Module 9: Seizures

Question 0

Causes of partial seizures?

Answer 0

#stroke
#Neoplasm
#Head trauma
#Infection
#Mesial temporal sclerosis

Question 1

Common causes of generalized seizure?

Answer 1

#Genetic epilepsy syndromes
#Metabolic derangement
#Fever
#Sleep deprivation

Question 2

Initial workup for generalized seizures versus partial seizures?

Answer 2

Systemic labs versus neuroimaging

Question 3

Provoked seizures are most likely what type seizure?

Answer 3

Generalized

Question 4

Types of simple partial seizures?

Answer 4

Most common:
#Psychotic – intercensal do/déjà vu
#Autonomic – rising up feeling in abdomen
#Olfactory – burning smell

Less common:
#Motor (rental)
#Sensory (parietal)
#visual (Occipital)

Question 5

Electrolyte abnormalities associated with seizures?

Answer 5

Hyponatremia, hypocalcemia, hypomagnesemia

Question 6

Drugs associated with seizures?

Answer 6

#Penicillins
#Local anesthetics
#Tricyclics
#lithium
#Amphetamine/cocaine/theophylline/PCP

Question 7

Endocrinopathy that can lead to seizures?

Answer 7

Hypoparathyroidism (hypocalcemia)

Question 8

Organ based causes of seizures?

Answer 8

#Uremia
#Hepatic failure
#TTP
#Sepsis

Question 9

Absence Seizure Versus Complex Partial Seizures – Duration? Automatisms? Postictal State? EEG Pattern?

Answer 9

Seconds versus minutes

Rare versus frequent (lipsmacking)

None versus postictal state

3 Hz in all leads versus focal area of abnormal spikes and waves

Question 10

Seizure versus syncope: precipitating factors? Premonitory symptoms? Posture at onset? Transition to unconsciousness?

Answer 10

None versus stress/Valsalva

None/vague versus tunneling vision/lethargy/nausea/diaphoresis

Any posture versus standing

Immediate versus over seconds

Question 11

Seizure versus syncope: Duration of tonic/clonic movements? Facial appearance? Post event confusion? Combining? Incontinence? Elevated CPK or myalgias?

Answer 11

30-60 seconds versus always under 15 seconds

Cyanotic versus pallid

Minutes/hours versus under five minutes

Occasionally versus rarely

Occasionally versus sometimes

Frequent versus sometimes

Question 12

Phenytoin – a.k.a.? Principal use? Side effects?

Answer 12

Dilantin

General tonic clonic, partial seizures

Cerebellar degeneration, 
gum hyperplasia, 
osteomalacia, 
rash, 
Adenopathy

Question 13

Carbamazepine – a.k.a.? Principal use? Notable Side effects?

Answer 13

Tegretol

Partial seizures, general tonic clonic

Vertigo, 
aplastic anemia, 
leukopenia, 
G.I. upset, 
hepatotoxicity

Question 14

Valproic acid – a.k.a.? Principal use? Notable Side effects?

Answer 14

Depakote

G TC, partial, myoclonic

HEPATOTOXICITY, 
thrombocytopenia, 
alopecia, 
weight gain, 
polycystic ovarian syndrome

Question 15

Phenobarbital – a.k.a.? Principal use? Notable Side effects?

Answer 15

Luminol

GTC, partial

Nothing notable (sedation, depression, confusion, ataxia)

Question 16

Ethosuximide – a.k.a.? Principal use? Notable Side effects?

Answer 16

Zarontin

Absence seizures

Cytopenia

Question 17

Gabapentin – a.k.a.? Principal use? Notable Side effects?

Answer 17

Neurontin

Partial seizures

G.I. upset

Question 18

Lamotrigine – a.k.a.? Principal use? Notable Side effects?

Answer 18

Lamictal

Partial, G TC

STEVENS JOHNSON’S

Question 19

Topiramate – a.k.a.? Principal use? Notable Side effects?

Answer 19

Topamax

GTC, partial

WORD fINDING DIFFICULTIES
Weight-loss
Metabolic acidosis

Question 20

Levetiracetam – a.k.a.? Principal use? Notable Side effects?

Answer 20

Keppra

Partial seizures

Behavioral disturbances