Epilepsy Flashcards
seizure
sudden episode of neuro dysfunction that is associated with abnormal electrical signaling in the brain
epilepsy
abnormally increasing tendency to have seizures
what are the typical causes of seizures in different age ranges?
infants - intrauterine or perinatal trauma
childhood - metabolic defects or congenital disorders
school age - genetic (petit mal or temporal lobe)
adulthood - tumors and strokes
Grand Mal Seizure
seizure of generalized onset that involves the whole cortex (loss of consciousness + incr. motor activity) - spike-wave (depolarization-relaxation) activity on EEG
Secondarily generalized seizure
starts with focal onset and then goes general
what is the most common primary generalized seizure disorder in childhood?
Juvenile myoclonic epilepsy (JME)
Petit Mal
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
Simple partial seizures
a seizure of focal onset that begins in one part of the cortex and manifests with associated symptoms
Jacksonian March
seen in simple partial seizures of the motor cortex than become generalized - characteristic spreading of clonic motor activity
complex partial seizure
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.
What is the most common seizure disorder?
complex partial seizures bc limbic system has low threshold for metabolic injury
types of continuous seziures
status epilepticus and epilepsia partialis continua (>30 mins)
why is status epilepticus a medical emergency?
leads to hyperthermia, hypoxia, and changes in BP and HR, as well as the possibility of the seizure activity causing damage
Best anti-convulsant tx options
Phenytoin
Carbamazepine
Valproic Acid
Phenobarbital
Best drug to tx status epilepticus
IV benzodiazepines
Best drug for absence seziure tx
Ethosuximide
Todd’s Paralysis
lateralized weakness or paralysis during the postictal state
Infantile Seizures
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.
Infantile Seizure Tx
ACTH
Febrile seizures
common childhood seizures that are considered generally benign. most often occur in 16-22 mos of age.
3 risk factors that might suggest epilepsy in febrile seizures
- > 15 mins
- focal or partial seizures (vs. generalized)
- repetitive seizures within 24 hours
Juvenile Myoclonic Epilepsy
lifelong condition typically characterized by absence seizures when young and then involuntary jerking movements (esp. in morning) in adolescence and finally generalized convulsions
What is the most likely cause of status epilepticus?
medication withdrawal
What is the most serious/concerning cause of status epilepticus?
infections
