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A. Small Animal Medicine and Surgery > Idiopathic Epilepsy > Flashcards

Idiopathic Epilepsy Flashcards

1
Q

what is a cluster seizure?

A

two or more seizures occurring within 24 hours

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2
Q

what is the prodromal phase?

A

altered behavior hours before seizure

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3
Q

what is a generalized seizure?

A

generalized neuronal hyper-excitability encompassing the entire cerebral cortex
both hemispheres

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4
Q

what is a focal seizure?

A

neurons of specific region of brain are involved in seizure focus
can affect any part of body, but head most often

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5
Q

what is the pathogenesis of seizures?

A

not completely understood
an imbalance in excitatory and inhibitory neurotransmission

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6
Q

what is the genetic mode of transmission of idiopathic epilepsy?

A

autosomal recessive
more than one gene involved

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7
Q

what is the age of onset of idiopathic epilepsy?

A

10 months- 5 years

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8
Q

for what ages should you do an MRI for onset of seizures?

A

less than a year
more that five years

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9
Q

what metabolic testing should you do for a dog with new onset of seizures?

A

CBS, chemistry profile, urinalysis
bile acid stimulation test
ammonia

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10
Q

what are some indications for starting an anticonvulsive medication?

A

status epilepticus
cluster seizures
intracranial lesion
increasing seizure activity with shortening interictal interval

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11
Q

what is the breakdown of categories of causes of status epilepticus?

A

40% idiopathic epilepsy
40% symptomatic (intracranial) epilepsy
20% reactive (extra-cranial) epilepsy

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12
Q

what are some at home options for cluster events?

A

rectal diazepam
intranasal diazepam
intranasal midazolam
rectal levetiracetum
pulse therapy levetiracetum

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13
Q

what is the mechanism of action of phenobarbital?

A

effects post synaptic barbituate receptor in presence of GABA
prolongs opening of chloride channels: hyperpolarization of cell membrane

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14
Q

what is the mechanism of action of bromide?

A

hyperpolarization of post-synaptic membrane via accumulation within cells

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15
Q

what is the mechanism of action of levetiracetam?

A

modulates release of neurtotransmitters via selective binding to the SVA2 protein

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16
Q

what is the mechanism of action of zonisamide?

A

blocks T-type calcium channels
inhibits voltage-gated sodium channels
enhances GABA release
inhibits glutamate release

17
Q

what is the mechanism of action of pregabalin?

A

binds to CaVa2 unit of the calcium channel
reduced calcium influx diminishes excitatory neurotransmitter release

18
Q

which medication has liver side effects as a concern?

A

phenobarbital

19
Q

which medication should you not give to cats?

A

potassium bromide

20
Q

what interactions do cannabinoids have?

A

inhibition of cytochrome P450 cytochrome oxidase
interference of diazepam derivatives and most likely also phenobarbital

21
Q

what is the mechanism of action of ketogenic diets?

A

ketone bodies have anti-epileptic properties
fatty acids metabolized into ketone bodies when low amount of carbohydrates
dogs easily become ketotic
medium chain triglycerides more easily produce ketone bodies in dogs

22
Q

what are the negative prognostic factors for seizure control?

A

presence of cluster seizures
age at presentation
duration of seizure disorder

23
Q

what are the clinical manifestations of generalized seizures?

A

tonic-clonic
tonic
clonic
myoclonic

24
Q

is glutamate excitatory or inhibitory?

A

excitatory

25
Q

what channels does glutamate control?

A

sodium/calcium channels

26
Q

which breeds are especially predisposed to seizures?

A

belgian shepherd
border terrier
finnish spitz
irish wolfhound
italian spinone
petite basset griffon de vendeen
labrador retriever

27
Q

what are the potential causes of primary epilepsy?

A

idiopathic
hereditary

28
Q

what is the half life of phenobarbital?

A

dog: 24-48 hours
cat: 34-43 hours
low protein diet decreases

29
Q

how is bromide excreted?

A

renal

30
Q

what are the side effects of levetiracetam?

A

rarely weakness
rarely sedation
very rarely excitement

31
Q

how is levetiracetam metabolized?

A

minimal hepatic
renal excretion

32
Q

how is zonisamide cleared?

A

hepatic- not P450
renal excretion

33
Q

is zonisamide used for emergency therapy?

A

no- maintenance only

34
Q

how is pregabalin cleared?

A

excreted unchanged through kidneys

35
Q

how do ketogenic diets act to decrease seizures?

A

ketone bodies anti-epileptic
fatty acids and medium chain triglycerides produce ketone bodies
also decanoic acid

36
Q

what is decanoic acid?

A

non-competitive AMPA receptor antagonist: inhibition of excitatory neurotransmission

37
Q

are dogs that present at a very young age or old age less responsive to medications?

A

very young age

A. Small Animal Medicine and Surgery (51 decks)

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