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Neurology (SA) > Seizures > Flashcards

Seizures Flashcards

1
Q

Seizures are due to a abnormal or excess synchronous brain activity, due to imbalance of which two neurotransmitter?

A

Glutamate - excitation

GABA - inhibition

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2
Q

Give examples of what may cause a reactive seizure

A

Metabolic disorder
Toxicity
(disturb in brain function)

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3
Q

Give examples of what may cause a structural seziure

A

Inflammation
Neoplasia
Trauma
(Due to intracranial pathology)

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4
Q

What are the 4 seizure stages/phases?

A

Prodrome - predicting events
Aura - abnormal feeling
Ictus - seizure itself
Post-ictus

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5
Q

How long do most seizures last and when do they typically occur?

A

60-90 seconds

At rest or whilst sleeping

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6
Q

What is a cluster seizure?

A

2+ seizures in 24 hours

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7
Q

After how long of seizuring does irreversible neuronal damage occur?

A

30-60 minutes

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8
Q

Focal seizures may be motor, autonomic or behavioural give an example of a focal seziure

A

Audiogenic reflex seizures in cats

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9
Q

Where do focal seizures tend to be most obvious? (body part)

A

Face

Licking, fly-catching

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10
Q

At what age do audiogenic reflex seizures begin to affect cats?

A

15 years

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11
Q

What is the treatment for audiogenic reflex seizures in cats?

A

Levetiracetam

Studies found more useful than phenobarbitone

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12
Q

What are generalised seizures?

A

Seizures involve both cerebral hemispheres

Consciousness impaired

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13
Q

At what age does idiopathic epilepsy typically occur in dogs?

A

6 months to 6 years

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14
Q

What breeds are predisposed to idiopathic epilepsy due to genetic inheritance?

A

Belgian Shepherd
Boerboels
Lagotto Romagnolo

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15
Q

What are the 3 tiers of confidence of epilepsy diagnosis?

A

Tier 1: clinical signs
Tier 2: clinical signs + unremarkable pre/post prandial bile acids, MRI and CSF
Tier 3: clinical signs, diagnostic tests AND ictal or interictal abnormalities on EEG

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16
Q

When may you consider sending a dog with seizures for an MRI?

A

If < 6months, >6 years
Interictal neuro abnormalities
Status epilepticus or cluster seizures
Drug resistance following IE diagnosis

17
Q

When should you start treatment for idiopathic epilepsy?

A

If status epilepticus or cluster seizures
Inter-ictal period <6 month
Severe post-ictal signs
1st seizure within 1 month of a traumatic event
Increasing frequency or severity of seizures

18
Q

What treatment is the drug of choice for epilepsy in cats?

A

Phenobarbitone

19
Q

Which anti-epileptic drugs are licensed in dogs?

A

Phenobarbitone
Bromide (not as monotherapy)
Imepitoin (not for cluster seizures, structural epilepsy or as combinational therapy)

20
Q

When is phenobarbitone contraindicated in cats and dogs?

A

Liver problems - hepatotoxic

21
Q

When should you monitor serum after changing the dose of phenobarbitone?

A

2 weeks after dose change

22
Q

When should you monitor bloods and bile acid stimulation tests after starting phenobarbitone?

A

3 + 6 months after starting treatment

monitor serum 2 weeks after dose change

23
Q

What phenobarbitone levels should you aim for in the blood?

A

25-30g/L

24
Q

Which 3 anti-epileptic drugs should not be used in cats and why?

A

Bromide - causes eosinophilic bronchitis
Propofol - Heinz bodies anaemia
Diazepam - hepatic necrosis if administered orally

25
Q

What is a general side effect of most anti-epileptic drugs?

A

Sedation

26
Q

What is the anti-epileptic drug of choice for PSS and hepatic encephalopathies?

A

Levetiracetam

27
Q

What is status epilepticus?

A

Single seizure >5 mins
OR
2+ seizures within 5 minutes without return to normal

28
Q

What condition in CKCS may be confused for a seizure?

A

Episodic falling syndrome

paroxysmal hypertonicity with quick return to normal

29
Q

Border terriers and other small breed are treated with gluten free diets for which condition that may be confused for true seizures?

A

Canine epileptoid cramping syndrome

AKA Paroxysmal gluten sensitive dyskinesia

30
Q

What anti-epileptic drug should be avoided with hepatic encephalopathy?

A

Diazepam - makes signs worse

Neurology (SA) (8 decks)

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