Seizures

Question 1

analgesics that may lower seizure threshold

Answer 1

fentanyl, tramadol

Question 2

Smoking cessation medication that increases risk of seizure

Answer 2

Wellbutrin (Zyban)

Question 3

produced by electrical impulses from through the entire brain

Answer 3

generalized seizures

Question 4

produced by electrical impulses in a relatively small part of the brain.

Answer 4

partial seizures

Question 5

most common type of seizure

Answer 5

tonic clonic (grand mal)

Question 6

tonic phase

Answer 6

generalized body stiffening usually for 30-60 seconds

Question 7

clonic phase

Answer 7

violent jerking for 30-60 seconds

Question 8

most common symptom of absence seizures

Answer 8

Facial automatisms (repetitive blinking)

Question 9

Awareness, Memory preserved, and Consciousness preserved, but there are sudden feelings of fear, anger, sadness, happiness or nausea

Answer 9

simple partial seizure

Question 10

usually in temporal lobes, last 30 seconds to 2 minutes, awareness is impaired. Sx include lip smacking, chewing, fidgeting ect

Answer 10

complex partial seizure

Question 11

Factors that can activate an epiloptogenic focus

Answer 11

hyperthermia, hypoxia, hypoglycemia, hyponatremia

Question 12

Signs related to neurological disorders which may cause seizures

Answer 12

Café au lait spots, Axillary freckling, Hyperpigmented macules, asymmetry of body

Question 13

4 conditions that can mimic a seizure

Answer 13

REM behavior disorder, TIA, Transient global amnesia, Migraine

Question 14

sudden arousals from REM sleep immediately followed by complicated, often aggressive, behaviors for which the patient is amnestic

Answer 14

REM Behavior Disorder

Question 15

Deficit of short-term memory that begins abruptly and persists for minutes to hours, without other cognitive or motor impairment

Answer 15

Transient Global Amnesia

Question 16

Most important diagnostic test for seizures

Answer 16

EEG

Question 17

Tx for Status Epilepticus after ABCs

Answer 17

IV and give thiamine and glucose. Midazolam 2.5mg IM or 5mg IV. If not effective after 20” give Phenobarbital IV

Question 18

Common Anti-seizure meds

Answer 18

Dilantin(phenytoin), Tegretol(carbamazapine), Levetiracetam (Keppra), Topamax (topiramate)

Question 19

anti-seizure meds that can cause gingival hyperplasia

Answer 19

dilantin and phenobarbitol

Question 20

Dosing recommendations for Keppra (Levetiracetam)

Answer 20

Start at low dose with gradual increase not more often than once every 2 weeks. Do not suddenly stop taking as seizures may become worse

Question 21

Dosing recommendations for Topiramate (Topamax)

Answer 21

Starting dose is up to 25mg (1 to 3mg/kg/day) taken nightly for the first week. Increase dose as needed by 1-3 mg/kg/day administered in two divided doses

Question 22

What should be done to minimize the risk of kidney stones associated with Topiramate (Topamax)?

Answer 22

Increase oral fluids

Question 23

Adjunctive therapies that can be considered for seizures

Answer 23

Biofeedback, ketogenic diet, Vagal nerve stimulation

Question 24

high fat/low carb: Body burns fat instead of glucose for energy

Answer 24

ketogenic diet