Epilepsy

Question 1

what is the etiology of most epilepsy?

Answer 1

unknown

Question 2

what is the most common location of focal epilepsy?

Answer 2

temporal lobe epilepsy

Question 3

tumors/lesions that are present throughout the body that are recurrent and will be replaced if removed

Answer 3

tuberous sclerosis (TS)

Question 4

limited to one side of the cerebral hemisphere or one area, and the patient is aware of the seizure

Answer 4

focal epilepsy

Question 5

what is the most common type of epilepsy?

Answer 5

focal epilepsy

Question 6

distributed on both hemispheres of the brain

Answer 6

generalized epilepsy

Question 7

stage of seizure that is a warning, hours to days, and is not part of the seizure

Answer 7

prodrome

Question 8

stage of seizure that is within seconds to minutes, part of the seizure, and can show EEG changes

Answer 8

aura

Question 9

period after the seizure when the patient has headaches, disorientation, confusions, and tiredness

Answer 9

post-ictal

Question 10

what are 4 DDx of focal seizures?

Answer 10

TIAs
migraine auras
rage/anger attacks
panic attacks

Question 11

what are 3 DDx of generalized seizures?

Answer 11

syncope
drug/alcohol withdrawal
psychogenic non-epileptic spells (PNES)

Question 12

resembles seizures but is extremely prolonged, asynchronous thrashing of limbs that worsens with restraints, shouting and cussing, and occurs without prodrome, aura, or post-ictal

Answer 12

psychogenic non-epileptic spells (PNES)

Question 13

what is the diagnostic for psychogenic non-epileptic spells (PNES)?

Answer 13

video EEG monitoring

Question 14

what is the treatment for psychogenic non-epileptic spells (PNES)?

Answer 14

CBT
adjustment to antiepileptic drugs

Question 15

what is the gold standard diagnostic for epilepsy?

Answer 15

EEG - shows the electrical activity of the brain

Question 16

what imaging can be used in a patient with epilepsy and history of trauma?

Answer 16

CT head

Question 17

what is the diagnostic imaging of choice for epilepsy?

Answer 17

3T MRI

Question 18

focal epilepsy that lasts 1-2 mins, no aura, +/- post-ictal

Answer 18

complex partial

Question 19

what is a focal epilepsy in which awareness is maintained?

Answer 19

simple partial

Question 20

what is a focal epilepsy in which the patient has impaired awareness?

Answer 20

complex partial

Question 21

non-purposeful, inappropriate, repetitive movements or behaviors

Answer 21

automatism

Question 22

epilepsy that originated on one side of the brain and spreads to the other side

Answer 22

focal to bilateral tonic-clonic seizure

Question 23

in generalized epilepsy, the patient has complete loss of what?

Answer 23

awareness/consciousness

Question 24

generalized non motor seizure that is staring spells for few seconds, no aura, patient is unaware of seizure, and has immediate recovery

Answer 24

typical absence (petit mal)

Question 25

what is the classical EEG finding in typical absence seizure (generalized)?

Answer 25

3 Hz spike and wave

Question 26

what triggers generalized, non motor (typical absence/petit mal)?

Answer 26

hyperventilation

Question 27

tonic phase of 1 min + clonic phase for 2-3 mins that is a generalized motor epilepsy

Answer 27

tonic-clonic seizures

Question 28

in which type of seizure does post-ictal (slow return of awareness and consciousness with soreness and sleep) return?

Answer 28

tonic-clonic seizures

Question 29

when should treatment be initiated?

Answer 29

after 2 or more unprovoked seizures

Question 30

what is the most common cause of drug failure?

Answer 30

wrong diagnosis leading to wrong drug

Question 31

when is epilepsy considered medically refractory and must be referred to surgery?

Answer 31

if patient fails 2 correct drugs

Question 32

what are the first line drugs for focal seizures? (3)

Answer 32

Carbamazepine Oxacarbazepine Lamotrigine

Question 33

what are the 1st line drugs for generalized seizures? (3)

Answer 33

Valproate-Depakote Lacosamide Levetiracetam

Question 34

what is the 1st line drug for absence seizures?

Answer 34

ethosuximide

Question 35

what are 4 drugs used in pregnancy?

Answer 35

Carbamazepine Oxcarbazepine Lamotrigine Levetiracetam

Question 36

what should all pregnant women with epilepsy do? (2)

Answer 36

take folic acid register with epileptic foundation

Question 37

what drug should be avoided in pregnancy?

Answer 37

valproate

Question 38

what is the most common cause of status epilepticus?

Answer 38

non-compliance

Question 39

when can AEDs be d/c? (2)

Answer 39

seizure free patient has normal EEG + MRI

Question 40

what treatment is recommended for refractory focal seizures?

Answer 40

brain surgery

Question 41

seizure lasting over 5 mins OR repeated seizures over 30 mins OR recurrent seizures so close together that the person cannot recover

Answer 41

convulsive status epilepticus

Question 42

what is the treatment for convulsive status epilepticus?

Answer 42

IV lorazepam/ativan

Question 43

electrical shutdown of the brain resulting in changes in heart function and breathing; is linked to generalized tonic-clonic seizures

Answer 43

sudden unexpected death in epilepsy (SUDEP)

Question 44

what is the treatment for SUDEP?

Answer 44

like status epilepticus (IV lorazepam/ativan)

Question 45

what is the treatment for alcohol/withdrawal seizures?

Answer 45

diazepam or lorazepam