Epilepsy & Seizure Disorders Flashcards
What is the definition of a seizure?
Abnormal electrical activity in the brain caused by the hyperexcitability of neurons, especially in cortical area
What is the definition of epilepsy?
2 or more unprovoked seizures (recurrent)
At what time point in a seizure does an “aura” occur?
the actual start of a seizure & may be though of as a ‘warning’
What is an “ictal”?
the period during a sudden attack, sucha s seizure or stroke
What does “refractory” mean with reference to seizures?
treatment fails to achieve seizure freedom for 12 months or more
What is the term for a prolonged seizure or a series of repeated seizures?
status epilepticus
How long does a seizure have to go to be considered status epilepticus?
Is this serious?
5 minutes
medical emergency
What are the 3 major etiologies of seizures?
- genetic
- cryptogenic
- structural/metabolic
What are the genetic etiologies of seizures?
- mutations of ion channels (NMDA, Ca2+, Cl-)
- mutations of transmitter receptors
- chromosomal abnormalities
What are the 3 general seizure classifications?
Focal onset
Generalized onset
Unkown onset
What are the subclssifications of Focal Onset Seizure?
- Aware / Impaired awareness
- Motor onset / Non-motor onset
Focal onset seizures may progress to what type of seizure?
bilateral tonic-clonic
What the subclassifications of Generalized onset seizures?
- motor
- tonic clonic
- other motor
- Non-motor
- (absence seizures)
What are the subclassifications of unkonwn onset seizures?
- motor
- tonic clonic
- other motor
- Non-motor
- unclassified
What type of seizure often begins with a blank dazed stare?
focal with impaired awareness
When should a patient be worked up for a febile seizure with an MRI & an EEG?
Todds paralysis or anything that might suggest prolonged seizure or focal nature
How many unprovoked seizures can a person have before they should be on seizure medication?
1 unprovoked
How many provoked seizures can a person have before they should be on seizure medication?
provoide seizures do not warrant seizure medication
What are the steps in evaluating a patient with a seizure disorder?
- History
- EEG
- Neuroimaging
- Lab studies
- prolactin
- CSF
What hormone is often elevated in indicituals who recently had a convulsive episode?
prolactin
What questions should you ask a patient when working up a seizure?
- What were they doing before it started?
- How long did it last?
- What did it look like?
- Awareness during episode?
- Incontinence?
- Recovery?
- What do you remember about the episode?
If a patient is experiencing a generalzed seizure where the whole brain is involved, what
generalized - whole brain is involved
What is the direction that results in a “positive” in an EEG & a “negative”?
positivity - downward deflection
negativity - upward deflection
Odd numbered electrodes in an EEG correleate to what side?
Even numbered?
odd - left
even - right



