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NEUROLOGY > EPILEPSY > Flashcards

EPILEPSY Flashcards

1
Q

Broadly, what are the types of epileptic seizures?

A
  1. Partial
  2. Generalized
  3. Unclassified
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2
Q

What are the types of PARTIAL seizures?

A
  1. simple

2. complex (with IMPAIRED consciousness)

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3
Q

What are the diff. types of generalised seizures?

A
  1. Absence- pt stares in to mid air
  2. TONIC-CLONIC seizure: pt collpases and WRITHES on the ground
  3. ATONIC- pt becomes FLACCID and collapses
  4. MYOTONIC- rhythmic jerking
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4
Q

Pt comes in with complaint of seizure. What is done?

A
  • blood work + glucose
  • EKG
  • EEG
  • CT/ MRI brain imaging
  • LP (meningitis/ encephalitis is suspected)
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5
Q

What is meant by having a partial seizure?

A
  • involved only ONE part of the brain
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6
Q

What is meant by generalized seizure?

A
  • involves the ENTIRE brain
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7
Q

Can a partial seizure become generalized?

A
  • YES

- it may start off as a partial seizure and then it may become generalized

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8
Q

Name some psychic symptoms.

What are they usually a.w?

A
  • dysphasia
  • deja vu
  • fear
  • HALLUCINATIONS
  • distortions of time

—–SEEN with partial seizures (involvment of HIGHER cortical areas)

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9
Q

What are autonomic symptoms that may occur with seizures?

A
  • sweating
  • piloerection
  • pupillary changes
  • epigastric rising sensation
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10
Q

Which autonomic symptom acts as an aura with medial TEMPORAL LOBE epilepsy?

A
  • epigastric sensation
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11
Q

What actually is an AURA?

A
  • a SIMPLE, PARTIAL SEIZURE

- no altered consciousness (affects only part of the brain > some symptoms)

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12
Q

What are some examples of auras?

A
  1. flashing lights (if OCCIPITAL lobe is involved)
  2. Muscle jerking (motor cortex is affected) —jacksonian seizure
  3. sudden Smell
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13
Q

How to differentiate cardiac syncope from seizures?

A
  • NO post-ictal state of confusion is seen with cardiac syncope
    -in seizures: confusion and lack of alertness
    (mins> hrs)
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14
Q

What is the common site of partial seizures?

A

TEMPORAL LOBE

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15
Q

What condition of the brain leads to the involvement of the temporal lobe?
Dx is by _____

A
  • MESIAL Temporal Sclerosis
  • —aka hippocampal sclerosis (Neuronal loss in hippocampus)

– MRI

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16
Q

Juvenile myoclonic seizures are commonly seen in whom______?

And how may it progress>

A

children

  • 5y.o: absence seizures first
  • 15 y.o: MYOCLONIC seizures …GRAND MAL after
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17
Q

What is the HALLMARK of JME?

A
  • MYOCLONIC jerks on awakening from sleep

- shock-like, irregular movements of both arms

18
Q

What is the first line rx of JME?

A
  • SODIUM VALPROATE
19
Q

What drug is C.I for myoclonic, tonic and atonic seizures?

A
  • Carbamazepine and Oxcarbamazepine
20
Q

What is childhood absence epilepsy like?

A
  • sudden impairment of consciousness
  • NO change in body tone
  • REMITS by puberty
21
Q

What helps to identify the type of seizure?

A

-EEG

22
Q

Will a pt have post-ictal confusion with absence epilepsy?

A

NO

23
Q

How to treat childhood ABSENCE epilepsy>

A

-ETHOSUXIMIDE

24
Q

Women having eclampsia is treated with what?

A

MgSO4

25
Q

How to treat the COMPLEX partial seizures that arise from hippocampal sclerosis?

A
  • LAMOTIGRINE

- CARBAMAZEPINE

26
Q

How to treat IIary generalized seizures?

A
  • LAMOTIGRINE

- CARBAMAZEPINE

27
Q

What is the use of carbamazepine?

A

-FOCAL onset seizure

auras

28
Q

Why is SODIUM VALPROATE not that great a choice for seizure?

A

many S.Es

wgt GAIN, HAIR LOSS, teratogenic/FATIGUE

29
Q

When is phenytoin used?

A

ACUTE management only

30
Q

Which is ideal anti-convulsants and why?

A
  • LEVETIRACETAM

well-tolerated/ moodswings

31
Q

Can lamotigrine be given for BOTH focal and generlaized seizures?

A

YES

32
Q

Which anti-convulsant also acts as a sedative?

A

TOPIRAMATE

—-also causes WGT loss

33
Q

How do anti-convulsants affect contraceptives?

A
  • AEDs are enzyme inducing
  • —-MORNING after pill should be INCREASED
    • efficacy of COC pill is altered
  • depot progesterone needs MORE freq. dose and implants suck
34
Q

Name some anti-convulsants.

A

carbamazepine
phenytoin
phenobarbitol
topiramate

35
Q

What is status epilepticus?

A
  • recurrent epileptic seizures WITHOUT full recovery of consciousness
  • LASTs MORE than 30 mins
36
Q

What are the diff. types of STATUS epilepticus>

A
  • generalized convulsive Status epilepticus
  • NON-convulsive status (altered state)
  • epilepsia partialis continua (continual focal seizures/ consciousness preserved)
37
Q

What precipitates status epilepticus?

A
  • infection/ trauma/ sub-arachnoid hemorrhage/ abrupt WITHDRAWAL of anti-convulsants
  • metabolic disorders (PYRIDOXINE/ hyponatremia)
38
Q

How to treat absence seizures?

A

CBZ

39
Q

What is the danger of status epilepticus?

A
  • excess cerebral energy demand and POOR substrate delivery
    > DAMAGE !
    —-respiratory insufficiency and hypoxia
    —hypotension
    – hyperthermia
    —rhabdomyolysis
40
Q

Steven-Johnson $ may occur following exposure to which AED?

A
  • Phenytoin

- Lamotigrine

41
Q

What are the long term effects of Phenytoin?

A
  • hirsutism
  • megaloblastic anemia
  • gingival hyperplasia

NEUROLOGY (36 decks)

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