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Epilepsy > Seizures > Flashcards

Seizures Flashcards

1
Q

Where in the cortex do generalize myoclonic seizures arise?

A

In the frontal lobe, especially the SMA region.

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2
Q

EMU studies of patient recall of seizures have found what about memory?

A

There is a greater incidence of loss of memory in left temporal lobe seizures.

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3
Q

In EMU studies what was found concerning awareness?

A

Greater likelihood of retained awareness of patients with right hemisphere ictal onset compared to left hemisphere onset.

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4
Q

What percentage of newly diagnosed patients with epilepsy ultimately achieve seizure freedom for 1 year or more on AEDs?

A

68%

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5
Q

What is the point prevalence of epilepsy in the USA nursing home population?

A

60 per 1,000 residents or 6%

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6
Q

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

A

Stroke, it represents 30% of the total number of cases.

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7
Q

What temperature range for induced systemic hypothermia to terminate status epilepticus?

A

31-35 degrees centigrade

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8
Q

What Systemic temperatures are associated with unacceptable morbidity?

A

30-31 degrees centigrade

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9
Q

Can seizures associated with focal epilepsy be forecasted by patients?

A

No

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10
Q

Seizures associated with focal seizures are usually singly or in clusters?

A

Clusters

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11
Q

What medications have class I evidence in the treatment is convulsive status?

A

Lorazepam, diazepam, and phenytoin or fosphenytoin

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12
Q

What is the preferred AED in CAE without convulsions?

A

ETX

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13
Q

In CAE which drug has a smaller effect on ADHD?

A

ETX

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14
Q

In CAE did ETX, VPA, or LTG differ in intolerable side effects?

A

No

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15
Q

What is the incidence of childhood epilepsy?

A

0.5 and 0.7 per 1,000 persons per year

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16
Q

What is the percentages of focal epilepsies?

A

60%

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17
Q

What proportion of childhood epilepsies are symptomatic focal epilepsies?

A

80%

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18
Q

When is the usual onset of childhood onset of focal symptomatic epilepsies?

A

Infacy

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19
Q

After 2 seizures what is the probability of additional seizures at 1 year and 4 years?

A

57% at 1 year and 73% at 4years

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20
Q

After the first unproved seizure in adults, what is the risk for seizure reoccurrence over the next 2 years if the EEG and MRI are normal?

A

25%

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21
Q

Does treatment after the first seizure in adults improve the prognosis for seizure remission?

A

Likely not

22
Q

Chronic epilepsy in the elderly and what other factors may contribute to cognitive deficits?

A

Vascular, inflammatory, and lifestyle factors.

23
Q

Although accumulation of tau and amyloid are found are there any characteristic associated with the Braak score?

A

No

24
Q

Panayiotopoulos syndrome semiology?

A

Out of sleep, pallor, nausea, retching, and repeated emesis and normal past history

25
Q

On EEG Panayiotopoulos looks like?

A

Posterior often occipital predominant discharges, elicited by eye closure while awake (fixation- off sensitivity)

26
Q

How does Gastaut type benign epilepsy differ from Panayiopoulos in semiology?

A

Brief visual hallucinations or transient loss of vision

27
Q

In Panayiopoulous the EEG can be seen with other locations of spikes?

A

Yes, 23% can have multi focal discharges

28
Q

Can primary generalizedepilepsies have focal clinical and electrographic findings?

A

Yes, up to 50% of patients

29
Q

What is the most effective AED for primary generalized epilepsy?

A

VPA although LTG and TPM are also effective

30
Q

In the SAND study which AED was better tolerated for primary generalized seizures?

A

VPA was better tolerated than TOM and LTG

31
Q

What AED was recently, 2015, was approved in the US for adjunctive treatment of primary generalized epilepsy?

A

Perampanel

32
Q

What semiology is seen in seizures arisin from the SMA?

A

Seizures coming out of sleep, short (10-20sec), with bikateral stiffness and abduction of all extremities, often with a loud tonic vocalization.

33
Q

What are independent determinants of mortality following status epilepticus?

A

Age, duration of status, etiology (e.g.- anoxia)

34
Q

Midline spikes are associated with what type of seizures?

A

70% of patients with midline spikes have generalized seizures

35
Q

At what age does idiopathic myoclonic epilepsy of infancy/childhood begin?

A

Between 4 months and 3 years

36
Q

In idiopathic myoclonic epilepsy of childhood is there a sex difference?

A

Slightly more common in boys

37
Q

How common are seizures in idiopathic myoclonic seizures of infancy?

A

Seizures often multiple times per day but not usually in clusters, seizures are brief lasting less than 1-3 seconds, and epileptic fall or head drop is not seen.and not associated with clinic or tonic movements.

38
Q

What does the EEG usually show during the myoclonic seizure in idiopathic myoclonic epilepsy if infancy?

A

2.5 - 4 Hertz spike wave

39
Q

What are dacrystic seizures?

A

Paroxysmal, stereotyped crying, usually with tears and sad face

40
Q

What is the usual etiology of dacrystic seizures?

A

With gelastc seizures- hypothalamic hamartoma and without gelastc seizures- temporal lobe

41
Q

What are the common features of the epilepsy syndrome of eyelid myoclonic with absences?

A

Photosensitivity with clinical events of repetitive eyelid blinking usually around 4-6 Hz.

42
Q

In the syndrome of eyelid myoclonic with absences, what is a potent precipating factor?

A

Eye closure is more potent than photic stimulation without eye closure.

43
Q

The eyelid myoclonic seizures in eyelid myoclonic with absences, what is the EEG correlation?

A

Most but not all eyelid myoclonic associated 3-6 Hz mixed spike, polyspike, spike wave. Some eyelid myoclonic events do not have an EEG correlate,

44
Q

Hypothermia in newborns with HIE will produce less or more seizures?

A

Less seizure burden

45
Q

What percentage of patients with stroke have at least a single seizure?

A

10%

46
Q

What is the percentage of stroke patients develop epilepsy?

A

2-5%

47
Q

When do seizures usually occur after a stroke?

A

A few weeks after the stroke

48
Q

What percentage of JME patients will be able to come off medications?

A

10% - 20%

49
Q

What causes loss of consciousness in focal seizures?

A

Seizure spread to subcortical structures-thalamus- which inhibits subcortical arousal systems and disruptions of normal cortical-thalamus and widespread neocortical interactions

50
Q

Insular seizure semiologies

A

Viscerosensory, somatosensory phenomena

Epilepsy (17 decks)

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