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Neuro > CS: Seizures > Flashcards

CS: Seizures Flashcards

1
Q

What is the neuro 6 finger rule?

A
  1. localisation
  2. signalment
  3. onset
  4. progression
  5. symetry
  6. pain
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2
Q

What is the neuro 6 finger rule?

A
  1. localisation
  2. signalment
  3. onset
  4. progression
  5. symetry
  6. pain
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3
Q

How can ^ WBC (neutrophils and monocytes) with leucopenia and eosinopenia be explained in an apparently not - infected animal?

A

Stress leucogram

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4
Q

How can ammonium biurate crystals be visualised? When would these be seen?

A

ultrasound bladder - see calculi in empty bladder

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5
Q

What effect would ^ ammonia have on the kidneys?

A

Enlarged

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6
Q

What effect does extrahepatic PSS have on the liver?

A

Small d/t lack of blood suppply

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7
Q

1st line tx of idiopathic epilepsy in dogs?

A
  • phenobarb (lic epilepsy)

- imepitoin (lic single generalised tonic clonic seizure - modern, more specific license) §

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8
Q

1st line tx of idiopathic epilepsy in dogs?

A
  • phenobarb

- imepitoin (single generalised tonic clonic seizure - modern, more specific license)

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9
Q

How can ^ WBC (neutrophils and monocytes) with leucopenia and eosinopenia be explained in an apparently not - infected animal?

A

Stress leucogram

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10
Q

How can ammonium biurate crystals be visualised? When would these be seen?

A

ultrasound bladder - see calculi in empty bladder

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11
Q

What effect would ^ ammonia have on the kidneys?

A

Enlarged

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12
Q

What effect does extrahepatic PSS have on the liver?

A

Small d/t lack of blood suppply

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13
Q

When is tx starting indicated in dogs?

A
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14
Q

1st line tx of idiopathic epilepsy in dogs?

A
  • phenobarb

- imepitoin (single generalised tonic clonic seizure - modern, more specific license)

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15
Q

When should serum plasma levles of phenobarb be checked in dogs?

A

@ 14d post tx

  • ^ liver enzymes ALT etc. >7d so no point checking before this pont as metabolism will change
  • if checking plasma levels as unresponsive to AED then measure trough levels (jsut before due next tx)
  • if >10mg/kg/day need to measure peak and trough
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16
Q

Side effects of phenobarbitone?

A
  • sedation
  • PUPD
  • polyphagia
  • liver tox if >35ug/ml
  • ataxia
  • anaemia (IMHA blood dyscrasia ~= sulphonamides)
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17
Q

What antiepileptics are lic for cats? 1st line tx?

A

NONE!
- phenobarb- chronic use ok
- diazepam for status epilepticus only (Not chronic use)
> metabolism diazepam slower in cats cf. dogs, can -> fulminant hepatic necrosis

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18
Q

What AEDs are liv in horses? Most common tx?

A

NONE!

- phenobarb (cheap)

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19
Q

How do phenobarb doses differ int he cat cf. dog?

A
  • only need SID as no induction of liver enzymes like in dogs
20
Q

When should serum levels of KBr be checked?

A

> 60-90d (takes long time to reach steady state)

21
Q

Side effects of KBr

A

~= phenobarb

  • no blood dyscrasia
  • GI irritant -> D+
  • with ^ salt intake, will compete with KBr -> loss of function
  • ataxia worse than phenobarb
  • PANCREATITIS possible
  • Br toxicity if loaded (loading does = 3-4x daily dose in one hit to rapidly reach therapeutic levels)
22
Q

If focal seizure is seen on the LEFT where is the lesion?

A

Right forebrain

23
Q

On MRI what are T1W, T2W and flare images?

A

T1: fat is white
T2: water and fat are white
flair= Fluid Attenuated Inversion Recovery : nulls fluid so can clearly see other structures without CSF interfering

24
Q

Side effects of imepitoin?

A
  • sedation
  • polyphagia
  • ataxia
  • hyperactivity (transient)
  • less cf. other AEDs
25
Q

Side effects of diazepam, KBr and levacitracin and gabapentin in the cat?

A
  • diazepam: severe liver necorisis
  • KBr: feline asthma
  • levacitram and gabapentin -> sedation and ataxia
26
Q

How do phenobarb doses differ int he cat cf. dog?

A
  • only need SID as no induction of liver enzymes like in dogs
27
Q

Dog having recurrent seziures despite tx with phenobarb.. next course of action?

A
  • check serum levels
  • add another drug
    > KBr lic 2nd line drug for phenobarb 1st line
    > if on imepitoin initially more likely to add in Leviteracitam (no evidence for interaction)
28
Q

Can idiopathic epilepsy cause asymetrical focal seizures?

A

NO!!!

29
Q

If focal seizure is seen on the LEFT where is the lesion?

A

Right forebrain

30
Q

On MRI what are T1W, T2W and flare images?

A

T1: fat is white
T2: water and fat are white
flair= Fluid Attenuated Inversion Recovery : nulls fluid so can clearly see other structures without CSF interfering

31
Q

Further diagnostics in equine epilepsy

A
  • EEG for partial seizures (refer)
  • skull rads are NOT USEFUL!!!
  • endoscopy/CT/MRI RARELY USEFUL!!!
    > though owners still may want tehse to r/o other things
32
Q

What is amaurosis? When may this be seen?

A

central blindness (normal PLR, no menace)

  • may be seen for several hours post ictally
  • depression, sedation, blindness of eye CONTRALATERAL to side of seizure
33
Q

What does PE in between status epilepticus show you?

A
  • typically normal (if stimulated may -> seizure)

- if neuro deficits present inbetween seziures indicates STRUCTURAL brain dz more liekly

34
Q

When can horses said to be safe to ride if epileptic?

A
  • seizure free for 6 months may ok? Still a risk (based on human driving legislation)
35
Q

How may blood results be altered by a seizure?

A

^ CK 2d post

36
Q

How should you approach a status epilepticus horse?

A

DONT! Leave it to finish - dont last long. very dangerous
> diazepam
> phenobarb dilute IV saline
> Pentobarbitone (careful! Usually used for PTS)

37
Q

Tx status epilepticus horses?

A

Talk to owner $$$ tx not definitive so may be a waste of money

38
Q

Further diagnostics in equine epilepsy

A
  • EEG for partial seizures (refer)
  • skull rads are NOT USEFUL!!!
  • endoscopy/CT/MRI RARELY USEFUL!!!
    > though owners still may want tehse to r/o other things
39
Q

What advantages does KBr have over phenobarbitone?

A

Less sedation - use if level of sedation on PB unnacceptable

40
Q

What biochemical changes occour to cells with chronic brain activity?

A

^ calcium -> 1* damage

41
Q

What is 2* damage associated with seziures?

A

> everything othrer than ^ ca

  • hypoxia
  • hypertension
  • hypercarbaemia
  • lactic acidosis
  • myoglobinuria
  • hyperkalaemia
42
Q

Tx course of action for stauts epilepticus

A
  1. stop the seizures
  2. protect the brain (cool, fluids, oxygen)
  3. think about seizures
43
Q

Always 1st line tx of status

A

Diazepam up the bum

44
Q

When may diazepam not be effective at controlling status? What should be given in this case?

A
  • if seziuring >1hr GABA may be depleted so use PHENOBARB aswell
  • but still give diazepam!!
  • phenobarb takes min 20 mins to act
  • if >120mins give propofol to induce anaesthesia
45
Q

What may be seen with propofol used to tx seizures?

A

Twitches - hard to differentiate from seizures!

> if you move the animal twitches will stop, seizures wont

Neuro (30 decks)

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