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Neurologic Conditions > Seizures > Flashcards

Seizures Flashcards

1
Q

What should be included in the DDx for seizures?

A
  • Syncope
  • TIA
  • Migraine
  • Hypoglycemia
  • Parasomnia
  • Pseudoseizure
  • Movement disorder
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2
Q

What inc the risk of seizures?

A
  • Brain injury
    • FHx
  • Neuro or Psych d/o
  • Drugs that dec threshold for seizures
  • Illicit drugs or alcohol
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3
Q

What is a Non-Epileptic seizure?

A

Spells of convulsions or non-convulsive events d/t a provactive stimulus

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4
Q

What are the provocative stimulus events that cause Non-epileptic seizures?

A
  • Prolonged sleep deprivation
  • Alcohol cessation after a prolonged binge
  • Excessively low Na, Ca, Mg or glucose
  • Drugs which “lower seizure threshold”
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5
Q

Do Non-epileptic seizures occur w/o provocative stim?

A

No

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6
Q

Is there a FHx of epilepsy in Non-epileptic seizures?

A

No

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7
Q

What will be found on PE in Non-epileptic seizures?

A
  • PE normal unless going thru alcohol w/ drawal
  • Tetany w/ very low serum Ca
  • Tachycardia & ABN behavior if under influence of drugs
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8
Q

What are the technical features in Non-epileptic seizures?

A
  • Interictal events EEG is usually normal
  • Serum Ca or Na may be very low during the event
  • Brain imaging usually normal
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9
Q

What causes Non-epileptic seizures?

A

Physio & physical changes can disturb the excitability of brain neurons permitting them to discharge spon

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10
Q

What is the tx for Non-epileptic seizures?

A

Reverse cause if possible

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11
Q

What is Epilepsy?

A

Seizures w/o a reversible cause

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12
Q

How do you dx epilepsy?

A

Based on hx of pt or witness

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13
Q

Who gets Partial seizures?

A

Happens at any age

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14
Q

What does Simple Partial seizure mean?

A

Consciousness not affected

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15
Q

What does Complex Partial seizure mean?

A

Consciousness affected

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16
Q

What is the location of Partial seizures?

A

Unilateral

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17
Q

What are the sx of Simple Partial epilepsy based on cortex of origin?

A
  • Motor sx= motor cortex
  • Sensory sx= parietal cortex
  • Visual sx= occipital lobe
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18
Q

What are the Psychic sx of Simple Partial Epilepsy?

A

Freightful or angry but awake & alert esp around temporal lobe

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19
Q

What is found on PE on Simple Partial Epilepsy?

A
  • Interictal exam may be normal
  • Reflect damage to area of brain where seizure originates
20
Q

What are the technical feaures of Simple Partial Epilepsy?

A
  • EEG will be normal >50% of the time
  • When EEg reveals “spikes” or seizures discharges, they typically emanate from the specific ABN area of cortical dysfx
  • +/- Brain imaging
  • MRI w/ & w/o contrast ~15% more sensitive than CT in localizing seizure onset
21
Q

Which epileptic pts should should get brain imaging?

A

MRI w/ or w/o contrast in adults w/ new onset seizure, children w/ ABN neuro exams or clearly focal seizures

22
Q

What causes Simple Partial Epilepsy?

A

Seizures us. result from damage to cerebral cortex

Most d/t brain lesions but some genetic

23
Q

What is Todd’s Postictal Paralysis?

A

Inhibitory neurons have turned off excitatory neurons to a focus→ limb paralysis→ CI to TPA (for stroke)

24
Q

How does Complex Partial Epilepsy begin?

A

Begin as a simple seizure & become secondarily complex or may begin as a complex seizure

25
Q

What are the assoc sx of Complex Partial Epilepsy?

A

Motor, sensory or autonomic

26
Q

Are Complex Partial Seizures convulsive or non-convulsive?

A

May become convulsive or non-convulsive

27
Q

What are the technical features of Complex Partial Epilepsy?

A
  • MRI may show mesial temporal lobe sclerosis
28
Q

How do pt w/ mesial temporal lobe sclerosis respond to meds?

A

Refractory to medicine (15%)

29
Q

Of the mesial temproal lobe sclerosis pts that are refractory to meds, how many can be controlled by surger & meds?

A

85%

30
Q

Which area of the brain is suited to sugical success w/ low morbidity?

A

Medial temporal lobes

31
Q

What causes Partial Onset-Secondarily Generalized Epilepsy?

A

Simple or complex partial onset comes secondarily generalized convulsive

32
Q

What do pts w/ Partial Onset-secondarily generalized Epilepsy experience w/ convulsions?

A

Injuries, tongue biting or urinary incontinence

33
Q

What is Convulsive Status Epilepticus?

A

Convulsions >30 min or series occuring repetitively over 30 min w/o regaining consciousness

Medical Emergency!!

34
Q

What is found on PE in Partial Onset-secondarily generalized epilepsy?

A

Injuries or tongue biting from convulsions

Neuro intact or neuro & intellectual deficits

35
Q

What is the cause of Primary Generalzied Epilepsy (PGE) (or Absence, Petit mal)?

A

All are genetic (AD) & begin during childhood or adolescence

36
Q

Are Absence seizures convulsive?

A

No! non-convulsive

37
Q

What are the sx of Absence seizures?

A
  • No postural change
  • Eyes flutter
  • No postictal confusion
38
Q

What activities can pt w/ Absence seizures continue?

A

Routine activities like walking, drawing or eating

39
Q

What can Absence seizures be precipitated by?

A

Hyperventilation (presumably d/t alkalosis)

40
Q

What is the prognosis of Absence seizures?

A
  • 1/3 disappear by adolescence or later
  • 1/3 persist
  • 1/3 develop other types of PGE
41
Q

What are the technical features of Absence seizures?

A
  • Brain imaging is usually normal
  • EEG shows char generalized spike-wave discharges; most typically 3/second
42
Q

What causes Primary Generalized Epilepsy (Myoclonic)?

A

Genetic

43
Q

What are the characteristics of Primary Epilepsy (Myoclonic)?

A

Generalized brief (whole body or both arms) jerks or spasms

44
Q

What are the technical features of Myoclonic epilepsy?

A

Same as Absence seizures expect the waves are 4-6/sec range

45
Q

What are Generalized convulsive or Grand mal seizures?

A
  • Most dramatic
  • Injuries common
  • Cannot tell were convulsions begin partially or primary generalized
46
Q

What are the technical features of Generalized convulsive or Grand mal seizures?

A
  • Generalized EEG ABN
  • Brain imaging normal unless brain injured from repeated head trauma

Neurologic Conditions (15 decks)

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