Neuro 1 pt5

Question 1

Seizures are defined as:

Answer 1

abnl paroxysmal “electrical” hyperactivity in the cerebral cortex

Question 2

Non-brain etiologies of seizures

Answer 2

HYPO- glycemia, natremia, calcemia
HYPER- osmolar, thermia, tensive encephalopathy
Kidney- Uremia
Drug- OD, withdrawal
Heart- Global cerebral ischemia, Eclampsia

Question 3

2/3 of seizures have ___ etiology

Answer 3

idiopathic

Question 4

How to diagnose Epilepsy

Answer 4

it’s a clinical diagnose that requires >=2 seizures

Question 5

2 basic types of primary seizures

Answer 5

Primary generalized- involve both hemispheres, +Loss of consciousness
Partial Sz’s- lmtd to one area of brain, no LOC

Question 6

what type of seizure? stiffen c cry/groan, then motor fit

Answer 6

Tonic-clonic seizure

Question 7

what type of seizure? (blinking or staring 10-20 sec c abrupt start/stop as many as 50 daily) EEG

Answer 7

Absence (petit mal) seizure

Question 8

What type of seizure? <2mins, remain conscious, types include motor, sensory, autonomic, psychic

Answer 8

Simple partial seizure

Question 9

What type of seizure? 30sec to 2min, may be post-ictal, amnestic, begin either in frontal or temp lobe AUTOMATISMS

Answer 9

Complex partial seizure

Question 10

What type of seizure? start as partial sz then involve b/l hemispheres. Occur in 30% pts. c partial epilepsy. Most Sz’s in sleep are this type.

Answer 10

Secondarily generalized seizure

Question 11

What type of seizure? meso-temporal sclerosis most common cause and the “auras” are the actual sz’s

Answer 11

Temporal Lobe Epilepsy

Question 12

Define Todd’s paralysis

Answer 12

focal weakness in a part of the body after a seizure.

up to 24h; lateralize to contralateral hemisphere

Question 13

4 synonyms for a fake seizure

Answer 13

Psychogenic sz
Functional sz
nonepileptic sz
pseudoseizures

Question 14

GABA is made in brain cells from __ via __

Answer 14

GABA is made in brain cells from glutamate via glutamic acid decarboxylase (GAD).

Question 15

__ acts as the most numerous inhibitory NT

Answer 15

GABA

Question 16

__ acts as most numerous excitatory NT

Answer 16

Glutamate

Question 17

GABA works on the NS to __ you.

Something that works against GABA-T raises __

Caffeine works on __ – it makes neurons fire more.

Answer 17

sedate

raises the seizure threshold

Glutamate

Question 18

___ inhibs GABA release. Too much gives sensation of glutamate s enough GABA

Answer 18

Caffeine

Question 19

__ is an amino acid which acts as a neurotransmitter in the central nervous system. It inhibits nerve transmission in the brain, calming nervous activity.

Answer 19

GABA

Question 20

What AED (antiepileptic) drugs can cause SJS?

Answer 20

1st generation, older drugs: PHB/PHT/CBZ

Question 21

Most AEDs are excreted by liver. Name 2 that are RENAL excreted.
With these 2 be careful with patients with renal failure or on dialysis

Answer 21

Levetiracetam

Gabapentin

Question 22

If monotherapy fails, want to use next drug that has different __

Answer 22

different mechanism of action

Question 23

2 parts of Epilepsy surgery. when do you do it?

Answer 23

Vagus nerve stimulator
for refractory partial sz
Temporal lobectomy
Resection of single, well circumscribed lesion found on MRI located in noneloquent areas have 80% success for cure

Question 24

What is the most epileptic part of the brain?

Answer 24

Temporal lobe

Question 25

Dx: sz’s are sustained by excess excitation and reduced inhibition
Glutamate excites the NMDA receptor
GABA fails to inhibit in Sz
BP, gluc, arrhythmias, temp, due to catecholamine surge and vigorous muscle activity
Too much Glutamate, or too little GABA

Answer 25

Status Epilepticus

Question 26

During a __ seizure, the person’s muscles initially stiffen and they lose consciousness. The person’s eyes roll back into their head as the muscles (including those in the chest, arms and legs) contract and the back arches. As the chest muscles tighten, it becomes harder for the person to breathe – the lips and face may take on a bluish hue, and the person may begin to make gargling noises.

Answer 26

tonic seizure

Question 27

During a __ seizure, the individual’s muscles begin to spasm and jerk. The elbows, legs and head will flex, and then relax rapidly at first, but the frequency of the spasms will gradually subside until they cease altogether. As the jerking stops, it is common for the person to let out a deep sigh, after which normal breathing resumes.

Answer 27

clonic seizure

Question 28

__ May be only way to distinguish complex partial SE from absence nonconvulsive SE

Answer 28

EEG

Question 29

a big complication of Status Epilepticus, along with
Resp. failure/ aspiration
hyperthermia
hypotension
acidosis
may not wake up at all if too many neurons dead.

Answer 29

Rhabomyolysis