OnlineMedEd: Neurology - Seizure

Question 1

Seizures are defined by ____________ firing of the awake brain.

Answer 1

synchronous

Note: synchronous firing occurs normally in sleep.

Question 2

What is the difference between general and partial seizures?

Answer 2

General seizures involve the whole body, while partial seizures involve only a part of the body.

Question 3

What is the difference between complex and simple seizures?

Answer 3

• Complex seizures are those in which you lose consciousness. (“COmplex means you’re COnked out.”)
• Simple seizures are those in which you maintain consciousness. (“Simple means you Stay awake.”)

Question 4

Go through the mnemonic VITAMINS for first-time seizures.

Answer 4

• Vascular (e.g., ischemic stroke)
• Infection (e.g., HSV encephalitis)
• Trauma
• Autoimmune
• Metabolic (e.g., hypoglycemia, hyponatremia)
• Ingestion and ingestion withdrawal
• Neoplasm
• pSych

Question 5

The best way to distinguish syncope from seizures is _________________.

Answer 5

to ask about the after effects; if the patient experienced a postictal state (with grogginess or feeling out of it) then it was likely a seizure; if the patient was back to normal five minutes later, then it was likely syncope

Question 6

If someone with epilepsy starts having more seizures, you need to __________________.

Answer 6

either change their current drug, increase their current drug, add a drug, or examine for other causes of seizures (the VITAMINS etiologies)

Question 7

Status epilepticus is defined as a seizure lasting more than ____________.

Answer 7

five minutes

Note: status can also be defined as failure to return to baseline in 20 minutes.

Question 8

Go through the treatment protocol for status epilepticus.

Answer 8

• 1st: lorazepam
• 2nd: fosphenytoin
• 3rd: midazolam and propofol
• 4th: phenobarbital

Question 9

After someone has their first seizure, what workup is indicated?

Answer 9

• EEG
• CT/MRI
• VITAMINS

Question 10

Trigeminal neuralgia presents with _______________.

Answer 10

electric shock pain down the jaw

Question 11

What is the classic presentation of the patient with atonic seizures?

Answer 11

The little kid who has to wear the football helmet all day (because they lose tone and hit the ground with their heads)

Question 12

Give the medications used to treat the following seizures: 
•Trigeminal neuralgia: 
•Absence seizures: 
•Myoclonic:
•Atonic:

Answer 12

• Trigeminal neuralgia: carbamazepine
• Absence seizures: ethosuximide
• Myoclonic: valproic acid
• Atonic: valproic acid

Question 13

In both atonic seizures and myoclonic seizures, there is usually no loss of ________________.

Answer 13

consciousness (the kid remembers hitting the floor)