Seizures Flashcards
What is a seizure?
Transient episode with signs/symptoms of excessive synchronous neuronal activity in the brain.
What are the characteristic events of a seizure?
May have impaired consciousness Tonic stiffening / clonic jerking Tachycardia / mydriasis urinary incontinence tongue biting mild cyanosis of mouth / distal extremities post-ictal fatigue
What is Todd’s paresis?
Post-ictal contralateral hemiparesis.
What are the types of focal onset seizures?
Primary partial
Complex partial
Secondary generalized
Describe a simple partial seizure.
No alteration in consciousness.
Manifestation is related to the brain region involved.
There may be an aura.
Can progress to complex partial or General tonic clonic seizure.
Describe a complex partial seizure.
Alteration in consciousness.
Early manifestation is related to brain region involved.
Staring off into space
Unilateral limb involvement, automatism, gaze deviation
Often no recall of the event
May progress into general tonic-clonic seizure
Describe a secondary generalized seizure.
This is a seizure that began as a focal seizure (simple or complex partial) and has now spread to involve the entire brain. (Tonic - clonic / whole body is involved)
If a seizure was localized to the medial temporal lobe, what kind of symptoms would you see?
Staring
Automatism
Posturing
Fear
If a seizure was localized to the lateral temporal lobe, what kind of symptoms would you see?
Staring, vertigo, hearing problems
If a seizure were localized to the frontal lobe, what kind of symptomology would you see?
Brief, bizzare, nocturnal
Supplementary motor area = fencing posture
Orbitofrontal cortex = elaborate smells, sounds
If a seizure were localized to the occipital lobe, what kinds of symptoms would you see?
Formed visual phenomena
Primary generalized seizure.
Entire brain is involved.
Genetic pre-disposition. Family members may not have seizures but can have abnormal EEG.
What is an idiopathic seizure?
Don’t know what caused it but its probably genetic.
What is a symptomatic seizure?
Know what caused the seizure. Head injury, brain tumor, etc.
What is a cryptogenic seizure?
We know something is causing it and something is really wrong with you but we can’t figure out what it is.
What are some examples of idiopathic seizures?
Benign Rolandic Seizures (centrotemporal spikes)
Familial Temporal epilepsy
Primary Generalized Epilepsy
What are some causes of symptomatic seizures?
Head injury meningitis congenital acutely symptomatic - low blood sugar / sodium tumor
Average speed of 3 Hz of spike-and-wave activity gives you what kind of seizure?
Absence seizure
Slow spike-and-wave is < 2.5 Hz
Lennox-Gastaut seizures
Drop spells || Stiffening spells at night
Rapid spike-and-wave >3.5 Hz (poly spike and wave)
Juvenile myoclonic seizures
In an adult with seizures that seem to originate within the temporal lobe, what can we look for on an MRI most times?
Mesial Temporal Sclerosis: Hippocampal area damage due to repetitive seizures in that area
What is the mechanism of focal seizure anti-epileptic medications?
Blocking Na+ channels.
What is the best medication to give for an absence seizure?
Ethosuximide
What is the best medication to give for juvenile myoclonic seizure?
Depakote (Valproic Acid)
