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clin med III final > Seizures > Flashcards

Seizures Flashcards

1
Q

define epilepsy

A
  • a condition in which a person has recurrent sz due to a chronic, underlying process
    • at least 2-3 sz w/o clear precipitating factors
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2
Q

interictal

A
  • between seizures
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3
Q

clonic

A
  • repetitive, flexion/extension movements
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4
Q

tonic

A
  • rigid posturing, continuous muscle tension
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5
Q

epileptogenic

A
  • factors that lower one’s sz threshold
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6
Q

epileptiform

A
  • having the appearance of sz activity
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7
Q

list the types of partial sz

A
  • simple partial
  • complex partial
  • partial with secondary generalization
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8
Q

list types of generalized sz

A
  • absence
  • generalized tonic clonic
  • myoclonic
  • atonic
  • tonic
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9
Q

partial seizures arise from what area of the brain

A
  • focal area
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10
Q

differentiate between simple partial and complex partial sz

A
  • simple: no alteration of consciousness
  • complex: impaired consciousness
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11
Q

jacksonian seizure

A
  • type of simple partial sz
  • clonic movements starting in hand or foot and progressing to involve whole limb
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12
Q

todd’s paralysis

A
  • focal weakness in a part of the body after a seizure.
  • typically affects appendages and is localized to either the left or right side of the body
  • usually subsides completely within 48 hours
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13
Q

simple partial sz in temporal lobe usually presents as

A
  • deja vu
  • epigastric discomfort
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14
Q

describe complex partial sz

A
  • combination of focal motor and focal sensory activity with alteration of consciousness
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15
Q

automatisms

A
  • involuntary, automatic behaviors
    • e.g chewing, lip smacking, swallowing, hand movements, emotional outburst
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16
Q

define generalized seizures

A
  • bilateral generalized electrical discharge arising from both cerebral hemispheres simulataneously
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17
Q

which sz is characterized by a sudden brief loss of consciousness lasting only a few seconds without loss of postural control

A

absence “petit mal”

18
Q

absence “petit mal” sz may be confused with

A

daydreaming

19
Q

is absence “petit mal” associated with postictal confusion

A

no, consciousness returns promptly

20
Q

during a absence “petit mal”, pt is absent to during the attack

A

higher cortical function

21
Q

most common type of sz due to metabolic syndromes

A

tonic-clonic “grand mal”

22
Q

describe tonic clonic sz

A
  1. sudden loss of consciousness
  2. tonic phase (10-40 sec): body rigid
  3. clonic phase (30 sec - 3 min): muscles relax and contract, lose bowel/bladder control
  4. postictal phase (min to hours)
23
Q

define status epilepticus

A
  • continuous sz, or recurrence without regaining consciousness
24
Q

status epilepticus is a medical emergency and can lead to

A
  • cardiorespiratory dysfunction
  • metabolic derangement
  • hyperthermia
  • irreversible brain damage after 2 hr
25
Q

which type of sz presents as sudden, brief generalized muscular contraction of limbs and trunk

A
  • generalized myoclonic sz
26
Q

generalized myoclonic sz is most commonly seen in what conditions

A
  • metabolic disorders
  • degenerative CNS disease
  • anoxic brain injury
27
Q

what are atonic seizures

A
  • sudden loss of postural tone lasting 1-2 sec
    • consciousness briefly impaired, no postictal confusion
    • may cause brief drop of head or nodding movement
    • longer -> fall to ground
28
Q

what are some drugs that lower sz threshold

A
  • theophylline: PDE inhibitor
  • anticonvulsants
29
Q

why should serum magnesium level be ordered in pt presenting with sz

A

low magnesium -> sz

30
Q

key diagnostic test for sz

A

EEG

31
Q

immediate treatment of acute sz

A
  • ABC
  • do no try to put anything in patient’s mouth
  • turn pt on side, protect head
32
Q

acute treatment of status epilepticus

A
  • IV lorazepam or diazepam +
  • IV phenytoin
33
Q

acute treatment of status epilepticus that continue after lorazepam and phenytoin tx

A
  1. add phenobarbital
  2. midazolam
34
Q

Antiepileptic drugs therapy is almost always started with how many drugs

A
  • single drug
    • ​titrated upward
35
Q

first line drugs for partial seizuers

A
  • carbamazepine
  • phenytoin
  • valproic acid
36
Q

first line drugs for generalized tonic-clonic

A
  • valproic acid
  • carbamazepine
  • phenytoin
37
Q

first line drugs for absence seizuers

A
  • ethosuximide
  • valproic acid
38
Q

first line drugs for myoclonic seizuers

A
  • valproic acid
39
Q

first line drugs for atonic seizuers

A
  • valproic acid
40
Q

what is vagal nerve stimulation

A
  • tx of refractory partial sz
  • implantable pacemaker-like device

clin med III final (7 decks)

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