Seizures Flashcards

1
Q

what is the #1 cause of childhood seizures?

A

Trauma

then CNS infection, arteriovenous malformations, other congenital defects

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2
Q

What should be suspected in a teenager/young adult with the first seizure of their life?

A

Drug/Alcohol usage

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3
Q

What should be assumed for an older adult with their first seizure?

A

Tumor! Until proven otherwise…

can also be alcohol withdrawal seizure

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4
Q

What is a seizure? prodrome? aura?

A

abnormal rhythmic neuronal discharge

prodrome = mood or behavioral changes that may precede the event by days or hours

aura = symptom just prior to a seizure (de ja vu or smell burning rubber)

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5
Q

epilepsy

A

stereotyped recurrent seizure secondary to abnormal neuronal disharges

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6
Q

status epilepticus

A

a state of continuous or frequent seizures

a failure to return to a normal mental status between two seizures

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7
Q

what are the 3 classifications of seizures?

A

1) primary generalized = both cerebral hemispheres involved at the onset of seizure

2) Focal = seizure begins in one are of the brain
- simple focal = no change in level of consciousness
- complex focal = change in level of consciousness (not necessarily to ground)

3) Secondary (reactive) seizures = due to metabolic changes
- hypoglycemia
- hyponatremia (only hypokalemia will NEVER cause a seizure)
- alcohol withdrawal
- trauma
- toxins
- infection
- eclampsia

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8
Q

Discuss seizures located in all 4 lobes

A
frontal = shaking
parietal = additional sensation (painful etc)... likely a brain tumor

occipital = tough to distinguish from migraines (usually usually see black and white) vs occipital seizures are colorful… both cause unformed visual hallucinations

temporal = hallucinations of actual things (ie mickey mouse)

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9
Q

Features of generalized seizure

A
*ENTIRE BRAIN*
NO aura
postictal confusion
bowel/bladder incontinence
*lateral tongue trauma*
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10
Q

6 types of generalized seizures

A

1) tonic = go stiff
2) tonic clonic = “grand mal” shaking
3) clonic = jerking
4) atonic = brief loss of muscle tone, may involve all musculature resulting in a fall, may only involve nuchal musculature resulting in head drop
5) petit mal (“absence”)
6) myoclonic

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11
Q

Absence seizure (petit mal)

A

pediatric epilepsy syndrome specific to children
resolve by adolescence
staring spell
lasts 5-15 seconds
provoked by hyperventilation - extremely sensitive test —> blow a string as fast as u can

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12
Q

Myoclonic

A

infantile
Juvenile Myoclonic Epilepsy
*most common inherited epilepsy
—> early morning myoclonic events (lifetime duration treatment of choice Valproic Acid)

Adult - most commonly associated with anoxic injuries to brain

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13
Q

4 types of focal seizures

A

motor = tonic or clonic movements, turn head to side OPPOSITE the side of seizures at onset

autonomic/visceral = gustatory, olfactory, epigastric fullness, nausea

sensory = positive phenomena (visual hallucinations)

psychic = dejavu

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14
Q

Why don’t you use a focal seizure treatment as the “default” seizure medication

A

if you treat a general seizure with focal seizure medication, you can actually cause more generalized seizures

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15
Q

Febrile seizures, why is it important to know if they are simple or complex?

A

They are associated with high temperature (specifically rate of change)

seen in children 6 months to 6 years

  • Simple = no focal features thus no increased risk of epilepsy
  • complex = focal feature thus IS an increased risk of epilepsy
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16
Q

what is the most common reason for status epilepticus?

A

missed a dose of anti-convulsant

17
Q

Treatments for status epilepticus

A

IV benzodiazepines - lorazepam, diazepam for short term

IV anticonvulsants - phenytoin, valproic acid, levitiracetam

18
Q

What is the EEG of an absence (grand mal) seizure?

A

3 second spike and slow wave discharges

19
Q

what cutaneous abnormalities are associated with seizures?

A

cafe-au-lait spots and neurofibromas

20
Q

what is the only electrolyte deficiency that you’re not worried can cause seizure?

A

Potassium (hypokalemia)

21
Q

How do you treat someone with their first seizure?

A

YOU DON’T!

22
Q

Best treatment for recurrent seizures?

A

anti-convulsants

23
Q

what is it when the person goes “AAAAHAHHHH HHAAAAAAAAAAAAA at night time?”

A

NOCTURNAL STRIDOR - multiple systems atrophy