Epilepsy and Trauma / Stroke Flashcards

1
Q

Types of post-traumatic seizures (2) and relative risk of epilepsy

A

Early (within first week): 10%
Late (after first week): 86%

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2
Q

Seizure prophylaxis in head injury

A

Mixed, but AAN recommends 1-week treatment in ADULTS with SEVERE brain injury
Not in children

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3
Q

Likelihood of Seizures as presenting symptom of stroke in:
Neonates
Children
Adults

A

Neonates - 80%
Children - 30%
Adults - Rare (no percentage in book)

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4
Q

Risk of epilepsy after stroke in
Pediatric
Adult

A

Pediatric: up to 40%
Adult: 5%

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5
Q

Classification of Post-stroke seizure and why

A

Early (within first week)
Late (after first week)
- even one late post-stroke seizure has high risk of recurrence >50%

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6
Q

Board “buzz word” classic EEG finding in stroke

A

Lateralized period discharges (LPDs, formerly PLEDS)

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7
Q

Classification of Traumatic brain injury (Mild, moderate, severe) based on :
Duration
Presence of structural brain injury

A
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8
Q
  • Most common malformations associated with Epilepsy (2)
  • Common Malformation NOT associated with seizures
  • Other factors increasing suspicion for causing seizures (3)
A

Most common malformations to cause seizures:
- Arteriovenous malformations (AVM)
- Cavernous malformations
Developmental venous anomalies (DVAs) are typically incidental
Factors increasing epileptogenic risk
- surrounding hemorrhage
- gliosis
- encephalomalacia

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9
Q

5-year risk for seizure in incidentally diagnosed Vascular malformations
- AVM
- AVM + hemorrhage
- AVM in temporal lobe
- CM
- CM + Hemorrhage
- CM in temporal lobe

A
  • AVM: 8%
  • AVM + Hemorrhage: 23%
  • AVM in temporal lobe: increased risk
  • CM: 4-6%
  • CM+ hemorrhage: 4-6%
  • CM in temporal lobe: no increased risk
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10
Q

Developmental venous anomalies (and presenting symptom):
% incidental (on MRI)
% with focal neurologic deficits
% with symptomatic bleeding
% with seiuzures
% unclear

A

% incidental: 61%
% with focal neurologic deficits: 6%
% with symptomatic bleeding 6%
% with seizures 4%
% unclear: 23%

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11
Q

Post-traumatic seizures: Factors increasing risk for developing epilepsy (and one that doesn’t)

A
  1. Late (after first week) - 86%
  2. Seizures in combination with moderate or severe TBI
  3. Epileptiform discharges on EEG doesn’t necessarily increase likelihood of epilepsy
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