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PSP > Seizure > Flashcards

Seizure Flashcards

1
Q

Seizure

A

Sudden change in behavior caused by electrical hyper synchronization of neuronal networks in the cerebral cortex

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2
Q

Unprovoked seizure

A

. Occurring in absence of precipitating factors and may be caused by static or progressive injury

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3
Q

Provoked seizure

A

. Seizures provoked by acute conditions

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4
Q

Acute symptomatic seizure

A

. In assoc. w/ transient CNS or systemic insult presumed to be an acute manifestation of the insult

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5
Q

Focal seizure

A

Originate w/in networks limited to one hemisphere
. Described according to whether or not consciousness and/or awareness are impaired
. Ictal onset consistent from one seizure to another
. Rarely does patient have more than 1 type of seizure

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6
Q

Generalized seizure

A

Initial activity is consistent w/ rapidly engaging networks distributing in bilateral cerebral hemispheres
. May begin w. Body movements, impaired consciousness, or both
. Onset of tonic-clonic seizures begins after the age of 30 suspect partial seizure that has become generalized or a provoked seizure

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7
Q

Aura

A

. Sensation perceived by a patient that precedes a condition affecting the brain

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8
Q

Ictal

A

Period during seizure

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9
Q

Postictal

A

State of consciousness following seizures

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10
Q

Automatism

A

. Unconscious movement that may resemble simple repetitive tics or may be a complex. Sequence of natural-looking movement

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11
Q

Epilepsy

A

. Chronic neurologic disorder
. 2+ unprovoked seizures separated by over 24 hrs
. One unprovoked seizure w/ underlying predisposition to seizures
. Diagnosis of an epilepsy syndrome

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12
Q

Provoked seizure from metabolic disturbance

A

. Cause: hyponatremia, hypo/hyperglycemia, hypo/hypercalcemia, uremia
. Confusion, lethargy, myoclonic jerks

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13
Q

Provoked seizure by drug intoxication

A

. CausE: cocaine, phencyclidine, methamphetmaines, ETOH

. Altered awareness, hyperactivity, incoordination

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14
Q

Provoked seizure from drug withdrawal

A

. Cause: alcohol withdrawal, Benzo withdrawal, barbiturate withdrawal, baclofen withdrawal
. Anxiety, agitation, sweating, hallucinations

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15
Q

Provoked seizure from medications

A

. Tricyclics antidepressants, clozapine,, cyclosporine

. Anything with low seizure threshold

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16
Q

Provoked seizure from infection

A

. Cause: meningitis, encephalitis

. Fever, headache, stiff neck

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17
Q

Provoked seizure from vasculopathy

A

. Cause: eclampsia, hypertensive encephalopathy

. Headache, blurred vision, edema

18
Q

Febrile seizures

A

/ generalized, last less than 15 minutes
. Not recurring during 24 hr period
. Occur in children 6 mo-5 yrs
. Fever over 38 C
. Usually 24 hrs of febrile illness
. They are otherwise benign (recur in 1/3 children during early childhood)
. Risk of future epilepsy that is only slightly higher than general population

19
Q

Causes of seizure disorder

A

. Genetic
. Structural: congenital or acquired through stoke or trauma
. Unknown

20
Q

Jacksonian seizure

A

. Focal
. Tonic than clinic movements that start unilaterally in hand, foot, or face and spread to other parts of same side
. Post ictal: normal consciousness

21
Q

Other motor focal seizures

A

. Turning head and eyes to one side

. Post ictal normal consciousness

22
Q

Autonomic focal seizures

A

. Rare
. Funny feeling in epigastric, nausea, pallor, flushing, lightheaded
. Post ictal: normal consciousness

23
Q

Subjective sensory of psychic phenomenon focal seizure

A

. Very rare
. Numbness, tingling, simple visual, olfactory, auditory hallucinations
. Anxiety or fear, deja vu, rage
. Post ictal: normal consciousness

24
Q

Focal seizures w/ impairment of consciousness

A

. May start w/ autonomic or psychic symptoms
. Consciousness is impaired and patient appears confused
. Automatisms (chewing, smacking lips, walking about, unbuttoning cloths)
. Patient may recall psychic or autonomic symptoms
. Amnestic for rest of seizure
. Temporary confusion and headache may occur

25
Q

Focal seizures that generalize

A

/ focal seizure evolving to bilateral tonic-clonic seizure
. May not recall local onset
. Recollection of aura and unilateral neurologic deficits during post-ictal period

26
Q

Tonic clinic seizures

A

. May start w/ cry
. Body stiffs (tonic rigidity) and breathing stops
. Clonic phase: rhythmic muscular contractions
. Tongue biting and urinary incontinence
. Post-ictal: confusion, drowsiness, fatigue, headache, amenstic about seizure and aura
. May have temporary UMN signs (hyperactive reflexes)

27
Q

Absence seizures

A

. Sudden brief lapse in consciousness,

. Blinking, or staring or movement of lips
. Post-ictal: confusion, no aura recalled

28
Q

Myoclonic seizures

A

. Sudden brief lapse of consciousness
. Sudden brief rapid jerks involving trunk or limbs
. Post ictal: variable

29
Q

Myoclonic atonic seizure

A

. Drop attack
. Sudden loss of consciousness w/ falling but no movements
. Post ictal: brief period of confusion

30
Q

Psychogenic nonepileptic seizure

A

. Psuedoseizure
. Similar to epileptic seizures but do not have neurologic origin (somatic manifestation)
. Frequently are misdiagnosed and treated for epilepsy
. 5-10% of outpatient pilepsy patients and 20-40% innpatient have these

31
Q

Seizure diagnostic evaluation

A 
. Neuroimaging: CT first, MRI if needed 
. Labs: serum AED, CMP
.lumbar puncture if suspect infection 
. ECG
. EEG
32
Q

Syncope vs seizure

A

. Syncope is sudden, may have prior palpitation or weakness (cardiogenic)
. Have prodrome (vasovagal lightheadedness, sweating, pallor)
. Occur soon after standing (orthostatic)
. Myoclonic jerking may occur but it is super brief
. Prompt recovery
. Non or minimal post-ictal confusion
.

33
Q

Involuntary movement disorders

A

. Hyper kinetic: tumor, tic, chorea, athetosis, dystopia
. Hypokinetic: Parkinson’s
. Primary from basal ganglion
. Secondary from antipsychotics, dopamine receptor antagonists or postsynaptic blockade of brain dopamine D2 receptor

34
Q

Basal ganglia

A

. Most often linked to initiation and execution of movements
. Act to facilitate desired movements and inhibit unwanted and/or competing movements
. Dopamine receptors

35
Q

Tremors

A

. Rhythmic oscillatory movements
. Resting: most prominent at rest, dec./disappear w/ voluntary movement, Parkinsonism
. Postural: actively maintaining posture, hyperthyroidism, anxiety, essential tumor
. Intention: appears w/ movement

36
Q

Tics

A

. Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals
. Repetitive winking, grimacing, shoulder shrugging
. May be temporarily suppressed
. Urge to perform tics
. Causes: Tourette syndrome, late effects of drugs (phenothiazines)

37
Q

Chorea

A

. Choreiform movements are brief, rapid, jerky, irregular, and unpredictable
. Seldom repeat themselves
. Occur at rest or interrupt normal coordinated movements
. Faced head, lower arms, and hands are involved
. See in huintington’s disease

38
Q

Athetosis

A

. Twisting and writhing than choreiform
. Commonly involves face and distal extremities
. Often assoc. w/ spasticity
. Cuases: cerebral palsy

39
Q

Dystonia

A

. Similar to athetoid but involve larger parts of the body including trunk, grotesque, twisted postures
. Primary: primary torsion dystonia, spasmodic torticolllis
. Secondary: drugs (antipsychotics)

40
Q

Facial dyskinesia

A

. Arrhythmic, repetitive, biz are movement that chiefly involve the face, mouth, jaw, and tongue
. Grimacing, pursing of lips, protrusions of tongue, opening and closing of mouth, and deviation of jaw
. Limbs and trunk involves less often
. Late complication of psychotropic drugs
. Occur in long standing psychoses, in some elderly individuals, or some edentulous person (tardive dyskinesia)

PSP (35 decks)

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