epilepsy Flashcards
seizure originates in one hemisphere localized
focal seizure
Focal seizure with no impairment of consciousness
Simple partial
Focal dyscognitive seizures have
impairment of consciousness
and are complex partial
BRIEF -
instantaneous impairment of consciousness and recovery
fumbling, manual automatism
absence
generalized
Prolonged confusion during seizure and post-ictally
language dysfunction
more focal - lateralizing findings
complex partial
3Hz spike and a slow wave indicative of
Absence epilepsy
mesial temporal sclerosis associated with
temporal lobe epilepsy
positive symptoms associated with seizure
- shaking, jerking
- flashing lights aura
- head deviation
- post-ictal confusion, tongue-biting, urination, todd’s paralysis
patient presents with a seizure no acute precipitant
- lab work - tox screen,
- EKG - r/o cardiac cause
- EEG
a negative EEG does not rule out
epilepsy
+ EEG ==>
50% risk of seizure recurrence in next 5 years
multiple seizures in the first 24 hours are
not predictive of recurrence
juvenile myoclonic epilepsy can be made worse with (COG)
- carbamazepine
- oxcarbazepine
- gabapentin
Myoclonus can be exacerbated by use of
lamotrigine
Only seizure type that you can use ethosuximide with is
Absence seizures
myoclonic and absence seizures cannot use - cop
CBZ
phenytoin
oxcarbazepine
only drug with oral/IV load, dont load too quickly to avoid cardiac arrythmias
phenytoin
gingival hyperplasia and hisrsutism is seen with
phenytoin
drug with neurotoxic side effects
carbamazepine
Drug of choice for JME
Valproate or lamotrigine
durg safe to use with OCP
valproate
anticonvulsant to give if someone is in SE
- benzo
- phenytoin bolus
If ICU is needed what meds do you give someone in SE?
- IV medazolam
- IV propofol
- IV phenobarb
- IV VPA
when do you refer for epilepsy TLE surgery
if appropriate seizure control not achieved in 9 months