seizures Flashcards
What are the essentials of diagnosis of epilepsy?
recurrent seizures, characteristic EEG cahnges, mental status abnormalities.
Are epileptic seizures provoked or unprovoked?
They are unprovoked episides that are recurrent.
epipelsy peaks what which ages?
youth and then over 60
What are the 3 categories of epilepsy?
genetic, structural/metabolic, unknown
Genetic epilepsy are common in what population/
children. they are inherited autosomal dominant or channelopathies
Structural/metabolic are associated with which age group?
adults.
What are the different types of structural/metabolic epilepsy?
head trauma, tumor, CVA, infections like meningitis or herpes, alzheimers
What are the 2 different type of focal onset seizures?
no alteration of consciousness( simple partial) and alteration of consciousness( complex partial)
The simple partial seizures include which 2 types?
aura and motor/sensory/autonomic psychomotor.
generalized onset includes which types of seizures?
tonic, clonic, atonic, myoclonic, absence.
Are partial seizures affecting the entire brain, or just a portion of it?
they are affecting a portion of the brian, and they are usually conscious during them.
Automatisms are common in which type of seizure?
complex partial seizures. this is where they smack lips, pick at clothes, walk aimlessly.
Staring can occur in which type of seizure?
complex partial
petit mal are common in which type of population/
children. They can spontaneously disappear with age. They are also called absence seizures.
generalized tonic clonic seizures are AKA?
grand mal seizures
A seizure that presents wtih staring spells lasting several seconds with eyelid fluttering and head nodding, and ability to resume activities is?
absence seizures.
seizure presenting with sudeen loss consciousness, tonic then clonic activity of limbs, post ictal period for hours after is?
grand mal seizure.
Which seizure is described as a drop attack that sx cause the patient to become limp and fall on the ground?
atonic seizure
What is a seizure described as breif un sustained jerks or series of them. They end as fast as they start.
myoclonic seizure
Wht is described as stiffening of the muscles as primary manifestation, the arms and legs can go up into the air, and consciousness may not be lost?
tonic seizures
What is the most common type of seizure in adults?
complex partial seizures.
What is on the differential for seizures?
GERD, breath holding spells, TIA, migrane, movement disorders, sleep disorders, arrhythmia.
What shoudl you worry about in status epilepticus?
when they last more than 30 minutes they are at increased risk for brain damage, they will get increased CK levels from breakdown of muscles causing renal failure.
Which drug would you treat status epilecticus with?
ativan.
What is included in the workup of acute seizures?
BMP, ETOH, Drug screen, LP if considering meningitis or HSV, imaging to r/o brain tumor.
When giving anti-seizure medications, what precautions do you have to take with child bearing age women?
they shoudl be on folate, contraceptive use, calcium.
If you have a patient with mood issues, which drug would you wnat to avoid?
keppra
What would be a good drug to use if they are bipolar?
lamictal
which durg will cause weight gain, and which will cause weight loss?
weight gain- depakote, and topamax for weight loss.
If they have a history of kidney stones which medications soudl you avoid?
topamax and zonegran.
What is a rescue drug for seizuresa?
benzodiazepines
which 2 are majorly teratorgenic?
valproic acid and phenobarb
With refractory seizures, what steps would you want to take next?
video eeg monitoring to rule out a psychogenic cause of the seizures.
which type of epilepsy is extremely refractory to medications?
temporal lobe epilepsy. tx surgically.
SUDEP has a cure? t/f
there is an uknown reason for this occurence, and it happens spontaneously. could possibly be related to cardiac arrhythmias, but can occur in patients who are on their medication regimens.
