Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CANN > Epilepsy > Flashcards

Epilepsy Flashcards

(71 cards)

Start Studying
1
Q

what are 3 ways to classify seizure?

A

where/onset, awareness, and motor/nonmotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are some causes of nonepileptic seizures?

A

alcohol withdrawals, fevers, psychological trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

IPSP and EPSP summation not action potential directly; usually thalamocortical

A

Paroxysomal Depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Focal cortical dysplasia

A

Focal area of abnormal neuronal organization and development
Most common cause of medically refractory epilepsy in kids and 2nd in adults
Seen as blurring of the grey–white matter junction and hyperintense signal on FLAIR imaging
Potential causes: mostly unknown, maybe genetics or in utero infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tuberous sclerosis complex

A

Loss of TSC1 (codes for hamartin) or TSC2 (tuberin) genes. Inherited or spontaneous
Affects mTOR pathway
Multisystem hamartomas (including cortical tubers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dravet’s Syndrome

A

SCN1A mutated; codes for a voltage-gated Na+ channel on GABAergic neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Angelman syndrome

A

UBE3A deleted or mutated on maternal copy of chromosome 15. Codes for ubiquitin protein ligase E3A Seizures, ataxia, severe intellectual disability and developmental delay, nonverbal, inappropriate laughter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rett syndrome

A

MECP2 mutation on X chromosome
Codes for methyl CpG binding protein 2 (MeCP2); involved in interpreting DNA methylation, synaptic maintenance
Predominantly in females
developmental regression, ataxia, seizures, stereotyped handwringing/loss of hand purposeful movement, difficulty with speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some infections that cause epilepsy?

A

Neurocysticercosis
Cerebral malaria
Viral encephalitis
Tuberculosis
HIV
Zika virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic brain inflammation leading to intractable seizures, progressive hemiparesis, and cognitive loss

A

Rasmussens syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

metabolic epilepsy caused by changes in

A

GLUT1 and mitochondria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are pharmokinetics of ASM?

A

Well absorbed orally
Cross the blood brain barrier readily
Most are metabolized in the liver (many by CYP2C9, CYP2C19, or CYP3A4) and excreted by the kidney - exceptions: gabapentin, vigabatrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which ASMs inhibit VG Na channels?

A

Phenytoin, Carbamazepine, Lamotrigine, VPA, Topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are ADRs of VG Na targeting ASMs?

A

affect heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Phenytoin

A

used for focal seizures, if given IV use fosphyentoin (Cerebryx), nonsedative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some drug interactions of phenytoin?

A

Induces CYP450, CYP2C19
“Broad spectrum inducer”
Can induce its own metabolism! Highly binds to plasma proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

which drugs affect phenytoin

A

eslicarbazepine, oxacarbazepine, topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ADRs of phenytoin (PHENYTOIN)

A

CytochromeP-450 inducer
Hirsutism
Enlargedgums(gingival hyperplasia)
Nystagmus
Yellow-browningofskin(melisma, freckle-like spots)
Teratogenicity
Osteopenia
Impairedfolate absorption
Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Carbamazepine

A

focal seizures and bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

induces CYP3As

A

Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some ADRs of Carbamazepine

A

exacerbate myclonic or absence seizures, osteopenia, blurred vision, blood disease, hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lamotrigine

A

for focal and general seizures, including absence. Also good for bipolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are ADRs lamotrigine?

A

SJS, dizziness, hemophagolytic lymphohistocytosis (uncontrolled immune response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

VPA

A

for focal seizures and general. Good for myoclonic and bipolar. Is a broad INHIBITOR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are some ADRs of VPA?
GI, sedates, bad neurodevelopment, pancreatitis, hepatotoxic
26
Topiramate
monotherapy for focal and general seizure
27
Whats MOA and interactions of Topiramate?
blocks VG Na channels, antagonize AMPA, enhance GABAa. May increase phenytoin
28
ADRs of Topiramate
sedation glaucoma, decreasing levels in pregnancy
29
What are ASMs that inhibit Ca channels?
Gabapentin, Pregabalin, Ethosuxide
30
Ethosuximide
ABSENCE SEIZURES by inhibiting T-tyoe Ca
31
Levetiracetam
does general tonic clonic seizures in adults and focal in kids by binds to synaptic vesicle protein, SV2A; don't give to someone with behavior probs
32
ASMs that block GluRs
Perampanel -AMPA and Felbamate - NMDA
33
Perampanel
focal in age 4 and up, and general in greater than 12
34
Perampanel drug interactions
Extensively metabolized by the liver Not recommended for patients with severe hepatic (or renal) impairment Also interacts with alcohol and levonorgestrel oral contraceptives
35
ADRs of Perampanel
weight gain, aggression
36
Felbamate
rarely used because only for very severe because causes liver failure/aplastic anemia.
37
ASMs that increase inhibition
Tiagabine, Vigabatrin, BZs, Phenobarbital
38
Tiagabine
focal seizures, inhibits GABA uptake through GAT-1
39
Vigabatrin
An irreversible inhibitor of GABA T which is that degrading enzyme of GABA. Used in infants, TSC
40
ADRs of Vigabatrin
dizziness, weight gain In infants: MRI abnormalities Long-term tx associated with irreversible peripheral visual field defects in 30-50% of patients and Higher in males. Decreases serum phenytoin
41
Phenobarbital
for really resistant status epilepticus, a barbituate, and 1st line in NEONATES. Induces CYP450s.
42
ADRs of phenobarbital
sedation, tolerance, cardio/respi depression, cleft palate
43
BZ for Myoclonic, atonic, focal and general t/c seizures. Admin I/V or rectally to stop status epilepticus and nasally for cluster seizures
Diazepam (also Lorazepam)
44
BZ Used for absence seizures; adjunctive for other types of seizures One of the more potent ASMs. SJS potential ADR
Clonazepam
45
All ... are rescue drugs
BZs
46
Cannabidiol trx ASM
Epidiolex
47
Toxicities of ASMs
Osteomalacia, osteoporosis (Carbamazepine, barbiturates, phenytoin, valproic acid) Altered connective tissue metabolism or growth (phenytoin, phenobarbital) Polycystic ovarian syndrome (valproic acid) Neurologic Neuropathy (phenytoin, carbamazepine) Cerebellar degeneration (phenytoin) Sexual dysfunction (phenytoin, carbamazepine, phenobarbital)
48
How does ASMs affect pregnancy?
Several anti-seizure drugs → ↑ metabolism of hormonal contraceptives → contraceptive failure (Phenytoin, phenobarbital, carbamazepine, topiramate, clobazam) Pregnancy planning is vital; many anti-seizure drugs are teratogenic Patients considering pregnancy should be on high doses of folic acid prior to conception
49
Syncope vs seizure
syncope - confusion for less than 30 sec, eyes upward lateral deviation, flaccid. seizure - confusion for greater than 2 min, tongue bite, stiff
50
how to diagnose nonepileptic seizures
need EEG at time of occurrence, which looks for sharp waves
51
What's 2 important characteristics of nonepileptic seizures
eyes closed tight for >40 sec, and assymetrical movements
52
when do seizures usually occur after alcohol withdrawal
6 to 48 hours later
53
TRUE or FALSE: you should use MRI for epilepsy
false because over 50% epileptic people have normal MRI
54
whens onset absence epilepsy, results, and treatment
4-10yrs, see 3Hz spikes and hyperventilation during seize, give ethosuximide
55
Onset age: 12-18 years old Seizures: myoclonic jerks (morning), GTC, some have absence Exam: neurologically normal, photosensitive
Juvenile Myoclonic
56
most common epilepsy in adults, deja vu, staring seizures, can be focal to bilateral tonic clonic
temporal lobe epilepsy which you can also treat with lobectomy if mesial temporal sclerosis
57
Etiology often brain insults, malformations of cortical development such as TSC; or genetic Age: by 4 yrs old Seizures: multiple types tonic, tonic-clonic, atonic, FASS, FAIS, FTBTC, atypical absence Exam: often diffuse neurologic impairment (cerebral palsy and intellectual disability); epileptic encephalopathy Prognosis: Drug resistant
Lennox Gastaut Syndrome which you treat with clobazam and vagus nerve stimulation
58
ADR carbamazepine
hyponatremia, SJS
59
ADR ethosuximide
GI effects, leukopenia
60
ADR Phenobarbital
somnolence
61
ADR Phenytoin
hirsutism, gingival hyperplasia
62
ADR VPA
tremor, weight gain, hair loss, GI
63
ADR pregabalin
weight gain
64
ADR Topiramate
change verbal fluency, memory, weight loss
65
ADR Vigabatrin
permanent peripheral vision loss
66
ADR clobazam
drooling
67
ADR Perampanel
irritability
68
which ASM decrease warfarin
carbamazepine, phenobarbital, phenytoin, elisacarbazepine
69
which ASM increase warfarin
felbamate, VPA
70
what drugs (besides warfarin) can ASM decrease
protease inhibitors and immunosuppressants
71
Neurology unit Specialized personnel Designed to evaluate, diagnose, and treat unprovoked seizures. Guidelines for use: Treatment failure of 1 year Failure of 2-3 AEDs
Epilepsy Monitoring Unit

CANN (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions