Seizures Flashcards

1
Q

What percentage of the population will have a seizures during their lifetime?

A

10%

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2
Q

What is the definition of a simple partial seizure?

A

a seizure that begins in a focal area of the brain and does not impair awareness.

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3
Q

What is the definition of a complex partial seizure/

A

a seizure with a focal onset that causes an impairment in awareness

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4
Q

Where is the most common location of onset for a complex partial seizure?

A

temporal lobe

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5
Q

What are some typical signs of a complex partial seizure?

A

lip smacking, chewing movements, picking at clothes, etc.

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6
Q

How do generalized tonic-clonic seizures typically start?

A

with a tonic phase that lasts several seconds in which the entire body becomes stiff, followed by a clonic phase

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7
Q

True or false: the rhythmic jerking of the clonic phase tends to occur asymmetrically in the body.

A

false - symmetric

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8
Q

What is the classic EEG finding in absence seizures?

A

three-per-second generalized spike-and-wave pattern

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9
Q

Is an absence seizure focal or generalized?

A

generalized

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10
Q

What is the most common cause of seizures in children?

A

febrile

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11
Q

What is the most common cause of seizures in the elderly?

A

stroke

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12
Q

What genetic cause of seizures will present in childhood with essentially any seizure type, intellectual disability and an EEG with slow (1 to 2/second) spike and wave discharges?

A

Lennox-Gastaut syndrome

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13
Q

What genetic epilepsy syndrome will present in childhood with simple partial seizures that have a nocturnal preponderance with centrotemporal spikes on an EEG?

A

benign rolandic epilepsy

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14
Q

What genetic epilepsy syndrome will present in adolescence or young adulthood with myoclonic, absence, or generalized tonic-clonic seizures occurring mainly in the early morning with a 4 to 6/per second polyspike and wave pattern on EEG?

A

Juvenile myoclonic epilepsy

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15
Q

Todd’s paralysis will typically be seen after what type of seizure?

A

after a secondarily generalized seizure

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16
Q

What lab abnormality will typically be seen after a tonic clonic seizure?

A

lactic acidosis with low bicarb

17
Q

What is the preferred imaging modality in a patient with a first-time seizure?

A

MRI

18
Q

What percentage of patients with epilepsy will have their seizures well controlled on monotherapy?

A

70%

19
Q

For phenytoin: site of action, seizure type treated, and main side effects?

A

Na+ channel

partial

gingival hyperplasia, coarsening of facial features, ataxia

20
Q

For carbamazepine: site of action, seizure type treated, and main side effects?

A

Na+ channel

partial

hyponatremia, agranulocytosis, diplopia

21
Q

For valproic acid: site of action, seizure type treated, and main side effects?

A

Na+ channels, GABA receptor

partial, generalized

GI symptoms, tremor, weight gain, hair loss, hepatotoxicity, thrombocytopenia

22
Q

For phenobarbital: site of action, seizure type treated, and main side effects?

A

GABA receptor

partial, generalized

sedation

23
Q

Ethosuximide: site of action, seizure type treated, and main side effects?

A

T-type Ca2+ channel

Absence

GI symptoms

24
Q

Gabapentin: site of action, seizure type treated, and main side effects?

A

unknown, but possibly a voltage-gated Ca2+ channel

partial

sedation, ataxia

25
Q

Lamotrigine: site of action, seizure type treated, and main side effects?

A

NA+ channel, glutamate receptor

partial, generalized

Rash, Stevens-Johnson syndrome

26
Q

Topiramate: site of action, seizure type treated, and main side effects?

A

NA+ channel, GABA activity

partial, generalized

word-finding difficulty, renal stones, weight loss, tingling in hands and feet

27
Q

Tiagabine: site of action, seizure type treated, and main side effects?

A

GABA reuptake

partial

sedation

28
Q

Levetiracetam: site of action, seizure type treated, and main side effects?

A

unknown, but possibly at synaptic vesicles

partial, generalized

insomnia, anxiety, irritability

29
Q

Oxcarbazepine: site of action, seizure type treated, and main side effects?

A

Na+ channel

partial

sedation, hyponatremia

30
Q

Zonisamide: site of action, seizure type treated, and main side effects?

A

unknown mech of action

partial, generalized

sedation, renal stones, weight loss

31
Q

What are the management steps for status epilepticus?

A
  1. ABCs, check glucose, establish IV access
  2. 100 mg IV thiamine followed by D50 influsion
  3. Lorazepam 0.1 mg/kg IV
  4. Phenytoin 20 mk/kg IV (or fosphenytoin)
  5. intubate if not already done
  6. phenobarbital 20 mg/kg IV
  7. induce coma with barbiturates, midazolam or propofol and institute continuous beside EEG monitoring
32
Q

Which AED is particularly concerning for birth defects?

A

valproic acid (neural tube defects)