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neurology FA + STEP 2 > FA seizures > Flashcards

FA seizures Flashcards

1
Q

partial (focal) seizures - often preceded by / types

A

seizure aura

  1. simple partial
  2. complex partial
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2
Q

simple vs complex seizure according consciousness

A

simple - intact

complex - impaired

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3
Q

Generilized seizures - types and characteristics

A
  1. absence (petit mal) - 3 hz, no postictal confusion,
    blank stare
  2. myoclonic - quick, repetitive jerks
  3. tonic clonic (grand mal) - alternating stiffening and movement
  4. tonic - stiffening
  5. atonic - drop seizures (falls to floor), commonly mistaken for fainting
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4
Q

epilepsy with fever?

A

FEBRILE SEIZURES ARE NOT EPILEPSY

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5
Q

ethosuximide - side effects

A
  1. GI 2. fatigue 3. headache 4. urticaria

5. Stevens-Johnson

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6
Q

epilepsy - benzodiazepines - drugs and clinical use

A
  • lorazepam / diazepam
    1. 1st line for acute status epilepticus
    2. also for eclampsia seizure
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7
Q

phenytoin - mechanism

Fosphenytoin?

A

Na+ channel inactivation
ZERO kinetic order
- phenytoin for parental use

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8
Q

phenytoin - clinical use

A
  1. simple seizure
  2. complex seizure
  3. tonic clonic seizure (1st line)
  4. status epilepticus (1st line for prophylaxis)
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9
Q

Phenytoin - side effects

A

A. Neurologic 1. nystagmus 2. diplopia 3. ataxia 4. sedation 5. peripheral neuropathy
B. Dermatologic 1. gingival hyperplasia 2. hirsutism
3. Stevens-Johnson syndrome 4. DRESS syndrome
C. Musculosceletal: 1. SLE like syndrome 2. osteopenia
D. Hematologic: Megalobl anemia
E. Reproductive: teratogenesis (fetal hydantoin syndrome)
F. Other: c P-450 induction

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10
Q

carbamazepine - clinical use

A
  1. simple seizure (1st line)
  2. complex seizure (1st line)
  3. tonic clonic
  4. 1st line for trigeminal neuralgia
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11
Q

Carbamazepine - side effects

A
  1. diplopia 2. ataxia 3. blood dyscrasias (agranulocytosis, aplastic anemia) 4. liver toxicity
  2. teratogenesis 6. induction of P-450 7. SIADH
  3. Stevens-Johnson syndrome
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12
Q

Valproic acid - mechanism of action

A
  1. Na+ channel inactivation

2. increase GABA concentration by inhibiting GABA transaminase

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13
Q

Valproic acid - side effects

A
  1. GI 2. distress 3. rare but fatal hepatotoxicity (messure LFTs) 4. teratogenesis (neural tube defects) 5. tremor 6. weight gain 7. pancreatitis
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14
Q

Valproic acid - clinical use

A
  1. simple
  2. complex
  3. tonic-clonic (1st line)
  4. absence
  5. myoclonic
  6. bipolar disorder
  7. migraine prophylaxis
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15
Q

gabapentin - mechanism

A
  1. primarily inhibits high voltage activated Ca2+ channels

2. designed as GABA analogs

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16
Q

gabapentin - clinical use

A
  1. simple seizures
  2. complex
  3. peripheral neuropathy
  4. postherpetic neuralgia
17
Q

Gabapentin - side effects

A

sedation

ataxia

18
Q

phenobarbital - clinical use

A
  1. simple
  2. complex
  3. tonic clonic
  4. 1st line in neonates
19
Q

topiramate - mechanism

A
  1. blocks Na+ channels

2. increase GABA action

20
Q

topiramate - clinical use

A
  1. simple
  2. complex
  3. tonic - clonic
  4. migraine prevention
  5. idiopathic intracranial hypertension (pseudotumor cerebri)
21
Q

topiramate - side effects

A
  1. sedation
  2. mental dulling
  3. kidney stones
  4. weight loss
22
Q

lamotrigine - mechanism / SE

A

blocks voltage gated Na+ channels

- Steven Johnson Syndrome (must be titrated slowly)

23
Q

lamotigine - clinical use

A
  1. simple seizure
  2. complex
  3. tonic-clonic
  4. absence
24
Q

levetiracetam - mechanism of action

A

unknown. may modulate GABA and glutamine release

25
levetiracetam - clinical use
1. simple seizure 2. complex 3. tonic-clonic
26
tiagabin - mechanism of action / clinical use
increases GABA by inhibiting reuptake | - partial
27
vigabatrin - mechanism of action / clinical use
increase GABA by IRREVERSIBLY inhibiting GABA tranasmaminase - partial
28
epilepsy drug that induce P-450
1. phenytoin 2. Carbamazepine 3. phenobarbital
29
trigeminal neuralgia - 1st line treatment
carbamazepine
30
eplepsy drugs with nystagmus
phenytoin
31
eplepsy drugs with diplopia
phenytoin and carbamazepine
32
eplepsy drugs with Steven Johnson syndrome
1. phenytoin 2. carbamazepine 3. Lamotrigine 4. ethosuximide
33
1st line treatment for tonoclonic seizures
1. Phenytoin | 2. Valproic acid
34
eplepsy drugs - status epilepticus 1st line
acute - benzodiazepines | prophylaxis - phenytoin
35
initial diagnostic workup of a 1st time seizure in an adult should include
1. basic blood tests (electrolytes, glucose, Ca2+, Mg2+, CBC renal + liver), 2. toxicology screen if unprovoked --> further evaluation with neuroimaging and EEG
36
CT after a seizure - contrast or not
not

neurology FA + STEP 2 (8 decks)

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