Seizures

Question 1

Phenytoin

Answer 1

Dilantin
Na+ channel
Treats partial seizers (and secondary)
SE: Gingival hyperplasia, coarsening of facial features, ataxia, hypersensitivity

Question 2

Carbamazepine

Answer 2

Tegretol
Na+ channel
Treats Partial
SE: Hyponatremia, agranulocytosis, diplopia, hypersensitivity

Question 3

Valproic acid

Answer 3

Depakote
Na+ channel GABA receptor
Treats partial, generalized, absence
SE: tremor, thrombocytopenia, weight gain, hair loss, hepatotoxicity, tremor, GI, accelerate osteoporosis, teratogen, PCOS

Question 4

Phenobarbital

Answer 4

GABA receptor
For Partial, generalized seizures
SE: sedation

Question 5

Ethosuximide

Answer 5

Zarontin
T-type CA channel
For absence seizures
GI symptoms

Question 6

Gabapentin

Answer 6

Neurontin
for partial seizures
SE: Sedation, ataxia

Question 7

Lamotrigine

Answer 7

Lamictal
For partial, generalized
SE: Rash, stevens-johnson syndrome

Question 8

Topiramate

Answer 8

Topamax
Na+ channel,
For partial, generalized
SE: word-finding difficulty, renal stones, weight loss

Question 9

Tiagabine

Answer 9

Gabitril
For partial
SE: Sedation

Question 10

Levetiracetam

Answer 10

Keppra
For partial, generalized
SE: Insomnia, anxiety, irritability

special: low risk hypersensitivity, low drug drug interations with warfarin, Juvenile myoclonic epilepsy

Question 11

Oxcarbazepine

Answer 11

Trileptal
Partial
Sedation, hyponatremia

Question 12

Zonisamide

Answer 12

Zonegran
For partial, generazlied
SE: sedation, renal stones, weight loss

Question 13

Periodic lateralizing discharges

Answer 13

Herpes encephalitis, focal brain lesions, nonketotic hyperglycemia, EtOH withdrawal, theophylline exposure.

Question 14

Generalized periodic discharges

Answer 14

Anoxic brain injury, CJD, diffuse process

Question 15

Stimulus Induced, Rhythmic, Periodic, or Ictal Discharges

Answer 15

critically ill

Question 16

Burst supression

Answer 16

Anoxic encephalopathy or with medications (propofol, barbituates)

Question 17

How to treat Status Epilepticus

Answer 17

Benzos (esp IV Lorazepam) then phenytoin

Question 18

Jacksonian March

Answer 18

motor cortex

Question 19

Sensory phenomena

Answer 19

parietal seizures

Question 20

visual phenomena

Answer 20

occipital seizures

Question 21

gustatory, olfactory, psychic phenomena, deja vu, jamais vu, depersonalization

Answer 21

temporal seizures

Question 22

Lennox-Gastaut

Answer 22

asso with mental retardation,
Slow (1-2hx) spike and wave
TX: VPA, lamictal, felbamate

Question 23

Benign Rolandic epilepsy

Answer 23

nocturnal preponderance
EEG: Centrotemporal spikes
TX: CBZ, sometimes none

Question 24

Absence epilepsy

Answer 24

Hyperventilation as trigger
EEG: 3 hz spike and wave
TX: Ethosuximide, VPA

Question 25

Juvenile myoclonic epilepsy

Answer 25

Early morning preponderance
4-6 hx polyspike and wave
VPA, lamotrigine (in questions: levetiracetam)

Question 26

west syndrome

Answer 26

1. Development delay
2. Hypsarrhythmia on EEG (a high voltage, chaotic, disorganized pattern that is VERY, VERY abnormal)
3. Infantile spasms

Question 27

Lennox Gastaut Syndrome

Answer 27

1. Mental retardation (often profound)
2. Multiple seizure types (including atypical absence seizures, atonic seizures,
   patients were helmets, knee pads, elbow pads, etc. to protect themselves from
   injury)
3. 1 – 2 Hz spike-and-wave discharges interictally (i.e., between seizures) – in other
   words, even when they’re not actually seizing, their brain is constantly firing
   epileptic discharges

Question 28

Juvenile Myoclonic Epilepsy

Answer 28

1. Absence seizures
2. Myoclonic jerks, usually in the morning
3. Generalized tonic clonic seizures, most commonly upon awakening

Question 29

Juvenile Absence Epilepsy:

Answer 29

1. Staring spells without warning
2. Hand, mouth automatisms
3. 3 Hz spike-and-wave on EEG