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Clin med neurology > Seizures > Flashcards

Seizures Flashcards

1
Q

What is a seizure

A

Electrical storm in the brain

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2
Q

What is epilepsy

A

recurrent unprovoked seizures associated with abnormal electrical activity in the brain

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3
Q

What is the criteria for being diagnosed with epilepsy

A

2 or more unprovoked seizures separated by AT LEAST 24 hours

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4
Q

When will you start someone on anti-seizure medication

A

after second unprovoked seizure

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5
Q

What are examples of a provoked seizure

A

infections
alcohol withdrawal
low blood sugar
surgery

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6
Q

What are the 3 main classifications of seizures

A

Focal onset
generalized onset
unknown onset

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7
Q

What are focal onset seizures

A

seizures that start in and affect one part of the brain

generally originates paroxysmal discharge in the temporal lobe

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8
Q

What is a primary generalized seizure

A

abnormal electrical discharge that originates from the diencephalic activating system and spread simultaneously through the brain

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9
Q

What are the stages of a seizure

A

prodrome
aura
ictal phase
post-ictal phase

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10
Q

What type of seizures do auras occur in

A

focal epilepsy

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11
Q

What is the ictal phase

A

Time from the first symptom (including aura) until the end of the seizure activity

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12
Q

What is an example of automatisms

A

lip smacking

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13
Q

What progression may you see in seizures as the activity spreads to other parts of the brain

A

Aura->focal aware-> focal unaware-> bilateral tonic clonic

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14
Q

What is the post-ictal phase

A

Time between the end of a seizure and return to baseline

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15
Q

What is a focal seizure with impaired awareness

A

Starts in one area of the brain
duration 1-3 minutes

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16
Q

What are signs someone is having a focal seizure with impaired awareness

A

picking at clothes
bicycling of legs
utilization behavior
Smacking lips

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17
Q

What is a bilateral tonic clonic seizure

A

may see head or eye deviation (pt. looking away from seizure)

will show figure 4 or fencing posture

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18
Q

If a patient demonstrates fencing posture, where is their seizure located

A

frontal lobe

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19
Q

If a patients hand goes up to their face, what does it tell you about the seizure

A

Tells you which side of the brain the seizure is happening in

hand=side of seizure

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20
Q

What are generalized seizures

A

absence
myoclonic
clonic
tonic
tonic-clonic
atonic

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21
Q

What is an absence seizure

A

sudden behavioral arrest

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22
Q

What is a clonic seizure

A

rhythmic contraction of arms and legs

23
Q

What is an atonic seizure

A

loss of muscle tone “drop attack”

24
Q

What type of seizures do children typically have

A

absence seizures
*generally happen in clusters

25
Q

If a myoclonic seizure disorder starts with childhood, what will happen as they grow

A

They should grow out of it

26
Q

If myoclonic seizures starts in juvenile ages, will they grow out of it

A

no

27
Q

When are myoclonic seizures most common

A

morning time upon waking up

28
Q

What happens if a seizure lasts longer than 5 minutes

A

They probably won’t stop on own-> call 911

29
Q

What side is best to turn a person on to and why

A

left
better venous return

30
Q

What is the difference between provocation and triggers

A

Provoked= things out of the ordinary that cause seizures

Trigger= known causes for seizure

31
Q

What is an example of provocation

A

severe hypoglycemia

32
Q

Which patients will have febrile seizures

A

children under age 5
-should be primary/general in onset…No prodrome

33
Q

What are medication side effects for anti seizure medications

A

Balance issues
double vision
prolonged nystagmus

34
Q

If someone has a “wine stain” on their face, what is it indicative of

A

brain was effected with seizure and the patient probably needs surgery

35
Q

What is a storage weber sign

A

a wine stain on the face

36
Q

How would you differentiate between confusion and aphasia

A

when a patient is aphasic, they can act out a word but cannot think of what it is

37
Q

What is PNES

A

psychogenic non-epileptic seizures

38
Q

can someone with epilepsy have non-epileptic seizures

A

Yes

39
Q

What is the most common correlation for PNES

A

sexual abuse

40
Q

If someone has a prolonged seizure that breaks on its own and they go into status, is this a sign of epilepsy or PNES

A

PNES

41
Q

What test do you need to truly confirm whether a seizure is epileptic or not

A

EEG

42
Q

What is the standard of care for seizures if a patient has only had one

A

avoid typical precipitants if unprovoked

Correct imbalance if provoked

43
Q

When should anti-convulsants be used for patients

A

if they have had 2+ unprovoked seizures

44
Q

What do broad spectrum ASMs treat

A

generalized and focused epilepsies

45
Q

What do narrow spectrum ASMs treat

A

only focal epilepsy
*may make generalized worse

46
Q

What is the drug of choice for idiopathic generalized epilepsy

A

Valproic acid
*avoid in women of child bearing age

47
Q

When can/should you consider stopping seizure medication

A

when a patient is seizure free for 2 years

48
Q

What type of birth control should a female be on while taking AEDs

A

IUD

49
Q

If the risk of seizures outweighs the risk of fetotoxicity, what drug should the mother be put on

A

Keppra
folic acid supplement

50
Q

What are acute repetitive seizures

A

closely group seizures over minutes to 2 days that increase in frequency

51
Q

What are the 3 types of status epilepticus

A

tonic clonic
focal with impaired consciousness
absence

52
Q

What is status epilepticus

A

continuous seizure activity for at least 5 minutes

OR

2+ seizure attacks without recovery of consciousness in between

53
Q

What makes status epilepticus complex

A

usually a combo of seizure types
The longer it goes, the less noticeable it is

54
Q

What is the first like agent for status

A

4mg IV lorazepam x 2

Clin med neurology (12 decks)

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