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Neurology > Seizure > Flashcards

Seizure Flashcards

1
Q

Epilepsy definition

A

> 2 unprovoked SZ, 24 hours apart

OR

1 unprovoked SZ c 60% chances of recurrence in 10 years

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2
Q

True SZ vs Psycho SZ

A

Sr. PRL increases for 30 min in TSZ

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3
Q

Focal Seizure/ Partial seizure Etiology

A

Discrete lesion

Structural Abnormality in the brain
Abscess/Tumour

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4
Q

Generalized Seizure Etiology

A

Diffuse lesion

Drugs / Metabolic (glu, Na+) / Toxins

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5
Q

Drugs causing Epilepsy

5AF

A

ABX (FQ/ B-L)

ANTI MALARIALS (CQ/MFQ)

ANTI VIRALS (ACY/GANCI)

ANTI CANCER (Busalfan/ chlorambucil)

ANESTHETICS (Fentanyl/ Meperidine/ Tramadol)

FLUMAZENIL

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6
Q

Toxins causing SZ

A

Withdrawal: Alcohol / Baclofen / Zolpidem / Barbiturate

OD: Cocaine/ Amphetamine

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7
Q

Focal Sz features

A

Automatism +

AURA+

Anterograde amnesia +

DURATION > 1min

Post ictal confusion +

LOC +/-

Loss of cognition +/-

+ve in CPS. -ve in SPS
(DYSCOGNITIVE)

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8
Q

C/f focal SZ

A

Todds paresis (Post Ictal Paralysis—self recoverable)

Jacksonian march (DIST—> PROX in 1 limb ONLY)

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9
Q

Absence sz features

A

Same as CPS BUT

<30 s
NO post ictal confusion
Tone = normal
100-140/day
4-8 years of age
AURA -

Remission by PUBERTY
F/h/o 20-40%

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10
Q

EEG Absence Sz

A

Spike and dome pattern (2-4Hz)

Precipitated by HYPERVENTILATION AND PHOTIC STIMULATION

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11
Q

Atypical Absence SZ features

A

Less abrupt

Increased DURATION

EEG-
Spike and wave <2.5 Hz**

Structural abnormalities ++

Resistant to AED

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12
Q

Myoclonic sz features

A

Jerky epilepsy

Caused dt Hypoxia/ Degenerative / Metabolic

Hanging—-> myoclonic sz

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13
Q

JME features

A

Early morning b/l jerks

Early adolescence

F/h/o +ve

Ppt by— FATIGUE/ Alcohol / SLEEP deprv

LOC x

AUTOMATISM x

Spike and wave pattern +

Neuroimaging NORMAL

Cx—GTCS

Remission uncommon

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14
Q

Stages of GTCS

A

Premonitary symptoms - Nausea/Abdo pain/ foaming saliva**/ palpitation

Tonic phase- (10-20/s)

1) Decorticate rigditiy
2) Versive head extension
3) Ictal cry + cyanosis

Clonic phase- (jerky) <1’min

Post Ictal phase-
Floppy
U. Incontinence
CONFUSION+

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15
Q

Aura types and lobes

Only in focal sz

A

Olfactory-temporal
Auditory- Lateral temporal
Gustatory- Parietal
Visual- occipital

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16
Q

Neuroimaging in GTCS

A

Maybe +

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17
Q

Epileptogenic potential of 3 types of stroke in order

A

Embolic»Hemorrhagic»thrombotic

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18
Q

Which type of SZ in Degenerative brain d/o

A

Myoclonic SZ

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19
Q

When to GIVE AED

A

F/H/O
Abnormal neuro exam (todds)
Abnormal imaging
Stat ep

20
Q

Stokes adams attack

A

Decreased Bp with decreased HR
(Dt myocardial muscle hypoxia)

SZ= Myoclonic

S/I elderly

21
Q

When not to stop AED

A

F/h/o
Abnormal eeg
Abnormal neuro exam
Sz free for 2-5 years

22
Q

SJS which AED

A

Lamotrigine

<1%

23
Q

Aplastic anemia S/E AED

A

CBZ

24
Q

Phenytoin S/E

6H OM

A

Hirsutism

Hydatoin syndrome (microcep/cleft/limb hypoplasia)

Hyperglycaemia

Hepatitis

Hypersensitivity

Hyperplasia of Gums

Megaloblastic anemia

Osteomalacia

25
Q

Hyponatremia s/I which AED

A

OXC & CBZ

26
Q

Na entry inhibitors AED

A

Lamotrigine

CBZ

27
Q

Phenytoin MOA

A

Na and Ca inhibitor

28
Q

Pseudolymphoma s/i which drugs

Lymphadenopathy ++

A

PHENYTOIN

PRIMIDONE

29
Q

Which AED exclusively excreted through kidneys

A

LEVETIRACETAM

30
Q

GTCS drugs

VLT

A

Val (x T type Ca+ channels in thalamus**)
Lamo
Topi

31
Q

Which is the only drug not causing obesity AED

A

Topiramate

xNa+

32
Q

NTD in which AED

A

CBZ

PHENYTOIN

VALPROATE

Rx- FA 3 months before pregancy
Vit K in last 2 weeks of pregnancy to mother if PHENYTOIN+

33
Q

Absence SZ drugs

EVL

A

Ethosuximide
(T type Ca ch in Thalamus)

Val

Lamo

34
Q

Doc atypical absence SZ

A

Valproate

35
Q

Pregnancy safe drugs

LOL

A

Lamo
Oxc
Levi

36
Q

Breast milk excretion max and min

A

Max levi

Min val

37
Q

Estrogen vs progesterone epileptogenic

A

Yes. No.

38
Q

JME drugs

VLL

A

Valproate (broad spectrum—will prebent progress to all three sz)

Lamo

Levi

39
Q

C/I drugs in JME

A

Phenytoin

CBZ

(Increase myoclonus)

40
Q

JME DOC in preganancy

A

LEVETIRACETAM

Lamo= risk of myoclonus

41
Q

S/E valproate

HAWA GIT

A 
Hepatotoxic 
Ataxia/tremors/sedation
Weight gain
Ammonia increase
GIT irritation
ITP
Transient alopecia/ TERATOGENIC
42
Q

EPILEPSIA PARTIALIS CONTINUA

A

Stat ep with FOCAL SZ

Can be caused dt hypo/hyperglycemia as well

43
Q

Rx stat ep

A

Loraz/Midaz—Fosphenytoin»Slow infusion phenytoin&raquo_space; val&raquo_space; levi——propfol (early ref SZ)—-iv thiopentone(late ref sz)

44
Q

AED not recommended in STAT EP

A

CBZ

As only in oral form

45
Q

Syncope vs Seizure

A

Tongue bite- Tip. Lateral edge

Position- standing. Supine/standing

Neurology (11 decks)

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