

61
Q

drug inducing its own metabolism (p. 361)

A

CBZ

62
Q

Antibiotic causes accumulation of PHY and Pb (p. 362)

A

Chloramphenicol

63
Q

Antibiotic causes accumulation of CVZ (p. 362)

A

Erythromycin

64
Q

Drugs causing breakthrough menstrual bleeding in women taking OCP (p. 362)

A

PHY, CBZ, Barbiturates

65
Q

Aromatic drugs responsible for skin erruptions (p. 362)

A

PHY. CBZ, Pb, Primitone, LMT

66
Q

Polymorphisms associated with increased risk of skin reactions (p. 362)

A

HLA B 1502

67
Q

Relapse rate is lower in patients with absence and generalized- onset than in patients with focal seizures (p. 362)

A

TRUE

68
Q

SE of PHY (p. 363)

A

gum hypertrophy, breast enlargement

69
Q

Phenytoin hypersensitivity signs (p. 363)

A

Rash, fever, lymophadenopathy, eisinophilia, blood dyscrasia

70
Q

PHY not given with this drugs because of undesirable reactions (p. 363)

A

Disulfiram, Chloramphenicol, Sulfamethizole, Cyclophosphamide, Warfarin

71
Q

drug acting on glutamic acid decarboxylase and sodium channel (p. 365)

A

Valproate

72
Q

drug inhibits GABA transaminase (p. 365)

A

Vigabatrin

73
Q

drug inhibitor of GABA reuptake (p. 365)

A

Tiagabine

74
Q

AED induces renal stones in 1.5% of population (p. 366)

A

Topiramate

75
Q

AED, works on voltage- gated sodium channel, renally excreted, prolong PR interval, worsen heart failure (p. 366)

A

Lacosamide

76
Q

Two frugs known to produce absence status (p. 366)

A

Valproate and Clonazepam

77
Q

Drug of choice for infantile spasms (p. 366)

A

ACTH or Vigabatrin

78
Q

Volatile anesthetic used in circumstances of SE (p. 368)

A

Isoflurane

79
Q

Ketogenic diet is main treatment for children with what deficiency syndrome (p. 369)

A

GLUT 1 deficiency syndrome

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