Mehl. Seizures terminology Flashcards
M. Focal-onset aware seizure (FOAS). What about consciousness?
Formerly known as simple seizures.
No loss of consciousness (LoC).
M. Formerly known as simple seizures.
- No loss of consciousness (LoC).???
Focal-onset aware seizure (FOAS).
M. Focal-onset impaired awareness seizure (FOIAS). consciousness, CP?
Formerly known as complex seizures.
LoC.
This includes staring into space blankly, as with absence seizures (discussed below).
M. Formerly known as complex seizures.
LoC.
This includes staring into space blankly, as with absence seizures (discussed below).???
Focal-onset impaired awareness seizure (FOIAS).
M. One part of the brain is affected.?
Partial
M. Partial - definition?
One part of the brain is affected.
M. Simple partial = CP?
no LoC + only affects one part of brain.
M. Complex partial = CP?
LoC + only affects one part of brain.
M. LoC + only affects one part of brain. Dx?
Complex partial
M. no LoC + only affects one part of brain. Dx?
Simple partial
M. Formerly known as generalized.?
Generalized- onset
Formerly known as generalized. Dumb changes in nomenclature. But I don’t know what to tell you.
M. Generalized- onset. Involves what?
Involves both cerebral hemispheres.
M. Tonic-clonic. Aka “grand mal” seizure; type of generalized seizure. It is characterized by two phases:??? 2
Tonic phase
Clonic phase
M. Tonic-clonic (type of generalized seizure). 2 phases. 1. Tonic - CP?
lasts a few seconds; muscles stiffen and the patient falls to the ground and loses consciousness.
M. lasts a few seconds; muscles stiffen and the patient falls to the ground and loses consciousness.??
M. Tonic-clonic. 2 phases. 1. Tonic
M. Tonic-clonic. 2 phases. 2. Clonic?
rhythmic jerking movements of the limbs; usually lasts several minutes. - Following the seizure (i.e., during the postictal phase), the patient may be confused, drowsy, and have no recollection of the seizure.
M. rhythmic jerking movements of the limbs; usually lasts several minutes. - Following the seizure (i.e., during the postictal phase), the patient may be confused, drowsy, and have no recollection of the seizure.???
M. Tonic-clonic. 2 phases. 2. Clonic
M. Tonic-clonic. HY post-seizure finding?
Tongue biting/lacerations are a HY post-seizure finding. If the Q tells you explicitly that the tongue is normal in this setting, they are telling you it is not a seizure.
M. Tonic-clonic. Tx for recurrent seizures are agents such???3
as valproic acid, carbamazepine, and phenytoin.
M. Tonic-clonic.
There is a difficult NBME Q where they tell you a patient has twitching of one arm prior to falling to the ground and having a tonic-clonic seizure. The answer on the NBME form is “complex partial,” not generalized tonic-clonic. This type of seizure is called FOIAS with secondary generalization, or complex partial with secondary generalization.
.
M. Tonic-clonic. In other words, if a patient has focal neurologic signs preceding a tonic-clonic seizure, this indicates an origin in one location prior to spreading to other areas.
.
M. Status epilepticus. CP?
seizure lasting >5 minutes, or 2 seizures within 5 minutes.
M. seizure lasting >5 minutes, or 2 seizures within 5 minutes.?
M. Status epilepticus.
M. Status epilepticus.
Definition used to be a seizure lasting >30 minutes, or 2 seizures within 30 minutes.
.
M. Status epilepticus. First line Tx?
benzo (IV lorazepam is usually 1st-line, but USMLE doesn’t care).
M. Status epilepticus. If BZD doesnt work, next step Tx?
If benzo doesn’t work, phenytoin (or fosphenytoin) is next, followed by barbiturates.
M. Status epilepticus. Tx step by step?
In other words, for USMLE: benzo –> phenytoin –> barbiturate (e.g., phenobarbital).
M. Myoclonic. CP?
A type of generalized seizure that causes muscle jerks lasting less than a second.
A succession of jerks can be seen over a short time period.
The patient will not have loss of consciousness.
A type of generalized seizure that causes muscle jerks lasting less than a second.
A succession of jerks can be seen over a short time period.
The patient will not have loss of consciousness.
M. Myoclonic.
M. Can present similarly to simple partial, despite the EEG showing generalized activity.??
M. Myoclonic.
M. Febrile seizure. Age?
Fever can precipitate idiopathic seizure in 2-4% of children ages 6 months - 5 years.
About a two-fold risk progression to epilepsy compared to general population.
M. Febrile seizure. Tx?
Tx is with benzodiazepine.
M. Febrile seizure.
Febrile seizures lasting longer than 10 minutes, seizures that are recurrent within 24 hours, or focal neurologic signs more significantly risk of progression to epilepsy.
.
M. Absence seizure. CP?
Vignette will be a kid staring off into space in class for 30 seconds spacing out, sometimes with rapid blinking.
This is considered loss of consciousness.
M. Vignette will be a kid staring off into space in class for 30 seconds spacing out, sometimes with rapid blinking.
This is considered loss of consciousness.??
Absence seizure
M. Absence seizure EEG?
EEG shows symmetric 3-Hz spike-and-wave discharges.
M. Absence seizure. Tx?
Tx is ethosuximide (thalamic calcium channel blocker).
