Neuro Seizures and Headaches Flashcards
Partial (focal) seizures
Affect 1 area of the brain.
Most commonly originate in medial temporal lobe.
Often preceded by seizure aura; can secondarily generalize.
Simple partial
consciousness intact)— motor, sensory, autonomic, psychic
Complex partial
impaired consciousness
Epilepsy
a disorder of recurrent seizures (febrile seizures are not epilepsy).`
Status epilepticus
continuous seizure for > 30 min or recurrent seizures without regaining consciousness between seizures for > 30 min.
Generalized seizures
involves both hemispsheres
Partial (focal) seizures where does it originate from.
medial temporal lobes
petit mal/absense
petit mal)—3 Hz, no postictal
confusion, blank stare
Myoclonic
quick, repetitive jerks
grand mal
Tonic-clonic (grand mal)—alternating
stiffening and movement loss of bowel and bladder functions
Tonic
—stiffening
atonic
drop” seizures (falls to floor);
commonly mistaken for fainting losses muscle tone and drops to the floor with loss of consciousness
Cluster headache
LOCALIZATION
DURATION
DESCRIPTION
Unilateral; 15 min–3 hr; repetitive
Repetitive brief headaches. Excruciating periorbital pain with lacrimation and rhinorrhea. May induce Horner syndrome.
More common in males
Tension
LOCALIZATION
DURATION
DESCRIPTION
Bilateral
> 30 min (typically 4–6 hr); constant
Steady pain. No photophobia or phonophobia. No aura.
Migraine
LOCALIZATION
DURATION
DESCRIPTION
Unilateral
4–72 hr
Pulsating pain with
nausea, photophobia, or phonophobia. May have “aura.” Due to irritation of CN V, meninges, or blood vessels (release of substance P, CGRP, vasoactive peptides).
Cluster headaches can be differentiated from trigeminal neuralgia based on
trigeminal neuralgia produces repetitive shooting pain in the distribution of CN V that lasts (typically) for < 1 minute. The pain from cluster headaches lasts considerably longer (> 15 minutes).
1st line for acute status epilepticus
benzo lorazepam diazepam
ethosuximide
absence seizures block T type thalamic ca channels.
prophylaxis for status epilepticus
phenytoin
1st line for trigeminal neuralgia
drug and moa
Carbamazepine
Gabapentin
Primarily inhibits high- voltage-activated Ca2+ channels; designed as GABA analog
rare but fatal hepatotoxicity (measure LFTs), neural tube defects in fetus (spina bifida),
Valproic acid
GABAa receptor
which is a ligand-gated Cl− channel.
Arylcyclohexylamines
ketamine
PCP analogs that act as dissociative anesthetics. Block NMDA receptors. Cardiovascular stimulants.
Cause disorientation, hallucination, and bad dreams.
