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Medicine II - OSCE > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q
A
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2
Q

Etiology of Seizures

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3
Q

Criteria of Dx of Epilepsy

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4
Q

Classification of Seizures

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5
Q

Types of Focal Seizures

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6
Q

Types of Generalized Seizures

A
  1. Generalized Tonic-Clonic Seizures
  2. Absence Seizures
  3. Myoclonic Seizures
  4. Tonic Seizures
  5. Atonic Seizures
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7
Q

CP of Focal Aware Motor Seizures (Simple Partial)

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8
Q

CP of Focal Impaired Awareness Seizures (Comple Partial)

A
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9
Q

CP of Generalized Motor (Tonic-Clonic) Seizures “GTCS”

A
  • No preceding Aura or warning
  • Ictal Stages
  • Post-Ictal Stages
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10
Q

CP of Generalized Motor (Tonic-Clonic) Seizures “GTCS”

  • Aura
A

No preceding Aura or warning

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11
Q

CP of Generalized Motor (Tonic-Clonic) Seizures “GTCS”

  • Ictal Stage
A
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12
Q

CP of Generalized Motor (Tonic-Clonic) Seizures “GTCS”

  • Tonic Phase of Ictal Stage
A
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13
Q

CP of Generalized Motor (Tonic-Clonic) Seizures “GTCS”

  • Clonic Phase of Ictal Stage
A
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14
Q

CP of Generalized Motor (Tonic-Clonic) Seizures “GTCS”

  • Post-Ictal Stage
A
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15
Q

CP of Generalized Non-Motor (Absence) Seizures

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16
Q

DDx of Seizures

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17
Q

Characters of (Pseudo-seizures)

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18
Q

Dx of Seizures

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19
Q

Dx of Seizures

  • Hx & Ex
A
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20
Q

Dx of Seizures

  • Labs
A
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21
Q

Dx of Seizures

  • Neuroimaging
22
Q

Dx of Seizures

  • EEG
23
Q

Significance of EEG

A
  • Differentiate epileptic seizures from conditions that mimic them.
  • Classify seizure types
  • Tailor therapy.
24
Q

The yield of EEG increases with ……

A
  • Sleep deprivation
  • Performing multiple studies
  • Performing the study in close proximity to the seizure.
25
Q

TTT of Seizures

26
Q

TTT of Seizures

  • TTT of Provoked Seizures
27
Q

TTT of Seizures

  • TTT of Unprovoked Seizures & Epilepsy
28
Q

ASMs may be prescribed for patients after a first unprovoked seizure if there is:

29
Q

TTT of Seizures

  • General Principles in drug therapy
30
Q

The choice of ASM is usually based on:

31
Q

Examples of ASM

32
Q

Drug of Choice

  • Focal seizures and secondarily Generalized seizures
A

Phenytoin, Carbamazepine, Oxcarbazepine, Levetiracetam,
Lamotrigine

33
Q

Drug of Choice

  • Primary generalized tonic-clonic seizures
A

Valproate, Lamotrigine

34
Q

Drug of Choice

  • Abxence Seizures
A

Valproate, Ethosuximide

35
Q

Drug of Choice

  • Juvenile myoclonic epilepsy
A

Valproate, Levetiracetam

36
Q

Drug of Choice

  • Patient taking multiple medications
A

Levetiracetam, Lacosamide

37
Q

Drug of Choice

  • Medication expense is a concern
A

Phenytoin, Carbamazepine, Valproate

38
Q

Drug of Choice

  • Pregnancy
A

Lamotrigine, Levetiracetam (avoid valproate)

39
Q

Drug of Choice

  • Hepatic Failure
A

Levetiracetam, Topiramate, Gabapentin

40
Q

Drug of Choice

  • Renal Failure
A

Carbamazipine, Oxcarbazepine, Lamorigine

41
Q

Withdrawing ASMs

42
Q

Ideal candidates for medication withdrawal have:

43
Q

TTT of Status Epilepticus

44
Q

TTT of Status Epilepticus

  • Life Support
45
Q

TTT of Status Epilepticus

  • Abort Seizures
46
Q

TTT of Status Epilepticus

  • Abort Seizures (Phase I)
A

Intravenous lorazepam (0.1 mg/kg) or diazepam (0.15 mg/kg)

47
Q

TTT of Status Epilepticus

  • Abort Seizures (Phase II)
A
  • Intravenous phenytoin (15-20 mg/kg)
  • Valproate (25-40 mg/kg) or Levetiracetam (1000- 3000 mg)
48
Q

TTT of Status Epilepticus

  • Abort Seizures (Phase III)
49
Q

TTT of Status Epilepticus

  • Abort Seizures (Phase IV)
A
  • Pentobarbital is loaded at a dose of 5 mg/ kg followed by IV infusion of 1-10 mg/kg/hr, titrated gradually upwards to a burst- suppression pattern on EEG
50
Q

TTT of Status Epilepticus

  • Determine the etiology
A
  • Once seizure control is established, focus on determining the etiology
  • History, examination, Laboratory studies, Neuroimaging and sometimes CSF examination.
51
Q

TTT of Status Epilepticus

  • Prevent Further Episodes
A
  • Correct the proximate cause of status epilepticus if detected.
  • Patients with known epilepsy need ASM regimen modification to prevent seizure recurrence.

Medicine II - OSCE (32 decks)

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