SECRETS Neurology - Epilepsy

Question 1

generalized tonic clonic seizure

Answer 1

loss of consciousness

whole body rigidity followed by whole body jerks

Question 2

atonic vs tonic

Answer 2

tonic = whole body rigidity
atonic = sudden loss of muscle tone

Question 3

partial vs generalized

Answer 3

partial = begins focally in 1 hemisphere (can become generalized)
generalized = begins diffusely throughout both hemispheres

Question 4

simple vs complex

Answer 4

simple = no alteration in consciousness
complex = alteration in consciousness

Question 5

absence seizure

Answer 5

generalized

alteration in consciousness

Question 6

absence seizure tx

Answer 6

ethosuximide

Question 7

ethosuximide MoA

Answer 7

block Ca channels

Question 8

tonic-clonic seizures tx

Answer 8

1st = valproic acid
2nd = carbamazepine, phenytoin

Question 9

acute status epilepticus tx

Answer 9

benzodiazepines

Question 10

status epilepticus

Answer 10

persistent seizure >30 min
widespread neuronal death
extremely dangerous to brain

Question 11

prevention of status epilepticus

Answer 11

phenytoin

Question 12

benzodiazepine MoA

Answer 12

increase Cl channel opening frequency

facilitate inhibitory GABA action

Question 13

barbiturate MoA

Answer 13

increase Cl channel opening duration

facilitate inhibitory GABA action

Question 14

most anticonvulsant MoA

Answer 14

block Na or Ca channels
increase threshold require for neuronal depolarization
decrease frequency of neuronal firing

Question 15

carbamazepine ADR

Answer 15

agranulocytosis

Question 16

phenytoin ADR

Answer 16

gingival hyperplasia, nystagmus, ataxia, cytochrome P450 induction

Question 17

valproic acid ADR

Answer 17

hepatotoxicity

Question 18

barbiturates, benzos ADR

Answer 18

respiratory depression

Question 19

lamotrigine, ethosuximide ADR

Answer 19

SJS

Question 20

gabapentin ADR

Answer 20

tremor

Question 21

epilepsy

Answer 21

recurrent, unprovoked seizures