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Clin Med-Neuro > Neural Tube Defects > Flashcards

Neural Tube Defects Flashcards

1
Q

anencephaly

A

occurs when the cranial end of the neural tube fails to close
- absence of cerebral cortex

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2
Q

spina bifida occulta

A

bony defect only

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3
Q

meningocele

A

only meninges herniate

- no neural tissue

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4
Q

myelomeningocele

A

spinal cord and meninges herniate

- nerve damage and paralysis

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5
Q

myeloschisis

A

cleft spinal cord resulting from failure of the neural folds to close normally in the formation of the neural tube

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6
Q

what is characteristic of macrocephaly

A

sundowning sign of eyes

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7
Q

who commonly gets seizures?

A

extremes of age

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8
Q

pathophysiology of seizures

A

imbalance between inhibitory and excitatory neurotransmitters resulting in abnormal brain activity in the brain

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9
Q

epilsepy

A

recurrent seizures due to a genetically determined or idiopathic/cryptogenic cause

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10
Q

when are seizures not epilepsy

A

when they are provoked

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11
Q

convulsion

A

refers to the spasmodic (tonic) and/or jerky, contract-relax (clonic) movement associated with some seizures

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12
Q

aura

A

neurological symptoms that might occur directly before a seizure

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13
Q

prodrome

A

can occur hours to a few days prior to the seizure

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14
Q

postictal phase

A

time period immediatly after a seizure; patient may be drowsy, confused, usually has no memory of the event

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15
Q

status epilepticus

A

refers to a continuous seizure or serial seizures without return to conciousness between seizures

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16
Q

tonic phase

A

state of muscle contraction with excessive muscle tone

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17
Q

clonic phase

A

state of alternating contraction and relaxation

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18
Q

diagnosis of seizures

A

EEG is very important (only 23% of people have abdmoralities on first EEG)

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19
Q

generalized seizures

A

both hemispheres, complete LOC

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20
Q

partial (focal) serizures

A

occur in one hemisphere but can become generalized secondarily
no or complete loss of conciusness

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21
Q

types of partial seizures

A

simple (NO LOC)

complex (altered state of conciousness)

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22
Q

absence seizures

A
  • generalized seizures
  • LOC
  • vacant, unresponsive stare for a short period of time (30 seconds)
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23
Q

tonic seizures

A
  • generalized seizures

- generalized muscle contraction

24
Q

clonic seizures

A
  • generalized

- cycles of regularly repeating contraction and relaxation typically of 2-3 per second

25
Q

myoclonic seizures

A
  • generalized

- extremely brief muscle contraction experienced as an electric shock

26
Q

atonic

A
  • generalized

- loss of muscle tone

27
Q

simple partial seizures

A

-NO LOC
-sensory and perceptual manifestations
(epigastric rising)

28
Q

complex partial seizures

A
  • altered consciousness

- repetitive semi-perposeful movements=motor automatisms

29
Q

manifestations of partial seizures

A
  • jacksonian march

- sensory/autonomic/psychiatric

30
Q

pseudoseizures

A
  • common in young females
  • can be interrupted by sensory stimuli
  • falls but extends arms
  • keeps eyes closed tightly
  • avoid painful stimuli or cover face
31
Q

psychotropics

A

bubroprion

32
Q

opioids

A

meperidine

propoxyphene (davron)

33
Q

antimicrobials

A

antimalarials

34
Q

chemo

A

MTX

chlorambucil

35
Q

anesthetics

A

ketamine

lidocaine

36
Q

who gets febrile seizures

A

children 6-36 months
peak at 18 months
boys

37
Q

what kind of seizure is a febrile seizure

A

70-75% simple type (complicated)

38
Q

characteristics of a complex febrile seizure

A
  • focal
  • lasts longer than 10 min
  • can have long postictal phase
  • likely to recur within 24 hours
39
Q

RF for febrile seizures

A

height of the temperature

40
Q

risk of recurrence of febrile seizures

A
  • 30-40% will have a recurrence (less than 10 % will have 3 or more)
  • lower temperature at the time of the first seizure
  • shorter interval between the onset of the fever and the initial seizure
  • first febrile seizure that is complex
41
Q

are antipyretic meds effective prophylactic tx?

A

NO

42
Q

what child has a 24% risk of having another seizure within the next year and a 45% risk over the next 4 years?

A

child who is neurologically normal, no prior neruo illness and has an unprovoked seizure

43
Q

most common cause of seizures in adults

A

alcohol withdrawl

44
Q

when should neuro imagine be done after an adult seizure?

A
  • to exclude structural brain abnormality if first seizure clearly not provoked
  • CT preferred
45
Q

who gets anticonvulsant drug therapy?

A

reserved for patients who are at increased risk of recurrant seizures

46
Q

valproic acid (depakote)

A

first line for all except absence (2nd line)

47
Q

phenytoin (Dilantin)

A

first for all but absence

48
Q

phenobarbital (luminal)

A

first line for all but absence

49
Q

topiramate (topamax)

A

first line for all but absence

50
Q

ethosuximide (zarontin)

A

first line for absence

51
Q

iamotrigine (lamictal)

A

first line for partial

52
Q

oxycarbazepine (trileptal)

A

first line for partial

53
Q

carbamazepine (tegretol)

A

first line for partial complex and tonic-clonic

54
Q

what is the goal for seizure drug therapy?

A

single drug therapy

55
Q

status epilepticus

A

-single unremitting seizure with a duration longer than 5-10 min or frequent stacking of seizures without recovery in the middle

56
Q

treatment of status epilepticus

A

valium (also available in rectal gel)

Clin Med-Neuro (8 decks)

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