Epilepsy

Question 1

seizure

Answer 1

sudden episode of neuro dysfunction that is associated with abnormal electrical signaling in the brain

Question 2

epilepsy

Answer 2

abnormally increasing tendency to have seizures

Question 3

what are the typical causes of seizures in different age ranges?

Answer 3

infants - intrauterine or perinatal trauma
childhood - metabolic defects or congenital disorders
school age - genetic (petit mal or temporal lobe)
adulthood - tumors and strokes

Question 4

Grand Mal Seizure

Answer 4

seizure of generalized onset that involves the whole cortex (loss of consciousness + incr. motor activity) - spike-wave (depolarization-relaxation) activity on EEG

Question 5

Secondarily generalized seizure

Answer 5

starts with focal onset and then goes general

Question 6

what is the most common primary generalized seizure disorder in childhood?

Answer 6

Juvenile myoclonic epilepsy (JME)

Question 7

Petit Mal

Answer 7

seizure of generalized onset (usually starts in upper brain stem), characterized by short episodes of blank starring w/o memory. EEG - 3 sec spike-wave cycles, generally no post-ictal state

Question 8

Simple partial seizures

Answer 8

a seizure of focal onset that begins in one part of the cortex and manifests with associated symptoms

Question 9

Jacksonian March

Answer 9

seen in simple partial seizures of the motor cortex than become generalized - characteristic spreading of clonic motor activity

Question 10

complex partial seizure

Answer 10

seizure of focal onset that begins in an association area of the cortex and causes behavioral, visceral and affective phenomena (limbic system involvement) w/o memory during event. generally in frontal and temporal lobes.

Question 11

What is the most common seizure disorder?

Answer 11

complex partial seizures bc limbic system has low threshold for metabolic injury

Question 12

types of continuous seziures

Answer 12

status epilepticus and epilepsia partialis continua (>30 mins)

Question 13

why is status epilepticus a medical emergency?

Answer 13

leads to hyperthermia, hypoxia, and changes in BP and HR, as well as the possibility of the seizure activity causing damage

Question 14

Best anti-convulsant tx options

Answer 14

Phenytoin
Carbamazepine
Valproic Acid
Phenobarbital

Question 15

Best drug to tx status epilepticus

Answer 15

IV benzodiazepines

Question 16

Best drug for absence seziure tx

Answer 16

Ethosuximide

Question 17

Todd’s Paralysis

Answer 17

lateralized weakness or paralysis during the postictal state

Question 18

Infantile Seizures

Answer 18

seizures affecting an infant from 4-18 mos of age, characterized by tonic, atonic, or mized activity. Can be caused by many things and generally are very serious. EEG shows hypsarrhythmia w/ multifocal spikes and periodic attenuation.

Question 19

Infantile Seizure Tx

Answer 19

ACTH

Question 20

Febrile seizures

Answer 20

common childhood seizures that are considered generally benign. most often occur in 16-22 mos of age.

Question 21

3 risk factors that might suggest epilepsy in febrile seizures

Answer 21

1. > 15 mins
2. focal or partial seizures (vs. generalized)
3. repetitive seizures within 24 hours

Question 22

Juvenile Myoclonic Epilepsy

Answer 22

lifelong condition typically characterized by absence seizures when young and then involuntary jerking movements (esp. in morning) in adolescence and finally generalized convulsions

Question 23

What is the most likely cause of status epilepticus?

Answer 23

medication withdrawal

Question 24

What is the most serious/concerning cause of status epilepticus?

Answer 24

infections