export_seizures Flashcards by Ahana Sen

Seizure

-‘abnormal excessive or synchronous neuronal activity in the brain’ –involuntary changes in awarness or behavior

How well did you know this?

Not at all

Perfectly

Epilepsy

recurrent, unprovoked seizures due to inherent brain dysfunction - different from seizures provoked by transient, reversible abnormalities (metabolic:hyponatremia, drug withdrawal, drug intox)

How well did you know this?

Not at all

Perfectly

Focal epilepsy most commonly from

-most from mescal temporal/hippocampus

How well did you know this?

Not at all

Perfectly

Epilepsy epedimiology

High in early childhood. (genetic, congenital malforms, trauma, neoplasm) - Decreases till 60-> vasc disease, neoplasm*, trauma, infections, neurogenerative. vasc more likely?

How well did you know this?

Not at all

Perfectly

Simple Partial Seizures

-Begins in definitive area of brain, does not effect consciousness. -autonomic/psychiatric symptoms–> often overwhelming fear/depersonilization

How well did you know this?

Not at all

Perfectly

Complex partial Seizures

A seizure that begins in definitive area in brain and DOEs affect consciousness. Aura is ALWAYS sign of focal seizure

How well did you know this?

Not at all

Perfectly

Primary generalized seizure

Affects whole brain at same time– consciousness is lost. -Ie. absence, atonic, tonic and tonic-clonic

How well did you know this?

Not at all

Perfectly

Secondarily generalized seizure

affects single part of brain then spread to rest of the brain

How well did you know this?

Not at all

Perfectly

Todd’s Paralysis

focal neurological deficit, usually weakness that persists up to 24 hours after a seizure

How well did you know this?

Not at all

Perfectly

Epilepsy Syndrome

seizure classification scheme which includes type of seizure, their localization, frequency, sequence of events, circadian distribution, precipitating factors, age of onset, mode of inheritance, physical or mental symptoms and signs, prognosis, and response to treatment

How well did you know this?

Not at all

Perfectly

Absence Seizure

-Staring -Primary generalized -EEG-spike and wave activity at 3 cycles per second -no post ictal

How well did you know this?

Not at all

Perfectly

Juvenile myoclonic syndrome

Myoclonic jerks, typically upon waking -triggers: sleep deprivation, classic- teenager after all nighter -EEG:generalized polyspike and wave discharge diffusely throughout at 4-6 Hz -TX: Depakote; or keppra

How well did you know this?

Not at all

Perfectly

Lennox-Gasaut Syndrome

Typically occurs in children ages 2-6. Seizures are very difficult to control. • Multiple seizure types, which vary among patients, include tonic (stiffening of the body, upward deviation of the eyes), atonic (brief loss of muscle tone and consciousness), atypical absence, and myoclonic (sudden muscle jerks).

How well did you know this?

Not at all

Perfectly

West Syndrome/tuber sclerosis

A syndrome of infants that consists of the triad of  infantile spasms, a pathognomonic EEG pattern (high amplitude waves and a background of irregular spikes) called hypsarrhythmia and mental retardation. • The best treatment is with adrenocorticotropic hormone.

How well did you know this?

Not at all

Perfectly

Benign rolandic epilepsy

-The most common epilepsy syndrome in children. Characterized by nocturnal seizures. • Has characteristic centrotemporal spikes. • Rarely needs treatment, children only have a few seizures and it always remits by age 16.

How well did you know this?

Not at all

Perfectly

Landau-Kleffner Syndrome

-Progressive aphasia in children affecting both Broca’s and Wernicke’s areas. Onset is typically seen b/w 3-5 y/o. -80-85% will demonstrate epileptiform activity during non-REM sleep

How well did you know this?

Not at all

Perfectly

Jacksonian March

Pattern of seizure progressing up someone’s body before generalizing.

How well did you know this?

Not at all

Perfectly

Tuberous Sclerosis

-cortical tubers, ash-leaf macules, GERD - tx: ACTH can prevent infantile spasms associated with TS by reducing CRH made ( excess excitability) -INFANTILE SPASMS

How well did you know this?

Not at all

Perfectly

Gelastic Seizure

-laughing fits -Hypothalamus neoplasm

How well did you know this?

Not at all

Perfectly

Syncopal Event

-Vasovagal -Can have convulsive movements -Absence of emotional cue (cardiac etiology)

How well did you know this?

Not at all

Perfectly

Non-Epileptic Seizures

-Pseudoseizures -different movements, lasting different amounts of time - VS> epileptic seizures are stereotypic ( identical for certain patient in duration/presentation) -R/O epilepsy -EEG can help differentiate -

How well did you know this?

Not at all

Perfectly

Mimics of seizure

The differential of a possible epileptic attack is quite large and includes anything that can cause a sudden, paroxsymal change in consciousness or neurological symptom. Common mimics of seizures include: syncope, transient ischemic attacks, migraines, movement disorders, narcolepsy/cataplexy, psychiatric pathology/non-epileptic seizures (NES), and malingering. It is important to note that in many patients NES and epileptic seizures may coexist.

How well did you know this?

Not at all

Perfectly

Electrolyte abnormalities in Seizure

hypomagnesia, hyper/hypo-glycemia, natremia, HYPO-calcemia

How well did you know this?

Not at all

Perfectly

Depakote

-Valproic acid -Anti-epileptic -WEIGHT GAIN -Class D in pregnancy–> neural tube defects

How well did you know this?

Not at all

Perfectly

Topimarate

-Topamax -Anti-epileptic - KIDNEY STONES

Oxcarbazepine,carbamazepine

-HYPONATREMIA

Phenytoin

-CEREBELLAR ATROPHY

Lamictal

-Stevens-Johnson syndrome

Simple Febrile Seizure

A GTC that lasts less than 1 min and doesn't occur again within 24hrs...associated with a febrile state

RF for epilepsy

-seizures \>15 min, not generalized but with focal fetters, and structural abnormalities on imaging

Complex Febrile Seizure

-focal features \>15 min, or recurs in 24 hours -3% will develop epilepsy -should be treated if complex,

Status Epilepticus

-life threatening -\>5-10 min or seizures without regaining consciousness in between \>30 min Benzos first line; IV phenytoin not given too quickly bc risk of cardiac arythmias

Epilepsia Partialis Continua

-persistant focal motor seizure, typically involving hand and foot

AED-principles

-Try to get dosage so one type will treat epilepsy -if no response, add more; but chance that 2nd will treat is only 10% -Make sure non-compliance is not the issue

Epilepsy interventions

-Most common-remove temporal lobe -determination of the focus is very important as to make sure no deficits occur in the patient ( other lobes as well) -Corpus collostomy in its with partial seizures to stop spread - Sometimes ( ie. Sturge Weber syndrome) --\> need dramatic surgical procedures -Vegas stimulation

Carbamazepine (Tegretol)

-partial seizures -SE: can worsen absence, myotonic, atonic. Hyponatremia, vertigo, HA, ataxia, blood dyscriasis

Oxacarbazepine (trileptal)

partial seizures -Hyponatremia; does not effect other drug levels

Phenytoin (Dilantin)

partial, general tonic-clonic, tonic and atonic -gum hyperplasia, osteoporosis, hirsutism, rash with chronic use.Ataxia, nystagmus, and confusion at high levels

Lamotrigine ( lamictal)

-juvenile myoclonic/ Lennox Gastaut - SE: Steven Johnson syndrome ( hi doses); must titrate slowly

Leviteracetam (keppra)

Se: depression, psycosis

Tiagabine (Gabitril)

Ajunct for partial -SE:sedation/cognitive slowing

Topimarate (topamax)

monotherapy in partial or mixed. drop attacks in Lennox-Gastaut Se: nephrolithiasis, weight loss, cognitive slowing ( esp higher doses)

Zonisamide ( Zonegran)

-Ajdunct in partial -Nephrolithiasis, weight loss

Valproate ( Depakote)

1mary generalized epilepsies including absence, myoclonic, and tonic-clonic -Weight gain, pancreatitis, neural tube, heaptic tox in children. interacts w/ other AEDS

Ethosuximide

Absence seizures

# reversed prompt -'abnormal excessive or synchronous neuronal activity in the brain' --involuntary changes in awarness or behavior

Seizure

# reversed prompt recurrent, unprovoked seizures due to inherent brain dysfunction - different from seizures provoked by transient, reversible abnormalities (metabolic:hyponatremia, drug withdrawal, drug intox)

Epilepsy

# reversed prompt -most from mescal temporal/hippocampus

Focal epilepsy most commonly from

# reversed prompt - High in early childhood. (genetic, congenital malforms, trauma, neoplasm) - Decreases till 60-\> vasc disease, neoplasm\*, trauma, infections, neurogenerative. vasc more likely?

Epilepsy epedimiology

# reversed prompt -Begins in definitive area of brain, does not effect consciousness. -autonomic/psychiatric symptoms--\> often overwhelming fear/depersonilization

Simple Partial Seizures

# reversed prompt A seizure that begins in definitive area in brain and DOEs affect consciousness. Aura is ALWAYS sign of focal seizure

Complex partial Seizures

# reversed prompt Affects whole brain at same time-- consciousness is lost. -Ie. absence, atonic, tonic and tonic-clonic

Primary generalized seizure

# reversed prompt affects single part of brain then spread to rest of the brain

Secondarily generalized seizure

# reversed prompt focal neurological deficit, usually weakness that persists up to 24 hours after a seizure

Todd's Paralysis

# reversed prompt seizure classification scheme which includes type of seizure, their localization, frequency, sequence of events, circadian distribution, precipitating factors, age of onset, mode of inheritance, physical or mental symptoms and signs, prognosis, and response to treatment

Epilepsy Syndrome

# reversed prompt -Staring -Primary generalized -EEG-spike and wave activity at 3 cycles per second -no post ictal

Absence Seizure

# reversed prompt - Myoclonic jerks, typically upon waking -triggers: sleep deprivation, classic- teenager after all nighter -EEG:generalized polyspike and wave discharge diffusely throughout at 4-6 Hz -TX: Depakote; or keppra

Juvenile myoclonic syndrome

# reversed prompt Typically occurs in children ages 2-6. Seizures are very difficult to control. • Multiple seizure types, which vary among patients, include tonic (stiffening of the body, upward deviation of the eyes), atonic (brief loss of muscle tone and consciousness), atypical absence, and myoclonic (sudden muscle jerks).

Lennox-Gasaut Syndrome

# reversed prompt A syndrome of infants that consists of the triad of  infantile spasms, a pathognomonic EEG pattern (high amplitude waves and a background of irregular spikes) called hypsarrhythmia and mental retardation. • The best treatment is with adrenocorticotropic hormone.

West Syndrome/tuber sclerosis

# reversed prompt -The most common epilepsy syndrome in children. Characterized by nocturnal seizures. • Has characteristic centrotemporal spikes. • Rarely needs treatment, children only have a few seizures and it always remits by age 16.

Benign rolandic epilepsy

# reversed prompt -Progressive aphasia in children affecting both Broca's and Wernicke's areas. Onset is typically seen b/w 3-5 y/o. -80-85% will demonstrate epileptiform activity during non-REM sleep

Landau-Kleffner Syndrome

# reversed prompt Pattern of seizure progressing up someone's body before generalizing.

Jacksonian March

# reversed prompt -cortical tubers, ash-leaf macules, GERD - tx: ACTH can prevent infantile spasms associated with TS by reducing CRH made ( excess excitability) -INFANTILE SPASMS

Tuberous Sclerosis

# reversed prompt -laughing fits -Hypothalamus neoplasm

Gelastic Seizure

# reversed prompt -Vasovagal -Can have convulsive movements -Absence of emotional cue (cardiac etiology)

Syncopal Event

# reversed prompt -Pseudoseizures -different movements, lasting different amounts of time - VS\> epileptic seizures are stereotypic ( identical for certain patient in duration/presentation) -R/O epilepsy -EEG can help differentiate -

Non-Epileptic Seizures

# reversed prompt The differential of a possible epileptic attack is quite large and includes anything that can cause a sudden, paroxsymal change in consciousness or neurological symptom. Common mimics of seizures include: syncope, transient ischemic attacks, migraines, movement disorders, narcolepsy/cataplexy, psychiatric pathology/non-epileptic seizures (NES), and malingering. It is important to note that in many patients NES and epileptic seizures may coexist.

Mimics of seizure

# reversed prompt - hypomagnesia, hyper/hypo-glycemia, natremia, HYPO-calcemia

Electrolyte abnormalities in Seizure

# reversed prompt -Valproic acid -Anti-epileptic -WEIGHT GAIN -Class D in pregnancy--\> neural tube defects

Depakote

# reversed prompt -Topamax -Anti-epileptic - KIDNEY STONES

Topimarate

# reversed prompt -HYPONATREMIA

Oxcarbazepine,carbamazepine

# reversed prompt -CEREBELLAR ATROPHY

Phenytoin

# reversed prompt -Stevens-Johnson syndrome

Lamictal

# reversed prompt A GTC that lasts

Simple Febrile Seizure

# reversed prompt -seizures \>15 min, not generalized but with focal fetters, and structural abnormalities on imaging

RF for epilepsy

# reversed prompt -focal features \>15 min, or recurs in 24 hours -3% will develop epilepsy -should be treated if complex,

Complex Febrile Seizure

# reversed prompt -life threatening -\>5-10 min or seizures without regaining consciousness in between \>30 min Benzos first line; IV phenytoin not given too quickly bc risk of cardiac arythmias

Status Epilepticus

# reversed prompt -persistant focal motor seizure, typically involving hand and foot

Epilepsia Partialis Continua

# reversed prompt -Try to get dosage so one type will treat epilepsy -if no response, add more; but chance that 2nd will treat is only 10% -Make sure non-compliance is not the issue

AED-principles

# reversed prompt -Most common-remove temporal lobe -determination of the focus is very important as to make sure no deficits occur in the patient ( other lobes as well) -Corpus collostomy in its with partial seizures to stop spread - Sometimes ( ie. Sturge Weber syndrome) --\> need dramatic surgical procedures -Vegas stimulation

Epilepsy interventions

# reversed prompt -partial seizures -SE: can worsen absence, myotonic, atonic. Hyponatremia, vertigo, HA, ataxia, blood dyscriasis

Carbamazepine (Tegretol)

# reversed prompt partial seizures -Hyponatremia; does not effect other drug levels

Oxacarbazepine (trileptal)

# reversed prompt partial, general tonic-clonic, tonic and atonic -gum hyperplasia, osteoporosis, hirsutism, rash with chronic use.Ataxia, nystagmus, and confusion at high levels

Phenytoin (Dilantin)

# reversed prompt -juvenile myoclonic/ Lennox Gastaut - SE: Steven Johnson syndrome ( hi doses); must titrate slowly

Lamotrigine ( lamictal)

# reversed prompt Se: depression, psycosis

Leviteracetam (keppra)

# reversed prompt Ajunct for partial -SE:sedation/cognitive slowing

Tiagabine (Gabitril)

# reversed prompt monotherapy in partial or mixed. drop attacks in Lennox-Gastaut Se: nephrolithiasis, weight loss, cognitive slowing ( esp higher doses)

Topimarate (topamax)

# reversed prompt -Ajdunct in partial -Nephrolithiasis, weight loss

Zonisamide ( Zonegran)

# reversed prompt 1mary generalized epilepsies including absence, myoclonic, and tonic-clonic -Weight gain, pancreatitis, neural tube, heaptic tox in children. interacts w/ other AEDS

Valproate ( Depakote)

# reversed prompt Absence seizures

Ethosuximide