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Foundations of Clinical Practice II > Seizures > Flashcards

Seizures Flashcards

1
Q

Definition of Seizures

A

Change in cortical electrical activity through transient sensory, motor or behavior changes

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2
Q

What is Epilepsy

A

Recurrent unprovoked seizures secondary to an underlying cerebral disorder

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3
Q

What is Status Elipticus

A

Medical emergency where epileptic seizure continues or is repeated without regaining consciousness

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4
Q

What is an Aura

A

A subjective sensation experienced before onset of some disorders (feeling of pain, smelling burning wood)

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5
Q

What is Automatism?

A

Automatic, involuntary movement during a seizure

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6
Q

Provoked vs Unprovoked seizures?

A

Provoked- specific trigger

Unprovoked- Not associated with a precipitating cause

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7
Q

What is a another name for a Simple partial seizure?

A

Focal Aware seizure

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8
Q

What is another name for Complex partial seizure

A

Focal Impaired Awareness seizure

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9
Q

What are the 2 classifications of Focal seizures

A
  1. Focal Aware

2. Focal Impaired Awareness

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10
Q

Most common Etiology of epilepsy?

A

Idiopathic 50%

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11
Q

Etiologies of Epilepsy

A 
Vascular disease
Idiopathic (50%)
Trauma
Alzheimers
Metabolic
Infection
Neuropathy
Drugs
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12
Q

Differential Diagnoses/Seizure Imitators

A

Syncope (MC immitator)
Paroxysmal movement disorders
Sleep Disorders
Transient Ischemic Attack

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13
Q

What are the most important questions to ask when obtaining a history of seizure disorder

A
  1. Family history
  2. Any history of head trauma
  3. Alcohol and medications
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14
Q

What diagnostic studies are needed to determine seizures?

A
  1. EEG
  2. Neuroimaging
  3. Labs (CBC, CMP, PRL, CK, toxicology screening for alcohol)
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15
Q

What are some other possible diagnostic tests you could order for seizures

A
  1. EKG

2. LP

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16
Q

What is the reasoning behind ordering CMP, PRL, and CK

A

CMP= Liver function

CK- From increased muscle shaking and tremors during seizure

PRL- Increased levels from altering regulation of the hormone form the hypothalamus

17
Q

Which is a preferred neuroimaging for seizures?

A

MRI- prefferrd over CT to identify any lesions, infarcts or tumors

18
Q

What kind of Electricalencephalogram will yield the best results to test for seizures?

A

Serial EEG’s (taken over a period of time)

19
Q

What does Focal onset mean?

A

Seizure activity originates in one part of the brain

20
Q

What are the symptoms of a Focal Aware seizure

A
  1. No alteration of awareness (consiousness)

2. Symptoms vary depending on the site of origin of seizure activity

21
Q

What is unique about the symptoms of Focal Aware (Simple Partial) seizures

A

The site of irritable focus determines which body functions are affected by a focal seizure

22
Q

What are symptoms of Focal Impaired Awareness seizures?

A
  1. Impairment of awareness (consiousness)
  2. Purposeless automatisms (repetitive behaviors -facial grimacing, chewing, lip smacking, snapping fingers)
  3. Postictal confusion +/- fatigue
23
Q

Symptoms seen in a Generalized Non-motor seizure (Absence)?

A
  1. Abrupt onset
  2. Sudden staring with impaired awareness (conciousness)
  3. Eyelid fluttering/minor automatisms
  4. EEG- will show a 3 Hz spike-and-slow wave pattern
24
Q

Symptoms of a Generalized Motor seizure (Myoclonic)?

A
  1. No alterations in awareness
  2. Sudden muscle contractions (jerks) that affect the arms bilaterally
  3. Often multiple or in clusters
25
Q

Symptoms/Components of a Generalized Motor Tonic-Clonic seizure

A
  1. Aura
  2. Tonic phase- stiffness of muscles
  3. Clonic phase- jerking and twitching of muscles
  4. Postical phase- patient is confused, fatigued
26
Q

Symptoms of a Generalized Motor Atonic Seizure

A
  1. Loss of control of the muscles, particullarly in the legs
  2. Result in collapsing
  3. Poor overal prognosis
27
Q

Another name for Generalized Motor Atonic seizures are?

A

Drop seizures

28
Q

What is the most common type of Febrile seizures in children under 5?

A

Generalized tonic-clonic seizures

29
Q

What are AAP guidelines for evaluating a child with Febrile seizures?

A

EEG, blood tests and neuroimaging should not be routinely performed

If a lab test is ordered it should focus on the cause of a fever not the cause of a seizure

30
Q

What is the criteria to diagnose Status Epilepticus?

A
  1. Single seizure lasting more than 5 minutes
    OR
  2. Two or more seizures without full recover between seizures
31
Q

1 cause of Status Epilepticus?

A

Non-compliance with antiepileptic medications in seizure patients

32
Q

Basics of seizure management steps

A
  1. Determine the type of seizure
  2. Determine risk of recurrence
  3. Rule out secondary causes
  4. Referral to Neurology
  5. Antiepileptic drugs should not be recommended after one seizure
33
Q

How is epilepsy treated?

A

ABC’s = Airway, Breathing, Circulation

IV Ativan (Lorazepam)

Foundations of Clinical Practice II (23 decks)

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