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Pato Exam 2 > Seizure > Flashcards

Seizure Flashcards

1
Q

Seizure (Crisis)

A

Evento repentino e intenso donde temporeramente ocurre una anomalía en el cerebro.
-Descarga excesiva neuronal en la corteza cerebral

Se divide en Crisis Convulsiva y no convulsiva

Puedes tener una crisis y no tener epilepsia

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2
Q

Convulsion

A

Intense, involuntary, repetitive muscular contractions.

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3
Q

Epilepsy

A

A Chronic disorder of the CNS characterized by enduring predisposition to generate epileptic seizures.

-Fourth most common neurologic disorder and its prevalence it’s higher in children and older adults.

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4
Q

Status Epilepticus (Tonic-Clonic)

A

Is a medical emergency that needs aggressive treatment given that the seizure lasts longer than 5 minutes.

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5
Q

Pathogenesis of Seizures

A

-Excess of excitation (Glutamate) and very little inhibition (GABA).
-High-frequency bursts of action potentials and hypersynchronization of neuronal population.
-The kind of seizure depends on the location of the abnormal activity.

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6
Q

Ictogenesis

A

Is the initiation and propagation of a seizure in time and space (Increased excitation or decreased inhibition)

-Neuronal (intrinsic) factors
-Biochemical modification of
receptors
-The type, number and distribution
of voltage- and ligand-gated
channels
-Activation of second messenger
system
-Modulating gene expression
-Extra-neuronal (extrinsic) factors
-Dehydration
-Hyperkalemia
-Hypernatremia
-Remodeling of synaptic contacts
-Modulating transmitter metabolism
by glial cells

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7
Q

Phases of Seizures

A

Prodrome (Preictal phase)
-days to hours before seizure (irritability, cognitive changes, anxiety)
Aura (early ictal phase)
-Seizure Begins, minutes to seconds before seizure. (Dreamlike experiences, hallucinations, unpleasant smells)
Seizure (ictal phase)
-the actual ever (Crisis)
Post-ictal (End of seizure)
-Phase following a seizure (tiredness, irritability, confusion, headache)

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8
Q

Pathophysiology of Seizures (Locally and Widely)

A
  1. Small numbers of neurons fire abnormally
  2. Normal membrane conductance and inhibitory synaptic currents break down.
  3. Excitability spreads (Locally and Widely)
    -Focally = Focal seizure affects one hemisphere of the brain
    -Widely = Generalized seizure affects both hemispheres of the brain
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9
Q

What happens during a seizure? (Events)

A

-The brain requires increased blood flow to eliminate CO2 and brings substrate for metabolic activity of the neurons (Seizure starts)
-Blood flow is not enough and follows ischemia caused by hypoxia.
-If this continues, neuronal destruction and Irreversible brain damage may ocurr.

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10
Q

Triggers of seizures

A

-Stress
-Tiredness
-Lack of sleep
-Hyperventilation
full list in the review

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11
Q

Drugs that can induce seizures

A

-Antipsychotic (Clozapine)
-Antivirals (Acyclovir)
-Antimicrobials (Ciprofloxacin, levofloxacib)
-Antidepressants (Bupropion)
-Lithium
-Anesthetics (Demerol)
-Metoclopramine (Reglan)
-Theophillinem
-Tramadol
-Flumazenil
-Memantine
-Radiocontrast agents
-Withdrawal from anticonvulsant, antidepressants and benzodiazepines.

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12
Q

Febrile Seizures

A

Seizure accompanied by fever without an infection present.

-Simple
-less than 15 minutes
-Tonic-clonic movement (Todo el
cuerpo)
-Complex (requires medical attention)
-More than 15 minutes
-One side of the body involved

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13
Q

Eclampsia

A

Evento convulsivo, crisis durante el embarazo.
Patofisiologia:
1. Hypertension (>140/90 or 130/80)
2. Endothelial damage
3. Cerebral edema
4. Ischemia Encephalopathy
5. Seizure focus

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14
Q

What is the Etiology of Epilepsy?

A

-Genetic
-Structural (Hypoxic-Ischemic encephalopathy)
-Infectious (Meningitis)
-Metabolic (Anomalía metabólicos crónicos)
-Immune (Rarely)
-Unknown

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15
Q

True or False: Epilepsy may be Provoked or Unprovoked seizures

A

True

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16
Q

Epilepsy Diagnosis (one of the following)

A
  1. At least two unprovoked seizures more than 24 hours apart.
  2. One unprovoked seizure and a probability of further seizures similar to the general recurrence risk (at least 60%)
  3. Diagnosis of an epilepsy syndrome
17
Q

When epilepsy is considered resolved?

A

Patient have remained seizure-free for the last 10 years, with no seizure medicines for the last 5 years.

18
Q

Focal Onset Seizures

A

-Affects one side or area of the brain.
-Can be aware or impaired awareness
Can be motor (clonic, tonic) or non-motor (Behavioral arrest)

19
Q

Generalized Onset Seizures

A

-Affects both side of the brain.
-Always impaired awareness
Can be motor (clonic, tonic) or non-motor (usually absence seizure)

20
Q

Unknown Onset Seizures

A

-The beginning of a seizure is not known
-Can be later diagnosed as focal or generalized.
-Can be motor or non-motor

21
Q

Focal Onset Aware Seizure

A

-Fully awake and able to recall events during the seizure
-Less than 2 minutes

22
Q

Focal Onset Impaired Awareness Seizures

A

-May have an aura
-Awareness may be only partially impaired.
-May wipe out memories of events that happen before the seizure.
-Last 1-2 minutes.

23
Q

Focal to Bilateral Tonic-Clonic seizures

A

-Focal Impaired awareness seizure spreads both side of the brain.
-Last 30 seconds to 3 minutes
-Afterwards, patients are very tired
-Patients might describe an aura

24
Q

Tonic seizures

A

-Focal or generalized
-Aware or unaware
-Body, arms, or legs suddenly stiff or tense
-Less than 20 seconds

25
Q

Clonic Seizures

A

-Focal or Generalized
-Aware or unaware
-Sustained rhythmical jerking and may fall if standing
-Last less than a minute

26
Q

Tonic-Clonic Seizure (Grand Mald Seizure)

A

-Generalized unaware
-Has a tonic and clonic phases (usually the tonic comes first)
-Last 1-3 minutes

27
Q

Myoclonic Seizure

A

-Focal or Generalized
-Aware or Unaware
-Brief shock-like jerks of a muscle or groups of muscles. Usually in the face.
-Last less than 100 milliseconds.

28
Q

Atonic Seizure

A

-Focal or Generalized
-Unaware
-Loss of muscle tone, jaw head or body may go limp. It may fall if standing
-Less than 15 seconds

29
Q

Absence Seizure

A

-Always Generalized
-Typical Absence
-The eyes may turn upwards and
eyelids flutter
-Less than 10 seconds
-Atypical Absence
-Staring into space and change in
muscle tone and movements
-More than 20 seconds

Pato Exam 2 (11 decks)

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