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Epilepsy Borrowed Decks > Seizure Semiology > Flashcards

Seizure Semiology Flashcards

1
Q

Hemisphere localization:
Dystonic limb posturing

A

Contralateral (mesial temporal)

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2
Q

Hemisphere localization:
Head turning

A

Ipsilateral (Early) - lateral temporal
Contralateral (late and versive / transition to generalization)

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3
Q

Hemisphere localization:
Figure of 4 sign

A

Contralateral

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4
Q

Hemisphere localization:
Todd’s Paralysis

A

Contralateral

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5
Q

Hemisphere localization:
Focal clonic activity

A

Contralateral (lateral temporal)

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6
Q

Hemisphere localization:
Unilateral eye blinking

A

Ipsilateral

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7
Q

Hemisphere localization:
Unilateral limb motor automatisms

A

Ipsilateral (temporal)

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8
Q

Postictal Nose wiping

A

Ipsilateral (temporal)

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9
Q

Localization clues:
Preservation of Ictal speech

A

Nondominant temporal lobe

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10
Q

Localization Clues:
Ictal speech arrest

A

Dominant temporal lobe

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11
Q

Localization Clues:
Postictal aphasia

A

Dominant Hemisphere

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12
Q

Localization Clues:
Ictal vomiting

A

Right temporal lobe

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13
Q

Localization Clues:
Hypermotor (3)

A

Frontal lobe (less commonly insular or temporal)

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14
Q

Localization Clues:
Ictal urinary urge

A

Right temporal lobe

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15
Q

Localization Clues:
Limb Paresthesia

A

Contralateral parietal lobe

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16
Q

Localization Clues:
Simple visual Hallucination

A

Contralateral occipital lobe

17
Q

Localization Clues:
Complex visual hallucination

A

Contralateral temporo-occipital lobe

18
Q

Features associated with supplementary motor seizures

A
  • prominent tonic posturing (usually of contralateral upper extremity)
  • Contraversive head and eye deviation
  • Preservation of consciousness
19
Q

Orbitofrontal versus anterior cingulate seizures
Features common to both (5)
Unique to Anterior cingulate (2)
Unique to Orbitofrontal (3)

A

Common to both:
- Hypermotor motor movements
- Elaborate Gestures
- Autonomic Features
- Fear
- Chepeau de Gendarme
Unique to AC
- Sudden mood changes
- Tonic / Dystonic Posturing
Unique to OF
- Olfactory sensations
- Hallucinations
- Prominent facial expression

20
Q

Features associated with Dorsolateral frontal seizures (4)

A
  • Unilateral clonic activity of face, spreading to arm / leg
  • Preserved Consciousness
  • Forced head turning (contralateral)
  • Aphasia (if dominant)
21
Q

Features associated wit parietal lobe seizures
- Generic (4)
- Less Generic, but potentially confused with others (2)
- Unique (2)

A

Generic:
- Tonic posturing / clonic activity (contralateral)
- Todd’s Paralysis (contralateral)
- Head deviation
- Postictal aphasia (if dominant)
Less Generic, but potentially confused w/ others
- Oral automatisms
- Complex gestural automatisms
Unique
- painful / thermal sensation
- sexual / groin paresthesia

22
Q

Features associated with occipital lobe seizures (4)

A
  • Elementary visual hallucinations (flashing or steady spots, simple geometric forms)
  • Repeated eye blinking
  • tonic eye / head deviation (IL or CL)
  • autonomic signs / emeries (panayiotoupolous)
23
Q

Features associated with Insular epilepsy (4)

A
  • Laryngeal discomfort / constriction
  • thoracoabdominal constriction or dyspnea
  • hypersalivation
  • unpleasant parasthesias or warmth in perioral region
24
Q

Helpful treatment for olfactory seizures

A

Selective amygdalectomy

25
Q

Clinical differences between:
- “normal” myoclonia during typical absence seizure
- Epilepsy with myoclonic absences (2)
- Eyelid myoclonia with absence seizure (3)

A

Eye blinking in typical absence:
- mild eye blinking or mouth movements
EMA
- severe, repetitive myoclonic jerks of shoulders, arms, and legs
- with concomitant tonic contraction
EEM
- prominent jerking of eyelids, often associated with upward devation of eyeballs and retropulsion of the head
- FOLLOWED by mild impairment of consciuosness
- can be photosensitive or triggered by eye closure in brightly lit room

26
Q

Head turning in frontal lobe seizures, significance of:
early head/eye turning
late head/eye turning

A
  • Early head turning, no consistently laterlizing
  • late head turning: consistent to contralateral side
27
Q

In frontal lobe seizures, early asymmetric tonic posturing suggests:

A

contralateral hemisphere

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