Seizure & Epilepsy: sum

Question 1

age of onset for febrile seizure

Answer 1

6m to 60m (5y)

Question 2

Describe simple febrile seizure

Answer 2

brief <15min - generalized - no recurrence within 24hr - no neurological disease

Question 3

Describe complex febrile seizure

Answer 3

> 15min - focal - recur within 24hr - underlying CNS disease

Question 4

Mx of febrile seizure

Answer 4

supportive

Question 5

risk of recurrance after first febrile seizure

Answer 5

1\3rd of patients

Question 6

Risk of epilepsy in patients with febrile seizure

Answer 6

2-10%

Question 7

risk of neonatal seizure increase in

Answer 7

preterm

Question 8

causes of neonatal seizure

Answer 8

1- HIE
2- ICH (intraventricular, subdural, subarachnoid) and Stroke
3- meningitis
4- electrolyte: Hypoglycemia, Hypo or Hypernatremia
5- IEOM
6- genetics.

Question 9

clinical presentation of neonatal seizure

Answer 9

subtle tonic, or clonic movement of one limb ± automatism

Question 10

Jitterness is associated with which electrolyte imbalance

Answer 10

hypoglycemia

Question 11

first antiepileptic in neonatal seizure

Answer 11

phenobarbital

Question 12

fifth day fits

Answer 12

benign familal neonatal convulsion with seizure occuring in the 5th or 6th day of life, self-limited

Question 13

infantile spasm age group

Answer 13

between 4-7m

Question 14

semiology of infantile spasm

Answer 14

flexion of trunk, neck, extremities followed by tonic phase, occurs in clusters, in between there might be loud cry

Question 15

west syndrome

Answer 15

triad of infantile spasm, hypsarrythmia on EEG, developmental regression

Question 16

hypsarrythmia on EEG

Answer 16

high amp - disorganized background - multifocal discharge

Question 17

Mx of infantile spasm

Answer 17

ACTH - vigabatric if patient w\tuberous sclerosis

Question 18

childhood absence epilepsy age of onset

Answer 18

4-8 years

Question 19

semiology of childhood absence epilepsy

Answer 19

staring with behavioral arrest, may develop eye blink or flutter, last seconds, return to baseline daily

Question 20

how to provoke childhood absence epilepsy

Answer 20

2-3 min of hyperventilation

Question 21

EEG findings of childhood absence epilepsy

Answer 21

3hz gen spike-wave discharge

Question 22

Mx of childhood absence epilepsy

Answer 22

ethusuxamide

Question 23

age of onset in ronaldic seizure

Answer 23

3-10y

Question 24

Semiology of rolandic seizure

Answer 24

1- simple focal motor (face, spread in arm and leg) may also generalize
2- sensory feature (parasthesia)
3- salivation
4- speech arrest
5- occur at night

Question 25

EEG of rolandic

Answer 25

focal discharges in centerotemporal reigon activated during sleep

Question 26

prognosis of rolandic

Answer 26

1\4th of patient will have only one seizure and has low seizure frequency with eventual spont remission

Question 27

mx of rolandic

Answer 27

carbamezapine

Question 28

Onset of JME

Answer 28

12-18 y

Question 29

semiology of JME

Answer 29

generalized tonic clonic,, with jerking movement in upper extermity in the morning

Question 30

risk factors of JME

Answer 30

sleep deprivation, stress, alcohol

Question 31

EEG of JME

Answer 31

polyspike and wake 4-6hz

Question 32

MX of JME

Answer 32

depakene

Question 33

lennox-gastuat syndrome def

Answer 33

tonic, tonic clonic, myoclonic, atypical absence, atonic with difficulty treating

Question 34

EEG findings of lennox gustat

Answer 34

diffuse - slow - spike wave - 1.5 to 2.5

Question 34

EEG findings of Landau-kleffner age

Answer 34

3-7 yr

Question 34

MX of lennox gustat

Answer 34

multiple medication, ketogeneic, surgical, corpus callosotomy, vNS

Question 35

clinical presentation of landau-kleffner

Answer 35

acquired aphasia after normal lang developmenta

Question 36

EEG findings of landau kleffner

Answer 36

sharp spikes, spike and wave, over bilateral temporal with electrical status epilipticus during slow wave sleep

Question 37

Mx of landau kleffner

Answer 37

Benzo + corticosteroid

Question 38

prognosis of landau kleffner

Answer 38

good in terms of seizure - variable for language

Question 38

definition of rasmussen's encephalitis

Answer 38

autoimmune progressive encephalopathy causing refractory seizures, cognitive decline, hemiparesis

Question 39

neuropathology of rasmussen's encephalitis

Answer 39

periventricular lymphocytic infiltrate

Question 40

imaging of rasmussen's encephalitis

Answer 40

atrophy in the affected cerebral hemisphere

Question 41

antibodies in rasmussen's encephalitis

Answer 41

anti-glutamate receptors

Question 42

Mx of rasmussen's encephalitis

Answer 42

high dose steroids and IVIG

Question 43

Defnitive management of rasmussen's

Answer 43

functional hemispherectomy

Question 44

mx of SE

Answer 44

ABCDE + Send blood for metaboic, toxicology, drug level + Blood sugar, IV lorazepam 0.05 to 0.1 mg per kg - if presist give phenyotin 20mg per keg - intubate and load on phenobarb or midozolam

Question 45

Complication after SE

Answer 45

neuronal damage, increased ICP, Cerebral edema, Hypoxia, aspiration, hypercapnia, tachycardia, cardiac arrthmia, ARD, myoglobinuria, hyperthermia, lactic acidosis, rabdo

Question 46

diff breath-holding spells from seizure

Answer 46

- triggered by emotional stimuli. - are two types cyanotic and pallid - LOC can occur after episode - movement that looks like tonic posturing or myoclonia after the attack - episodes stop at 4 years usually

Question 47

diff Sandifer's syndrome from seizure

Answer 47

- tonic neck ectension + dystonic posturing of trunk - Associated with GERD

Question 48

diff Syncope from seizure

Answer 48

- brief loss of consioussness as well as postural tone secondary to transient decrease in cerebral profusion - MC etiology is vasovagal

Question 49

diff night terror from seizure

Answer 49

- occurs in first third of night - agitation and facial flushing - amnesia for event -

Question 50

diff movement disorder from seizure

Answer 50

tic disoderd, sleep myoklonia, paroxysmal dyskinesia