NEUROLOGY 4 Flashcards
what is a seizure/why does it occur?
-imbalance of excitatpry & inhibitory influences on cerebral neurons
-too many cells become excited n synchronise
what is the tonic phase in a seizure?
clonic phase?
-tonic is limbs stuck and outstretched
-clonic is paddling of legs
-what is pre-ictal phenomenon?
-ictus?
-post-ictal phenomenon + examples?
[seizure clinical description] what is the difference between generalised & focal seizures?
generalized: involves both cerebral hemispheres
focal: only part of cerebral hemisphere
[seizure clinical description] what are types of generalised seizures?
-tonic-clonic
-tonic
[seizure clinical description] what are types of focal seizures?
-simple: conciousness is well preserved
-complex: conciousness is affected
what is the definition of a “cluster of seizures”?
two (+) seizures in a 24-hr period
OR one seizure per day
what is the definition of status epilepticus?
a seizure that shows no
clinical signs of arresting after 5 minutes of
activity, or recurrent seizures with no recovery
between them
what is paroxysmal dyskinesias?
-how can it be differentiated form seizures?
-some possible causes?
-differentiated:: patients are often aware and concious. episodes last long time
what are 3 types of epilspsy?
1-idiopathic epilepsy
2-symptomatic epilepsy
-cryptogenic epileysy
-which species gets more idiopathic epilepsy: cats or dogs?
-what is the age range for idiopathic epilepsy?
dogs
6mo-6yrs
describe the tx outcomes of seizure management
how can you investigate seizure activity?
[5 steps sorta?]
anti-seizure medication should be started after unsuccessful investigation into underlying cause. what are 5 indications to start anti-seizure meds?
-after unsuccessful investigation into underlying cause
what are 3 anti-seizure drugs that are lisenced in dogs?
-phenobarbitone/barbital
-imepitoin
-potassium bromide
what are seizure drugs lisenced in cats?
what are some (5) off-lisence anti-seizure drugs?
-levetiracetam
-zonisamide
-gabapentin
-pregabalin
-topiramate
phenobarbitone:
-what is the MOA?
-what are some expected side effects?
-what are some expected bloodwork changes due to side effects?
phenobarbitone:
-what should be done to monitor side effects?
potassium bromide:
-what is the MOA?
-what are some side effects?
potassium bromide:
-what should be done to monitor side effects?
-dietary management: increase Cl
-assess serum levels n kidney function
which drug woul d be better for urgent action: phenobarbitol or potassium bromide?
phenobarbitone: reaches steady state faster
imepitoin:
-what is the MOA?
-what should be done to monitor?
levetiracetam:
-what is the MOA?
-what are some side effects?
-what should be done to monitor?
zonisamide:
-what is the MOA?
-side effects?
moa complex
-IDK WHAT OT EMORIZE!!
-used in the US more
benzodiazepines:
-what is the MOA?
-two examples drugs?
-GABA agonist
-diazepam/midazolam
out of the anti-seizure drugs discussed, which can be used in an emergency setting?
what are some diagnostics for a patient newly seizing with ASD?
-what do you add diagnostically if this is a returning patient?
what are 2 first line emergency anti-seizure meds?(5-30 mins)
-diazepam
-midazolam
what are 2 preffered second line emergency anti-seizure meds? (30-60 mins)
-what si a third possibility?
-phenobarbital
-levetiracetam
-can also do potassium bromide but not as good [due to long time till steady state]
what are 2 third line emergency anti-seizure meds? (60-120 mins)
-levetiracetam
-propofol
what is a fourth line emergency ant-seizure med? (>120 mins)
-ketamine
-inhalant anaesthesia
