Epilepsy

Question 1

Epilepsy

Answer 1

Recurrent seizures (2 in 24 hours) or one seizure with a risk for future seizures

Question 2

Where do most seizures occur

Answer 2

outside the brain (fever, toxins, infection, hypoxia, cardiac arrythmias)

Question 3

Pathophysiology

Answer 3

disrupted electrical communication in the brain neurons, imbalance with excitatory and inhibitory mechanisms –> neurons don’t fire when they are supposed to

Question 4

Focal seizures

Answer 4

disruption in one hemisphere (most epilepsy cases)

Question 5

Generalized seizures

Answer 5

disruption in both hemispheres

Question 6

Absence seizures

Answer 6

loss of awareness, less than 10 seconds, blank facial expression

Question 7

Myoclonic seizures

Answer 7

trunk and arm muscles jerking in tandem, loss of tone in neck

Question 8

Clonic seizures

Answer 8

legs and arms in spasm, jerk than relax

Question 9

Tonic seizures

Answer 9

sustained muscle contractions, awake

Question 10

Generalized tonic clonic seizures

Answer 10

sustained rigidity followed by jerking, altered mental status, pallor, eye deviation, incontinence

Question 11

Atonic seizure

Answer 11

loss of consciousness, muscle tone, abrupt onset

Question 12

Aura

Answer 12

a feeling, subjective lasting 1-2 minutes before onset of a seizure

Question 13

Postictal

Answer 13

1-2 hours after a seizure, body is tired (no eating or drinking)

Question 14

What type of medication is the first line of treatment

Answer 14

anticonvulsants

Question 15

Phenytoin (Dilantin)

Answer 15

monitor serum lab values of calcium/magnesium, vitamin D intake is important

Question 16

Fosphenytoin

Answer 16

adverse effects are less common, more expensive, monitor magnesium/vitamin D

Question 17

Phenobarbital

Answer 17

monitor sedation/serum lab values/vitamin D, ensure vitamin D intake, withdrawal symptoms with abrupt stopping

Question 18

Valproic acid

Answer 18

monitor serum levels, comes in sprinkle form

Question 19

Gabapentin

Answer 19

don’t take at same time as antacids

Question 20

Levetiracetam

Answer 20

monitor phenytoin levels, monitor gait and coordination, vitamin B supplements can help with adverse effects

Question 21

What surgery can be done

Answer 21

removing part of the brain affected in cases of uncontrolled seizures

Question 22

Ketogenic diet

Answer 22

high fat and low carb, higher levels of ketones can decrease seizures

Question 23

Vagal nerve stimulator

Answer 23

stimulator placed under skin in chest, wire wrapped around vagal nerve for focal or partial seizures

Question 24

Common causes for seizures

Answer 24

sleep deprivation, missed doses of medication

Question 25

Status epilepticus

Answer 25

seizures that last longer than 5 minutes, more than 1 seizure without returning to normal LOC