[CLMD] Seizures and Syncope [Hon] Flashcards
What is a paroxysmal disorder?
What falls under this category?
Episodic
Migraine, syncope, dizziness, seizure, transient global amnesia
Define Epilepsy
Epilepsy is 2 or more unprovoked seizures
What is a consideration physicians must make with epileptic patients in terms of stigma?
Must be compassionate toward patients with epilepsy
HUGE stigma and restrictions towards patients w/ epilepsy
If you have a patient with SUSPECTED epilepsy, and the single EEG comes back negative, can you rule out epilepsy?
NOOOOOO
Must perform multiple EEGs to confirm
What is the single most important information regarding the diagnosis of epilepsy?
HISTORY of the events; preferably by the witnesses
What are the two categories of seizures?
Partial Seizures
Generalized Seizures
What is a partial:
SIMPLE seizure?
Focal motor or sensory activity
No loss of consciousness
Lasts seconds
NO post-ictal state
What is a partial:
COMPLEX seizure?
Nonresponsive staring
Loss of consciousness
Lasts 1-3 min
Post-ictal state
What is a partial:
SECONDARY generalized seizure?
Bilateral tonic-clonic activity
Loss of consiousness
Lasts 1-3 min
Post ictal state
Take home message about partial seizures:
What is the ONE form of partial seizures that does not have loss of consciousness?
Simple
What is generalized:
Absence seizure?
Nonresponsive staring
Rapid blinking/chewing
Loss of consciousness
No post ictal state
What is generalized:
Tonic-clonic seizure?
Bilateral extension followed by symetrical jerking of extremities
Loss of consciousness
Post ictal state
What is generalized:
Atonic seizure?
Sudden loss of muscle tone
Head drops
Patient collapses
Loss of consciousness
Post ictal state
What is generalized:
Myoclonic seizure?
Brief, rapid symmetrical jerking of extremities and or torso
Loss of consciousness
Lasts few seconds
Slight post-ictal state
Which of the generalized seizures has NO post ictal state?
Absence
What are the (6) antiepileptic drugs that can be used for BOTH partial and generalized seizures?
Valproic acid
Lamotrigine
Topiramate
Levetiracetam
Zonisamide
Perampanel
What is the ONE drug that works for ONLY absence seizures?
Ethosuxamide
What is the one combination that is synergistic in treatment of epilepsy?
Valproic acid
+
Lamotrigine
What is status epilepticus?
Prolonged seizure (generally greater than 10 min) or repeated seizures without recovery in between
What is the first line treatment for status epilepticus?
Lorazepam IV
then
Fosphenytoin/Phenobarbital/Valproic acid
What is transient global amnesia?
Sudden, temporary, isolated episode of loss of memory
No other neurologic symptoms or signs
Usually lasts a few hours then resolves, usually doesn’t recur
