seizures Flashcards
type of seizure that
affects 1 area of the brain
originates in temporal lobe
preceded by aura (smell of rubber)
partial seizure (focal)
type of partial seizure with intact consciousness
simple partial seizure
type of partial seizure with impaired consciousness
complex partial seizure
type of seizure that
is diffuse or starts in temporal lobe (partial) and becomes generalized
generalized seizure
type of generalized seizure with a blank stare + smaking of lips or quiver of face
absence generalized seizure
type of generalized seizure with twitching of muscle or group of muscles (repetitive jerks)
myoclonic generalized seizure
type of generalized seizure with stiffening + movement
tonic-clonic generalized seizure
type of generalized seizure with stiffening (no shaking)
tonic generalized seizure
type of generalized seizure with dropping (looks like fainting)
atonic generalized seizure
continuous seizure (>30 min) or recurrent seizures without regaining consciousness between seizures for >30 min
status eplipeticus
=medical emergency
common causes of childhood seizure
genetic
infection (febrile)
trauma
metabolic
common cause of adult seizure
brain tumor
trauma
stroke
infection
common cause of elderly tumor
stroke brain tumor trauma hyponatremia infection
disease with following characteristics:
H - Hamartomas in CNS (retina, glioneuronal = cortical tubers + skin)
A - Angiofibromas (see on face)
M - Mitral regurgitation
A - Ash leaf spots (hypomelanotic macules)
R - cardiac Rhabdomyoma
T - answer
O - autosomal dOminant
M - Mental retardation
A - renal Angiomyolipoma, Astrocytomas (subependymal giant cell)
S - Seizures, Shagreen patches
Tuberous sclerosis
incomplete penetrance, variable expressivity (looks different for each person)
classic triad of tuberous sclerosis:
seizures
mental retardation
angiofibromas
these mutations cause:
TSC1 gene → hamartin protein
TSC2 gene → tuberin gene
tuberous sclerosis
disease that causes:
S - Sporadic (non-inherited, somatic), Stain (port-wine in V1/V2 of CN 5)
T - tram track Ca2+
U - Unilateral (ipsilateral leptominingeal angioma)
R - Retardation
G - Glaucoma (due to episcleral hemangioma), GNAQ gene (anomaly of neural crest derivatives: mesoderm/ectoderm)
E - Epilepsy
Sturge-Weber Syndrome
port wine stain of ophthalmic/mandibular br. of CN 5 is seen in
Sturge-Weber Syndrome
lightening pain, electric shocks along maxillary br. of CN 5 triggered by light touch (wind, bed sheets) is called
trigeminal neuralgia (tic douloureux)
treatment for trigeminal neuralgia (hyperexcitable CN 5)
anticonvulsants: carbamazepine phenytoin gabapentin topiramate
drug of choice for absence seizures
ethoSUXimide (Sucks to have Silent Seizures)
if refractory - valproic acid
used to treat status epilepticus
BZD (diazepam, lorazepam)
used to treat eclampsia (HTN + pregnant)
magnesium sulfate
if refractory - BZD
additional side effects of phenytoin
gingival hyperplasia Steven Johnson Syndrome hirsutism drug-induced lupus megaloblastic anemia - ↓ folate absorption peripheral neuropathy teratogen
anti-epileptics that are teratogens
phenytoin - fetal hydantoin syndrome (cleft lip/palate, CHD, intellectual disability + developmental delay
carbamazepine
valproic acid - spina bifida (increase folic acid to 4 mg if still taking it)
hepatotoxic anti-epileptics
valproic acid
carbamazepine
anti-epileptic that induces P450
carbamezapine
anti-epileptics that block Na channel →↓ AP in neurons
phenytoin carbamazepine valproic acid topiramate lamotrigine
used to treat status epilepticus
stop seizure: BZD (diazepam, lorazepam)
prevent future seizure: phenytoin
anti-epileptics that ↑GABA activity
BZD valproic acid gabapentin phenobarbital topiramate levetiracetam tiagabine vigabatrin
drug of choice for generalized seizures
valproic acid
drug of choice for partial seizures
lamotrigine
anti-epileptics that ↓T-type Ca channel →↓ AP in neurons
ethosuximide
phenytoin
gabapentin
treatment of tonic-clonic seizures
valproic acid
phenytoin
carbamazepine
