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ClinPhar II Lec > Epilepsy with no drugs > Flashcards

Epilepsy with no drugs Flashcards

1
Q

A sudden, disorganized electrical discharge in one or more
parts of the brain that interrupts normal brain signals and
disrupts the normal balance of inhibitory and excitatory input

A

Seizure

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2
Q

A CNS disorder in which nerve cell activity in the brain becomes
disrupted, causing seizures or periods of unusual behavior,
sensations and sometimes loss of consciousness

A

Epilepsy

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3
Q

Epilepsy is defined by the occurrence of at least ______________ unprovoked seizures,
with or without convulsions, separated by at least __________

A

two; 24 hours

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4
Q

T/F: It can still be defined as epilepsy even if the seizure occured without convulsions

A

True

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5
Q

T/F: Anything that disrupts the normal
homeostasis or stability of neurons can
trigger hyperexcitability and seizures

A

True

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6
Q

Calming Neurotransmitter

A

GABA

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7
Q

Excitatory Neurotransmitter

A

GLUTAMATE

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8
Q

Too much __________: Anxiety, Preseverating, Restlessness, Migraines, Tics and Motorsterotypies

A

Glutamate

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9
Q

Causes or Triggers of Epilepsy

A
  • Infections (meningitis and encephalitis, COVID-19)
  • Acquired brain injuries (head trauma)
  • High fever (febrile seizures)
  • Lack of sleep
  • Electrolyte Imbalance, Hypoglycemia
  • Sudden alcohol, smoking or drug withdrawal
  • Flashing lights
  • Medications (diuretics, analgesics, antidepressants)
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10
Q

Seizures can start in any
of these lobes:

A

Occipital, Parietal, Frontal, Temporal

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11
Q
  • Location: Back of the head
A

Occipital

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12
Q

For processing visual information

A

Occipital

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13
Q

visual disturbances,
temporary blindness, headache
and difficulty with spatial
orientation

A

Occipital

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14
Q

Location: Behind frontal lobes

A

Parietal

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15
Q

For processing sensory
information (touch, pain, taste)

A

Parietal

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16
Q

: tingling or numbness,
difficulty understanding spatial
relationships or distances,
dizziness, vertigo, difficulty
reading and writing, pain
sensations

A

Parietal

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17
Q

Behind the forehead

A

Frontal

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18
Q

For movement, planning,
decision-making, emotion
regulation

A

Frontal

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19
Q

jerking movements,
difficulty speaking or slurred
speech, abnormal sensations,
out-of-body experience, impaired
awareness, confusion, changes
in mood or behavior

A

Frontal

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20
Q

Either side of head,
behind the temples

A

Temporal

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21
Q

For memory, learning, emotions,
and auditory information

A

Temporal

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22
Q

auras (strange
smells, tastes or déjà vu), altered
awareness or confusion,
automatisms, auditory
hallucinations, difficulty speaking
or understanding speech

A

Temporal

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23
Q

Risk Factors

A
  • Patients with mental retardation, cerebral palsy, head injury,
    or strokes are at an increased risk for seizures and epilepsy

-elderly

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24
Q

n the elderly, the onset of seizures is typically associated
with _________ neuronal injury induced by _________,
____________________, and other
conditions

A

focal; strokes; neurodegenerative disorders (Alzheimer’s disease)

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25
Q

Affect both sides of the brain or groups of cells on both
sides of the brain at the same time

A

Generalized onset seizures

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26
Q
  • Tonic-clonic (Grand Mal)
  • Absence (Petit Mal)
  • Atonic epilepsy
A

Generalized onset seizures

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27
Q

Grand Mal

A

Tonic-clonic

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28
Q

Absence

A

(Petit Mal)

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29
Q

Most dramatic type of generalized seizure

A

Tonic-clonic (Grand Mal)

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30
Q

May start as a focal seizure first, then generalized

A

Tonic-clonic (Grand Mal)

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31
Q

muscle stiffening of the entire body;

A

phase 1: tonic

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32
Q

rhythmic jerking of the limbs and face

A

phase 2: clonic

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33
Q

Last from seconds to several minutes

A

Tonic-Clonic

34
Q

Typically patient loss consciousness

A

Tonic-Clonic

35
Q

period of confusion or drowsiness

A

(Tonic-Clonic) Post-ictal phase

36
Q

“daydreaming” or “spacing out”

A

Absence (Petit Mal)

37
Q

”staring spell”

A

Absence (Petit Mal)

38
Q

Brief lapses or impaired consciousness
lasting from five to ten seconds

A

Absence (Petit Mal)

39
Q

Often occurs in children

A

Absence (Petit Mal)

40
Q

Patient may stare blankly, blink rapidly,
or appear fidgety

A

Absence (Petit Mal)

41
Q

Usually, no jerking movements or other
physical manifestations, lip smacking

A

Absence (Petit Mal)

42
Q

“Akinetic” or “Drop seizures”

A

Atonic epilepsy

43
Q

Sudden loss of muscle tone,
causing the person to fall

A

Atonic epilepsy

44
Q

May involve the entire body or
just certain muscle groups

A

Atonic epilepsy

45
Q

Usually lasts for a few second

A

Atonic epilepsy

46
Q

Brief loss of consciousness
may occur

A

Atonic epilepsy

47
Q

Can start in one area or group of cells in one side of the brain

A

Focal onset seizures

48
Q

Simple partial seizures

A

Focal onset aware seizures

49
Q

Individuals remain fully aware of their surroundings

A

Focal onset aware seizures

50
Q

May experience unusual sensations, movements, or other
changes related to the affected brain area

A

Focal onset aware seizures

51
Q

Complex partial seizures

A

Focal onset impaired awareness seizures

52
Q

Involves a degree of altered awareness or confusion

A

Focal onset impaired awareness seizures

53
Q

Individual may appear dazed, unresponsive, or engage in
automatic behaviors like hand rubbing, lip smacking or
fidgeting without full control or awareness

A

Focal onset impaired awareness seizures

54
Q

May later be diagnosed as a generalized or focal seizure

A

Unknown onset seizures

55
Q

clonic, atonic, tonic, myoclonus, or epileptic spasms

A

Motor symptoms (Generalized)

56
Q

Typical or atypical absence seizures

A

Non-motor symptoms (Generalized)

57
Q

Automatisms or repeated automatic movements

A

Motor symptoms (Focal)

58
Q

Changes in sensation, emotions, thinking or cognition,
autonomic functions or lack of movement

A

Non-motor symptoms (Focal)

59
Q

Either tonic-clonic or epileptic spasms

A

Motor seizures (UNknown)

60
Q

Behavior arrest

A

Non-motor seizures (Unknown)

61
Q

include somatosensory or focal motor features

A

Complex partial seizures or focal onset impaired awareness
seizures

62
Q

non-detectable with only
very brief (in seconds) periods of altered consciousness

A

Absence seizures

63
Q

major convulsive
episodes and are always associated with a loss of
consciousness

A

Generalized tonic-clonic seizures

64
Q

T/F: Interictally or between seizure episodes, there are typically no
objective or pathognomonic signs

A

true

65
Q

T/F: No diagnostic laboratory tests for epilepsy

A

True

66
Q

In some cases, particularly following GTC seizures, ____________
can be transiently elevated

A

serum prolactin levels

67
Q

Diagnostic Tests:

A

ECG, MRI, CT scan

68
Q

very useful in the diagnosis of various seizure disorders

A

ECG

69
Q

imaging of the temporal lobes

A

MRI

70
Q

typically not helpful except in the initial evaluation for a
brain tumor or cerebral bleeding

A

CT scan

71
Q

In the presence of suspected infection, __________ may
also be performed

A

lumbar puncture

72
Q

Not a first-line diagnostic tool for seizures
* Supportive role in diagnosing seizures when other tests
are inconclusive

A

Positron emission tomography (PET) scan and Single-photon
emission computed tomography (SPECT)

73
Q

General Approaches to Treatment:

A
  • Assessment of seizure type and frequency
  • Identification of treatment goals
  • Development of a care plan
  • A plan for follow-up evaluation
74
Q

If a decision is made to start AED therapy, _____________ is
preferred, and approximately 50% to 70% of all patients
with epilepsy can be maintained on one drug

A

monotherapy

75
Q

When to stop AEDs?

A

The drug considered less appropriate for the seizure type,
or the agent deemed most responsible for adverse events
should be discontinued first

Decreasing the number of AEDs can decrease side effects
and increase cognitive abilities

76
Q

Factors favoring successful withdrawal of AEDs:
Seizure-free period of ___________
* Complete seizure control within _________ of onset
* An onset of seizures after age _______, but before age __________
* A normal neurologic examination and _________

A

Seizure-free period of two to four years
* Complete seizure control within one year of onset
* An onset of seizures after age two, but before age 35
* A normal neurologic examination and EEG

77
Q

AED Withdrawal is Generally not suggested for patients with

A

juvenile myoclonic epilepsy (JME),
absence with clonic-tonic-clonic
seizures, or clonic-tonic-clonic seizures

78
Q

Non-pharmacologic Therapy

A

Diet, Surgery, Vagus Nerve Stimulation

79
Q

Implanted medical device that is FDA-approved for use as
adjunctive therapy in reducing the frequency of seizures in
adults and adolescents older than 12 years of age with
partial-onset seizures that are refractory to AEDs

A

Vagus Nerve Stimulation

80
Q

T/F: Placing a spoon in a person’s mouth
during a seizure to protect the
tongue is NOT RECOMMENDED

A

True

81
Q

T/F: For single unprovoked seizures, No AEDs are recommended unless there is presence of
risk factors for recurrence

A

true

82
Q

Special situations requiring treatment:

A

-recurrent unprovoked seizures
-more than 1 episode of seizure
-sleep-deprived individuals
-abnormal EEG

ClinPhar II Lec (6 decks)

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