OME - Seizure

Question 1

Definition seizure?

Answer 1

Synchronous firing in awake brain

Question 2

General vs. Partial seizure?

Answer 2

1. General: involves entire body

2. Partial: only part of body

Question 3

Complex vs. Simple Seizure?

Answer 3

1. Complex: LOC

2. Simple: No LOC

Question 4

DDx first time seizures?

Answer 4

"VITAMINS"
Vascular 
Infection
Trauma
Autoimmune 
Metabolic 
Ingestion / Withdrawal 
Neoplasm 
S - PSEN

Question 5

2 types of withdrawal causing seizure?

Answer 5

1. Benzos

2. Alcohol

Question 6

DDx LOC?

Answer 6

1. Syncope

2. Seizure

Question 7

Only real way to differentiate syncope vs. Seizure?

Answer 7

*Post ictal state
Other clues:
1. Jerking
2. Tongue biting 
3. Incontinent
4. Not remembering

Question 8

Reasons for breakthrough seizures?

Answer 8

1. Non compliance

2. “Vitamins”

Question 9

How to medicate after first time seizure?

Answer 9

None needed if normal MRI and Normal EEG

Question 10

Definition Status?

Answer 10

1. Seizing more than five minutes

2. Multiple seizures over 20 minutes w/o return to baseline

Question 11

Rx status?

Answer 11

1 - 5) Moralizer

6. Fosphenytoin (IV)
7. Midazolam + Propofol
8. Phenobarbital

Question 12

Work up first time seizure?

Answer 12

1. EEG
2. MRI
3. “VITAMINS” W/o

Question 13

Trade Name Keppra?

Answer 13

Levetiracetam

Question 14

VPA or Keppra cheaper?

Answer 14

VPA

Question 15

VPA or Keppra better side effect profile?

Answer 15

Keppra

Question 16

3 general drugs seizure disorder maintenance?

Answer 16

1. Keppra - Best profile
2. VPA - Cheapest
3. :Lamotrigine

Question 17

Rx Atonic Seizure?

Answer 17

VPA

Question 18

Rx Trigeminal Neuralgia?

Answer 18

Carbamazepine

Question 19

Rx Myoclonic Seizure?

Answer 19

VPA

Question 20

What is absence seizure?

Answer 20

1. Seen in kids
2. Positive LOC
3. No loss of tone
4. Usually outgrown

Question 21

What is myoclonic seizure?

Answer 21

1. No LOC

2. Positive unnecessary useless tone

Question 22

What is an atonic seizure?

Answer 22

1. No change in tone

2. LOC

Question 23

What is nonconvulsive status?

Answer 23

1. LOC
2. AMS
3. Not shaking
4. Put EEG on and are in status

Question 24

What to do if suspect seizure, but cannot capture eeg?

Answer 24

1. Place on EEG
2. Video tape
3. Try to induce by keeping awake / strobe lights, etc.

Question 25

Benzo that can be given rectal?

Answer 25

Diazepam

Question 26

Benzos with IM?

Answer 26

1. Lorazepam
2. Midazolam
3. Diazepam

Question 27

Benzo with nasal?

Answer 27

Midazolam

Question 28

Another name for Keppra?

Answer 28

Levetiracetam

Question 29

What is NCSE?

Answer 29

Nonconvulsive status epilepticus

Question 30

Side effect seen with Keppra?

Answer 30

“Keppra rage”

Question 31

SIde effect seen with lamotrigine?

Answer 31

SJS - need to slowly titrate

Question 32

Side effects depakote?

Answer 32

1. Teratogen
2. Tremor
3. Hairloss