Mehl. Epilepsy + misconstrued as seizures Flashcards
M. Most common epilepsy disorder?
Temporal lobe epilepsy
M. Temporal lobe epilepsy. Originates where?
Originates at the medial temporal lobe.
M. Temporal lobe epilepsy. preceded by what?
Seizures are often precedes by visual auras, or warning signs. These can manifest as gustatory/olfactory sensations or déjà vu.
M. Temporal lobe epilepsy. most common type of seizure (is seizure terminology).?
Focal-onset impaired awareness seizure (FOIAS) type, with or without secondary generalization.
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.
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M. absence of any preceding neurologic findings –> seizure. Origin?
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.
M. West syndrome aka? linked to what?
Aka infantile spasms; X-linked recessive.
M. West syndrome. CP?
Epilepsy syndrome in infants characterized spasms.
M. West syndrome. EEG?
Causes an abnormal EEG pattern called hypsarrhythmia, which is chaotic pattern
M. West syndrome. leads to what neurologic result?
Leads to intellectual disability.
M. West syndrome. Tx?
Treatment is with ACTH (obscure, but apparently endogenous cortisol, which can mitigate the progression).
M. Treatment is with ACTH (obscure, but apparently endogenous cortisol, which can mitigate the progression). in what disease?
West syndrome.
M. Lennox-Gastaut. Definition/CP?
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]).
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?
Lennox-Gastaut.
M. Lennox-Gastaut. prognosis?
Poor prognosis, with 5% mortality rate in childhood; 80-90% persistence of seizures into adulthood.
M. Juvenile myoclonic epilepsy. CP?
Characterized by myoclonic jerks (usually hypnagogic and/or hypnopompic) that progress to tonic-clonic seizures after several months.
M. Characterized by myoclonic jerks (usually hypnagogic and/or hypnopompic) that progress to tonic-clonic seizures after several months.
M. Juvenile myoclonic epilepsy.
M. Juvenile myoclonic epilepsy. Age?
Age of onset is usually 10-16, but can also start in adulthood.
M. Juvenile myoclonic epilepsy. Tx?
Tx is valproic acid.
M (misconstrued as seizures). Adams-Stokes attack. Definition?
Idiopathic arrhythmia disorder in Peds that causes transient hypoxia to the brainstem, resulting in seizure-like episodes.
M (misconstrued as seizures).
Idiopathic arrhythmia disorder in Peds that causes transient hypoxia to the brainstem, resulting in seizure-like episodes. Dx?
Adams-Stokes attack
M (misconstrued as seizures). Adams-Stokes attack. EEG?
EEG does not show any seizure activity.
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.
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M (misconstrued as seizures). Breath-holding spell. Definition?
Child will involuntarily stop breathing following a trigger – e.g., being upset, frightened, or experiencing pain.
M. Child will involuntarily stop breathing following a trigger – e.g., being upset, frightened, or experiencing pain.
M (misconstrued as seizures). Breath-holding spell.
They’ll say 3-year-old was having a tantrum followed by falling on the floor + appearing blue. Dx?
M (misconstrued as seizures). Breath-holding spell.
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.
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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.
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M (misconstrued as seizures). Syncope.
The muscular activity (twitching) is due to hypoxia to the brain, similar to Adams-Stokes attack.
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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).
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