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Neurology > Seizure Types and Treatment > Flashcards

Seizure Types and Treatment Flashcards

1
Q

What are the two definitions of a seizure?

A
  • Occasional, sudden, excessive, rapid and local discharges or gray matter;
  • Alteration of behavior that results from abnormal and excessive activity of a group of cerebral neurons
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2
Q

Abnormal spikes are seen on ____ associated with cellular networks during a seizure

A

EEG

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3
Q

What are some possible triggers for a seizure?

A
  • Genetic predisposition
  • Trauma, ischemia, stroke, malformation of cortical development
  • Febrile illness, sleep deprivation
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4
Q

What neuron channels are associated with seizure pathophysiology?

A

AMPA and NMDA

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5
Q

What are the two types of seizure?

A

Partial and Generalized

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6
Q

What are the two types of partial seizures?

A

Simple and Complex

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7
Q

What are the types of generalized seizure?

A
  • Absence
  • Tonic
  • Atonic
  • GTC
  • Myoclonic
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8
Q

What is the most important component of a diagnosis of epilepsy?

A

HISTORY (then EEG, MRI, and labs)

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9
Q

What is epilepsy?

A

The tendency to have recurrent unprovoked seizures

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10
Q

Abnormalities in which levels of brain function can lead to epilepsy?

A
  • Neuronal networks
  • Neuronal structures
  • Neurotransmitters
    • Synthesis, inhibition, excitation
  • Synaptic development
  • Ion channels
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11
Q

What is the term for epilepsies of undetermined type?

A

Lennox-Gastaut syndrome

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12
Q

What is a key distinguishing feature of simple partial seizures?

What are some signs and symptoms?

A

Consciousness is not impaired

  • Clonic movements of face, arm leg
  • Somatosensory and autonomic symptoms
  • Psychic symptoms: Deja vu; hallucinations; illusions
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13
Q

Are simple partial seizures long or brief?

What are the post-ictal symptoms?

A

Brief

No post-ictal symptoms (usually)

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14
Q

What is Todd paralysis (associated with simple partial seizures)?

A

Focal weakness in a part of the body after a seizure

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15
Q

What are other names for complex partial seizures?

What feature is often used to distinguish these from simple partial seizures?

A

“Temporal lobe” or “Psychomotor” seizures

Consciousness is impaired

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16
Q

What are some manifestations of compex partial seizures?

A
  • Staring
  • Automatisms: Facial grimacing; gestures; chewing; lip smacking; repetitive speech
  • Fragmented but coordinated motor tasks
17
Q

How long do complex partial seizures last?

What are the post-ictal symptoms?

A

Lasts 30 seconds to a minute

  • Post-ictal impairment
    • Lethargy
    • Confusion
    • Lasts minutes to hours
18
Q

What two parts of the brain are associated with complex partial seizures?

A

Temporal lobe and Frontal lobe

19
Q

What are the features of an aura?

What brain region associated with complex parital seizures is responsible for auras?

A
  • Aura (associated with temporal lobe origin)
    • Fear
    • Stomach pain
    • Light headedness
    • Rising sensation in head or chest
    • Distortion of memory or time
    • De’ja vu
20
Q

What post ictal symptoms are associated with a complex partial seizure of temporal lobe origin?

A
  • May have automatism
  • Fatigue or deep sleep (not well for hours afterwards)
  • Headache
  • Emesis
21
Q

What symptoms are associated with complex partial seizures of frontal lobe origin?

A
  • Arrest of activity
  • Versive head and or neck movements
  • Blank stare (loss of contact)
  • Few automatisms
  • Abrupt on and off
22
Q

What is a tonic-clonic seizure?

A

Loss of consciousness with stiffening of limbs (tonic phase) that has evolution to generalized jerking of muscles (clonic phase)

23
Q

What are the post ictal symptom of a tonic-clonic seizure?

What age group is more likely to have these?

A

Deep sleep post-ictal

Majority in childhood

24
Q

What are the typical features of an absence seizure?

How long does it last?

A

Abrupt cessation of activity and change in facial expression (blank stare)

Motor, behavioral and autonomic changes

Less than 30 seconds

25
Q

Describe absence seizures in terms of…

Eye movement:

Head movement:

Autonomic phenomena:

A
  • Eye movement:
    • Clonic eye movements: Nystagmus; blinking
  • Head movement:
    • Head nodding
  • Autonomic phenomena:
    • Pupil dilation
    • Pallor
    • Flushing/sweating
    • Salivation
26
Q

Which type of clonic seizure is associated with EEG changes?

What does a migrating clonus indicate?

A

Focal clonic seizures are associated with EEG changes

Migrating clonus indicates metabolic or anoxic damage

27
Q

How long do tonic seizures last?

What are features of a tonic seizure?

A

Brief, 60 seconds

Sudden onset of increased extensor tone

Imparied consciousness

28
Q

What are the features of an atonic seizure?

A
  • “Drop attacks” - sudden loss of tone
  • Usually only brief loss of consciousness
29
Q

How long are myoclonic seizures?

To which locations are they generalized?

A
  • Sudden, brief (<350 mS)
  • Generalized or confined to face, trunk
30
Q

Myoclonic Seizures may be seen prior to what other types of seizures?

Myoclonic seizures can also serve as a sign of ______ ____ _______

A
  • Can be seen prior to absence, tonic or tonic-clonic seizures
  • Myoclonic seizures can also serve as a sign of diffuse brain injury
31
Q

Define Status Epilepticus

A

30 minutes of sustained seizure activity or two or more seizures without full recovery of consciousness between seizures

32
Q

What are the two most important components of an evaluation of seizures?

A

History and Physical

33
Q

What evaluations should be used for the following disorders…

  • Focal seizure:
  • Primary generalized epilepsy:
  • Developmental regression:
A
  • Focal seizure: MRI
  • Primary generalized epilepsy: EEG only
  • Developmental regression: Extensive evaluation
34
Q

What initial lab studies should be done in the evaluation of seizures?

A
  • Glucose, electrolytes, BUN
  • ABG
  • Antiepileptic drug levels
  • CBC
  • Urinalysis
35
Q

What second phase studies should be done in the evaluation of a seizure?

A
  • Lumbar puncture
  • Liver function tests
  • Toxicology screen
  • Metabolic testing
  • EEG
  • Brain imaging (CT or MRI)
36
Q

What risks of therapy exist in treatment of seizures?

A
  • Idiosyncratic reaction
  • Systemic toxicity
  • Stigma
  • Expense
37
Q

What are some side effects of antiepileptic medication?

A
  • Direct toxicity
  • Dermatologic
  • Bone marrow effects
  • Hepatic effects

Neurology (26 decks)

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