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PR3153 > IC6 > Flashcards

IC6 Flashcards

1
Q

Epilepsy: Age distribution (peaks)

A

infants < 1y/o and in people > 60 y/o

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2
Q

Mean age of first seizure onset

A

~11.1y/o

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3
Q

Prevalence of seizure in SG ethnic groups - high to low

A

Indians, chinese, malay

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4
Q

Definition of epilepsy

A

Disease of brain defined by any of following:
1) >/= 2 unprovoked seizure spaced > 24h apart
2) 1 unprovoked seizure + probability of further seizure (60%) after 2 unprovoked seizures, in next 10yrs
3) Diagnosis of epilepsy syndrome

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5
Q

Definition of acute symptomatic seizure

A

Seizure that occur from an immediately recognisable stimulus (about 1 week) with an acute brain insult

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6
Q

Definition of unprovoked seizure

A

Seizure that occur in the absence of a potentially responsible clinical condition or beyond interval estimated for occurrence of acute symptomatic seizure

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7
Q

Definition of dissociative seizure

A

Abnormal paroxysmal psychic, sensory and/or motor manifestations which resemble epileptic seizures but are not related to abnormal epileptiform discharges (meaning, EEG looks normal)

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8
Q

Etiology of epilepsy

A
  1. Structural
  2. Genetic/presumed genetic
  3. Neurodegenerative
  4. Metabolic
  5. Infectious
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9
Q

How does Focal onset occur

A

seizures begin only in one hemisphere

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10
Q

Generalized onset

A

seizures begin in both hemispheres

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11
Q

Secondarily generalized

A

seizure being in one hemisphere, then spread to the other

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12
Q

Focal onset seizures (without dyscognitive features) seizures is known as ____ seizure

A

simple partial seizures

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13
Q

Focal onset seizures (with dyscognitive features) seizures is known as ____seizure

A

complex partial

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14
Q

Early ictal indicates the ___ phase

A

Aura

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15
Q

Which phase indicates the seizure?

A

Ictal phase

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16
Q

Main symptoms in focal onset (simple partial)

A

Motor, autonomic, sensory & psychic (somatosensory) symptoms

17
Q

‘Grand Mal’ refers to which seizure?

A

Generalised tonic-clonic seizure

18
Q

Which seizure requires immediate medical attention?

A

Generalised tonic-clonic seizure

19
Q

How long is full recovery for simple partial seizure

A

Several mins - hours

20
Q

Which is the Characteristic and defining seizure type in the Lennox – Gastaut syndrome?

A

tonic seizure/ atonic seizure

21
Q

‘Petit Mal’ refers to which seizure?

A

Absence seizure

22
Q

Population affected by clonic seizure the most

A

Most frequent in neonates, infants or young children

23
Q

Population affected by absence seizure the most, and usual onset

A

More common in children than adults; first onset 4-12 y/o (rarely aft 20 y/o)

24
Q

Characteristics of absence seizure which differentiates it from complex partial seizure

A
  • Never preceded by auras
  • Lasts seconds (rather than mins)
  • Begin frequently and end abruptly
  • Produce characteristic EEG pattern (3 Hz spike waves)
25
Q

What is classic drop attack

A

postural tone is suddenly lost, causing collapse to the ground like a rag doll

26
Q

Do all epileptic patients have abnormal EEG?

A

No

27
Q

Can EEG be abnormal for normal people?

A

Yes, false positive 0.5-1%

28
Q

How many years after 1st seizure would the recurrence risk be highest?

A

2 years

29
Q

In what situations would seizure recurrence risk be higher after 1st seizure?

A
  • epileptiform abnormalities on EEG
  • Prior brain insult (e.g. stroke, brain trauma)
  • Structural abnormality in brain imaging - - Nocturnal seizure
30
Q

After 2 unprovoked seizures, risk of recurrent seizures at 4 years is ____

A

~ 70%

31
Q

Based on FIRST and MESS study, treatment after 1st seizure showed…

A
  • Reduced risk of 2nd seizure
  • No effect on long-term prognosis
  • No evidence of higher risk of death, injuries, or status epilepticus in patients allocated to deferred treatment
32
Q

Treatment goals in epilepsy treatment

A
  • Absence of epileptic seizures
  • Absence of ASM-related side effects
  • Attainment of optimal quality-of-life
33
Q

About ___ of patients are able to achieve seizure-freedom after treatment

A

two-thirds

34
Q

_____ is the most common comorbidity in children with epilepsy (30–40%)

A

Intellectual disability

35
Q

Most common psychiatric comorbidities in patients with epilepsy

A

depression (23%) and anxiety (20%)

PR3153 (17 decks)

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