CLINICAL MED- TYPES OF SEIZURES Flashcards

1
Q

Generalized tonic clonic seizures

Duration

Phases

A

Duration: 1-5 minutes and followed by post ictal phase

Phases:

  1. Partial seizure that undergoes secondary generalization
  2. Onset of generalization characterized by forceful head movements (versive) or brief vocalization
  3. Pretonic clonic phase; irregular asymmetric clonic jerking of extremities
  4. Tonic phase; generalized sustained contraction ie body becomes rigid
  5. Clonic phase; slower jerking
  6. Post ictal phase; limp and in deep sleep from which he awakens with confusion, headache and muscle pain
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2
Q

Recollection in GTCS

A

In secondary generalization, the pt may remember aura

In GTCS of generalized onset or that which developed from complex partial seizure—> no recollection

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3
Q

Absence seizure onset

A

In childhood or adolescence

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4
Q

Typical absence seizure duration

A

Few seconds that start and end abruptly

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5
Q

Characteristics of absence seizure

A
  • Unresponsiveness with fixed blank stare
  • Eye fluttering, face twitching
  • No falling (postural tone may be increased or decreased)
  • Brief clonic jerks
  • Automatisms
  • Aware of attack?
  • NO POST ICTAL PHASE
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6
Q

Myoclonic seizures

A

Sudden involuntary brief jerk of muscle or group +/- loss of consciousness

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7
Q

Myoclonic seizures affect who

A

Children or

YA—> JUVENILE MYOCLONIC EPILEPSY (syndrome)

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8
Q

Juvenile myoclonic epilepsy

A

In YA after stress of high dose caffeine

6-22 years

Jerks worse in morning

GTCS in morning

40%—>absence

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9
Q

Atonic seizure characterized by

A

Sudden loss of tone which causes pt to fall to the ground

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10
Q

Atonic seizures associated with

A

Mental retardation

Lennox-Gastaut syndrome (severe)

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11
Q

Partial seizures begin in

A

Focal brain area

most common type in adults

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12
Q

Motor manifestation of simple partial seizures

A

ie arise from motor cortex there4

  • Head deviation to one side
  • speech arrest or vocalization
  • stereotyped limb, facial movements that are coordinated—> look purposeful
  • Jacksonian march; spread from distal to proximal in seconds
  • Todd’s paralysis; muscle weakness that persists for minutes, hours mistaken for TIA, stroke
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13
Q

Sensory manifestations of simple partial seizure

A
  1. Visual—>spots, starts, light
  2. Auditory—>ringing, musical sounds
  3. Somesthetic—>tingling,numbness, electric
  4. Olfactory—> burning rubber
  5. Gustatory—> acidic, sweet taste
  6. Vestibular—> vertigo
  7. Epigastric—> butterflies
  8. Primary sensory cortex—> primitive
  9. Higher level/ MESIAL temporal—> detailed
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14
Q

Simple partial seizure with nausea and epigastric symptoms that may cause pt tp lose consciousness and be generalized

A

Temporal lobe lesion/seizure?

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15
Q

Deja vu entendu

A

AUDITORY FAMILIARITY

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16
Q

Jamais vu/ jamias entendu

A

UNFAMILIARITY

17
Q

What could happen in temporal lobe seizure

A

Autoscopy

18
Q

Progression of seizures

A

SP—>CP—>GTCS

19
Q

Left temporal lobe CPZ characteristics

A

Automative repetitive behavior

Simple—> lip smacking, fumbling, chewing, swallowing etc

20
Q

Automative repetitive behavior with frontal lobe involvement

A

Complex

Bicycling, pelvic thrusting

21
Q

MESIAL TEMPORAL LOBE EPILEPSY

Associated with

A

Complex partial seizure (symptomatic)

22
Q

MESIAL TEMPORAL LOBE EPILEPSY

MRI findings

A

Hippocampal sclerosis

23
Q

MESIAL TEMPORAL LOBE EPILEPSY

EEG features

A

Focal spikes

24
Q

MESIAL TEMPORAL LOBE EPILEPSY therapy

A

Refractory to medicine, treated with epilepsy surgery

25
Q

LENNOX GASTAUT SYNDROME

Occurs in

A

Children with poor prognosis

26
Q

LENNOX GASTAUT SYNDROME

Associated with which seizure types

A
  • GTCS
  • Atypical absence (more prolonged and complex automatisms)
  • Atonic
27
Q

LENNOX GASTAUT SYNDROME

EEG findings

A

Slow spike and wave discharges