Seizure disorders Flashcards
1
Q
Absence (petit mal)- Eti
A
- Generalized, entire brain
- Begins in childhood, cease by age 20
- May be induced with hyperventilation
2
Q
Absence (petit mal)- Sx
A
- Brief consciousness impairment- seconds with abrupt recovery
- 3 hz spike and wave pattern
- Pt unaware
- Clonic, tonic, atonic
- Enuresis or automatisms
3
Q
Tonic-clonic (Grand mal)- Eti
A
- Generalized seizure
- Both sides of brian
4
Q
Tonic-clonic (Grand mal)- Sx
A
- Cessation of resp
- Sudden LOC
- Tonic first- stiffening with moan, flexion and pronation, incontinence, cyanosis
- Clonic follows- tongue biting, rhythmic shaking, decreased freq and increased amplitude
5
Q
Status elipticus- Sx
A
- Repeated seizures without recovery of consciousness
- lasts > 30 min
- 2 without clearing in-between
- > 5 min (new def)
6
Q
Generalized seizures- Dx
A
- EEG
7
Q
Generalized seizures- Tx
A
- Phenytoin
- Carbamazepine
- Valproic acid
- Phenobarbital
- Trial diff drugs until seizure free for 2 yrs, withdrawl
8
Q
Generalized seizures- - Eti
A
- May have prodrome
- Occur with postural changes
9
Q
Generalized seizures- Outcome
A
- Report to DMV
- Dont do dangerous activities
10
Q
Febrile seizure- Eti
A
- 3 mo to 6 years
- 3-5% children
- > 38.8 C
- Generalized
- Assoc with infection, can’t have with CNS infection
- 1/3 have additional
- developmental delay with normal neuro exam
11
Q
Febrile seizure- Dx
A
- Eval source of fever, CNS infection
12
Q
Febrile seizure-Tx
A
- Symptomatic
- Don’t need to tx
- Progress to epilepsy in 15-20%
13
Q
Simple partial seizure- Sx
A
- Motor, sensory and autonomic aura
- Clonic mvmt single musc group
- Pallor, sweating, fulgins, piloerection, pupillary dilatation, borborygmi
- Psychic sx
- Consciousness preserved
- Postictal hemiparesis
14
Q
Complex partial seizure- Sx
A
- Altered consciousness
- Impaired responsiveness
- Automatism- coordinated involuntary mvmt
- Arises from temporal node
- Lip smaking, grabbing bed sheets, turning hands
- Aura, epigastric sensations, fear, deja vu
- 1-3 min
15
Q
Partial seizures- Tx
A
- Phenytoin
- Carbamazepine
- Oxcarbazepine
16
Q
Seizures- Eti
A
- Trauma
- Mass lesion
- Stroke
- Lytes imbalance
- Drugs
- Eclampsia
- CNS dysfunction
17
Q
Alcohol withdrawal seizures- Eti
A
- Within 48 hrs of alcohol withdrawal
- Period of high or prolonged intake
18
Q
Alcohol withdrawal seizures- Sx
A
- Generalized tonic- clonic seizures
- Tremors first then hallucinations, formiacation
- More dangerous in days 4-5 - Autonomic instability: arrhythmia, HTN
- Self limited
19
Q
Alcohol withdrawal seizures- Dx
A
- Hx
- CT or MRI
20
Q
Alcohol withdrawal seizures- Tx
A
- Benzodiazepines
- Lorezepam, diazepam, phenobarbital
21
Q
Postictal state
A
- Drowsy, lethargy
- Resp resumes
- HA
- Todd’s paralysis
22
Q
Febrile seizure- Sx
A
- Simple: generalize, last 15 min, focal features, recur within 24 hrs, postictal neuro signs, likely 2/2 underlying infection
