Mehl. Epilepsy + misconstrued as seizures 04-14 (1)

Question 1

M. Most common epilepsy disorder?

Answer 1

Temporal lobe epilepsy

Question 2

M. Temporal lobe epilepsy. Originates where?

Answer 2

Originates at the medial temporal lobe.

Question 3

M. Temporal lobe epilepsy. preceded by what?

Answer 3

Seizures are often precedes by visual auras, or warning signs. These can manifest as gustatory/olfactory sensations or déjà vu.

Question 4

M. Temporal lobe epilepsy. most common type of seizure (is seizure terminology).?

Answer 4

Focal-onset impaired awareness seizure (FOIAS) type, with or without secondary generalization.

Question 5

M. Temporal lobe epilepsy. For USMLE, pick “medial temporal lobe,” or just “temporal lobe,” if they ask for the origin of a seizure in the absence of any preceding neurologic findings.

Answer 5

.

Question 6

M. absence of any preceding neurologic findings –> seizure. Origin?

Answer 6

For USMLE, pick “medial temporal lobe,” or just “temporal lobe,” if they ask for the origin of a seizure in the absence of any preceding neurologic findings.

Question 7

M. West syndrome aka? linked to what?

Answer 7

Aka infantile spasms; X-linked recessive.

Question 8

M. West syndrome. CP?

Answer 8

Epilepsy syndrome in infants characterized spasms.

Question 9

M. West syndrome. EEG?

Answer 9

Causes an abnormal EEG pattern called hypsarrhythmia, which is chaotic pattern

Question 10

M. West syndrome. leads to what neurologic result?

Answer 10

Leads to intellectual disability.

Question 11

M. West syndrome. Tx?

Answer 11

Treatment is with ACTH (obscure, but apparently ­ endogenous cortisol, which can mitigate the progression).

Question 12

M. Treatment is with ACTH (obscure, but apparently ­ endogenous cortisol, which can mitigate the progression). in what disease?

Answer 12

West syndrome.

Question 13

M. Lennox-Gastaut. Definition/CP?

Answer 13

Severe childhood-onset epilepsy characterized by near-daily seizures and cognitive decline (hyperoralism is a sign of cognitive regression [babies put things in their mouths]).

Question 14

M. Severe childhood-onset epilepsy characterized by near-daily seizures and cognitive decline (hyperoralism is a sign of cognitive regression [babies put things in their mouths]). Dx?

Answer 14

Lennox-Gastaut.

Question 15

M. Lennox-Gastaut. prognosis?

Answer 15

Poor prognosis, with 5% mortality rate in childhood; 80-90% persistence of seizures into adulthood.

Question 16

M. Juvenile myoclonic epilepsy. CP?

Answer 16

Characterized by myoclonic jerks (usually hypnagogic and/or hypnopompic) that progress to tonic-clonic seizures after several months.

Question 17

M. Characterized by myoclonic jerks (usually hypnagogic and/or hypnopompic) that progress to tonic-clonic seizures after several months.

Answer 17

M. Juvenile myoclonic epilepsy.

Question 18

M. Juvenile myoclonic epilepsy. Age?

Answer 18

Age of onset is usually 10-16, but can also start in adulthood.

Question 19

M. Juvenile myoclonic epilepsy. Tx?

Answer 19

Tx is valproic acid.

Question 20

M (misconstrued as seizures). Adams-Stokes attack. Definition?

Answer 20

Idiopathic arrhythmia disorder in Peds that causes transient hypoxia to the brainstem, resulting in seizure-like episodes.

Question 21

M (misconstrued as seizures).
Idiopathic arrhythmia disorder in Peds that causes transient hypoxia to the brainstem, resulting in seizure-like episodes. Dx?

Answer 21

Adams-Stokes attack

Question 22

M (misconstrued as seizures). Adams-Stokes attack. EEG?

Answer 22

EEG does not show any seizure activity.

Question 23

M (misconstrued as seizures). Adams-Stokes attack.

Q will give you kid with miscellaneous arrhythmia description + describe twitching that sounds like seizure –> answer = Adams-Stokes attack.

Answer 23

.

Question 24

M (misconstrued as seizures). Breath-holding spell. Definition?

Answer 24

Child will involuntarily stop breathing following a trigger – e.g., being upset, frightened, or experiencing pain.

Question 25

M. Child will involuntarily stop breathing following a trigger – e.g., being upset, frightened, or experiencing pain.

Answer 25

M (misconstrued as seizures). Breath-holding spell.

Question 26

They’ll say 3-year-old was having a tantrum followed by falling on the floor + appearing blue. Dx?

Answer 26

M (misconstrued as seizures). Breath-holding spell.

Question 27

M (misconstrued as seizures). Breath-holding spell. The child often cries or becomes upset, exhales forcefully, stops breathing, then develops cyanosis, which can sometimes be followed by brief loss of consciousness and jerking (can be mistaken for seizure). - Shows up on NBME so you need to know it exists.

Answer 27

.

Question 28

M (misconstrued as seizures). Syncope. Just be aware that syncope in elderly (e.g., from aortic stenosis or atrial fibrillation) can sometimes cause twitching of muscles that accompanies fainting, where it resembles a seizure.

Answer 28

.

Question 29

M (misconstrued as seizures). Syncope. The muscular activity (twitching) is due to hypoxia to the brain, similar to Adams-Stokes attack.

Answer 29

.

Question 30

M (misconstrued as seizures). Syncope. - Shows up on an NBME form as elderly patient with cardiovascular Hx who has seizure-like episode. - Vignette might say there is no evidence of tongue-biting (meaning not a seizure).

Answer 30

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