Seizures.

Question 1

Epilepsy:

Answer 1

neurological condition, which affects the nervous system.

Question 2

Seizure:

Answer 2

sudden episode of transient neurologic symptoms such as involuntary muscle movements, sensory disturbances and altered consciousness. A seizure is caused by abnormal electrical activity in the brain, which is often diagnosed on an electroencephalogram (EEG); over firing of neurons.

Question 3

Seizures are caused by:

Answer 3

traumatic brain injuries, infection, stroke, degenerative changes in the brain, tumors; unknown cause.

Question 4

Partial seizures:

Answer 4

simple partial, complex partial, and secondarily generalized.

Question 5

Generalized seizures:

Answer 5

absence, atypical absence, atonic, tonic, clonic, tonic-clonic, myoclonic, and febrile.

Question 6

Status epilepticus:

Answer 6

15 minutes of continuous seizures; medical emergency.

Question 7

Generalized seizures…

Answer 7

go across both sides of the brain.

Question 8

Auras may be experienced with…

Answer 8

simple or complex partial; sometimes tonic-clonic.

Question 9

Simple partial:

Answer 9

<30 seconds; occur at any age; most common type; fully aware; normally no post-ictal phase.

Question 10

Complex partial:

Answer 10

30 seconds to several minutes; may feel tired or confused for 15 minutes but won’t return to normal for several hours; experience automatism; aura is common; occurs in LG.

Question 11

Secondarily generalized:

Answer 11

starts as other partial seizures in a single portion of the brain then spreads to others becoming a generalized tonic-clonic; grand mal seizure; will shriek when diaphragm tightens.

Question 12

Absence/petit mal:

Answer 12

simple: blank stare 10-20 seconds.
complex: eye blinks, licking lips, rubbing fingers; 10-20 seconds.
no aura.

Question 13

Atypical absence:

Answer 13

blank stare, somewhat responsive; eye-blinking and lip movements may occur; hard to distinguish with cognitive impairment; common in LG.

Question 14

Atonic:

Answer 14

<15 seconds; will lose muscle tone, suddenly drop things; will remain conscious; common with LG.

Question 15

Tonic:

Answer 15

<20 seconds; muscle tone increased, body stiffens; will occur during sleep; if person is standing, they will fall; common with LG.

Question 16

Clonic:

Answer 16

length will vary; not seen often; seen more in newborn; rhythmic jerking - will be symmetric.

Question 17

Tonic-clonic/grand mal:

Answer 17

last 1-3 minutes; will lose consciousness; tonic then clonic; bowel and bladder control is lost; will drool or foam at the mouth; familial tendencies; post-ictal phase; occurs in LG.

Question 18

Myoclonic:

Answer 18

1-2 seconds; sometimes many will occur in a short time; fall asleep and body jerks; common in LG - get them up too quickly, subject to light or sound too quickly.

Question 19

Febrile:

Answer 19

t cause brain damage; may have temp of 106, will do ice bath.
occurs most in 3-5 months; peaks at 17-24 months.

Question 20

Psychogenic:

Answer 20

pseudoseizures; differentiate between real and fake with video EEG.

Question 21

LG:

Answer 21

mixed seizure disorder; won’t see all 6 every time: tonic, atonic, myoclonic, atypical absence, tonic-clonic, complex partial.
will be taking high doses of seizure meds: tegretol, keppra, lamictal, dilantin.

Question 22

Dilantin will cause:

Answer 22

gingival hyperplasia.

Question 23

Tegretol will cause:

Answer 23

osteoporosis; in teens within 18-24 months.

Question 24

Topamax is used…

Answer 24

with migraine and seizure prevention; antidepressant; appetite suppressant; decreases mentation.

Question 25

Topamax will cause:

Answer 25

ataxia or tremors.

Question 26

Vimpat and Gabitril…

Answer 26

are newer meds; fewer SE and greater control.

Question 27

Depakote will cause:

Answer 27

thrombocytopenia - titrate dose with platelet count.

Question 28

Ketogenic diet:

Answer 28

works for children with focal seizures and seizure conditions such as infantile spasms, Rett syndrome, tuberous sclerosis complex, Dravet syndrome, Doose syndrome, and GLUT-1 deficiency; high fat diet; available in formula.

Question 29

Modified Atkins diet:

Answer 29

for children with intractable seizures.

Question 30

Low glycemic index treatment:

Answer 30

developed in 2002 as an alternative to the Ketogenic diet. Treats either generalized or partial onset seizures.

Question 31

Frank, a 7-year-old boy, often blanks out anywhere from a few seconds to 20 seconds at a time. During a seizure, Frank doesn’t seem to hear his teacher call his name, he usually blinks repetitively and his eyes may roll up a bit. During shorter seizures, he just stares. Then he continues as if nothing has happened. Some days he may more than 50 of these spells.

Answer 31

absence.

Question 32

“In the morning I get these “jumps”. My arms fly up for a second and I often spill my coffee or drop what I am holding. Sometimes I get a few jumps in a row. Once I have been up for a few hours my jumps stop.”

Answer 32

myoclonic.

Question 33

“Sometimes Sam just falls to the ground and hits his head and bruises his body. Even if I am right next to him and prepared, I may not catch him.”

Answer 33

drop/atonic.

Question 34

“These seizures frighten me. They only last about 1 to 2 minutes, but it seems like an eternity. I can often tell Heather is going to have one because she acts cranky and out of sorts. It begins with an unnatural shriek. Then she falls, and every muscle seems to be activated. Sometimes she turns blue. Finally it stops and she falls into a deep sleep.”

Answer 34

tonic-clonic.

Question 35

“It is like a pressure that starts in my stomach, then it rises to my chest and throat and I smell a burnt odor. At the same time I feel anxious and I sweat.”

Answer 35

simple partial.

Question 36

“Harold’s spells begin with a warning; he says he’s going to have a seizure and usually sits down. Then he makes a funny face. During the seizure he looks at me when I call his name, but he doesn’t answer. Sometimes he will pick at his shirt.”

Answer 36

complex partial.

Question 37

“At first I thought Chris was just having the little body jerks when he was moved or startled, like my other children had when they were infants. However, the jerks became more often and more violent. They only lasted a few seconds, but started to occur in groups lasting a few minutes.”

Answer 37

infantile spasms.

Question 38

“The first time we heard about this disorder the words had no meaning. I asked the doctor for information, and he said there wasn’t much written for parents. He loves school (special education classes) and after many trials and errors with medication he is currently under control only having a few seizures a month.”

Answer 38

LG syndrome; 5-10 seizures per month is good.