Epilepsy II

Question 1

What percent of children will have a seizure before age 20?

Answer 1

5%

Question 2

______ percent of people will be seizure-free after their first drug.

Answer 2

Seventy

Question 3

True or false: partial seizures will typically present with abnormalities in one or a couple EEG leads.

Answer 3

True

Question 4

Hand automatisms (seemingly purposeful movements that appear periodically) are characteristic of ____________.

Answer 4

partial seizures

Question 5

Describe the difference between idiopathic and cryptogenic as used by pediatric neurologists.

Answer 5

Idiopathic: genetic predisposition
Cryptogenic: thought to have an etiology not yet proven

Question 6

Neurologists call medication-responsive epilepsy “____________” and medication-refractory epilepsy “_______________.”

Answer 6

benign; catastrophic

Question 7

Almost all febrile seizures occur by age _______.

Answer 7

3 years

Question 8

The incidence of febrile seizures is _________.

Answer 8

2% - 4% in the U.S.

Question 9

Simple seizures are ______________. Complex are ________________.

Answer 9

generalized; focal

Question 10

True or false: rapid rise of temperature is correlated with febrile seizure.

Answer 10

False. This is an old wives’ tale that has been disproven

Question 11

Febrile seizures ___________ often.

Answer 11

recur (especially if the first occurred before age 1 or there is a positive family history of epilepsy)

Question 12

True or false: there are typically cognitive sequelae with febrile seizures.

Answer 12

False. Neurocognitive studies have demonstrated that those who’ve had febrile seizures do not have higher rates of cognitive sequelae.

Question 13

Pre-emptive treatment of febrile seizures does not prevent ____________.

Answer 13

future epilepsy

Question 14

Lennox-Gastaut syndrome presents with what EEG sign?

Answer 14

The slow spike and wave (slow because it’s slower than 3 Hz)

Question 15

In general, you should not treat people until they’ve had ______________.

Answer 15

two prior seizures

Question 16

Start anticonvulsant therapy with ______________.

Answer 16

one drug; then move to different single drugs if that fails – only consider polytherapy when many single drugs have failed

Question 17

Lamotrigine can sometimes make __________ worse.

Answer 17

myoclonic (even though lamotrigine is a broad-spectrum antiepileptic)

Question 18

Why is valproic acid not given to teenage girls?

Answer 18

Because it can cause polycystic ovary disease

Question 19

To qualify as epilepsy, the seizures need to be ________________.

Answer 19

unprovoked

Question 20

Seizures most often occur in what age groups?

Answer 20

The very young and the very old

Question 21

True or false: more than 1/3 of epileptics are resistant to pharmacotherapy.

Answer 21

True! About 36%

Question 22

The most common childhood seizures are ____________.

Answer 22

febrile seizures (usually occurring in the 18 - 22 month age)

Question 23

Of simple and complex seizures, which kind is more likely to recur?

Answer 23

Complex

Question 24

What is the efficacy of ketogenic diets?

Answer 24

At least 50% of patients show some response, with 7% being seizure-free