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X Clin Med III Final Exam > Seizures > Flashcards

Seizures Flashcards

1
Q

What is epilepsy?

A

Condition in which person has recurrent seizures due to a chronic, underlying procss
At least 2-3 seizures w/o clear precipitating factors!!

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2
Q

Tonic vs clonic

A

Tonic: rigid posturing, continuous muscle tension
Clonic: repetitive, flexion/extension movements

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3
Q

Types of partial seizures

A

Simple (no loss of consciousness or memory)
Complex (consciousness or memory impaired)
Secondarily generalized

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4
Q

Impaired consciousness with complex partial seizure

A

Unable to respond to visual or verbal commands
Reduced awareness of ictal period
May become partial with secondary generalization

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5
Q

General description of simple partial seizure (focal aware seizure)

A

Depending on areas involved

Pt can interact with others during and recall events

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6
Q

Simple partial seizure affecting motor cortex

A

Clonic movements starting in hand or foot and progressing to involve whole limb (Jacksonian seizure)
Todd’s paralysis: lasts minutes to hrs

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7
Q

Simple partial seizure affecting sensory cortex

A

Paresthesias, numbness of limb, face

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8
Q

Simple partial seizure affecting temporal lobe

A

Deja vu

Epigastric discomfort

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9
Q

Simple partial seizure affecting occipital lobe

A

Flashing lights

Visual changes

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10
Q

Most common type of seizure in adults with epilepsy

A

Complex partial seizure

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11
Q

Phases of complex partial seizure

A

May start with aura (psychic sx)
Ictal phase: sudden behavioral arrest or motionless stare and then automatisms (involuntary, automatic behaviors like chewing, swallowing, emotions, hand movements etc)
Posticital: HA, confusion, amnesia, somnolence

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12
Q

Generalized seizures

A

Bilateral electrical discharge arising from both cerebral hemispheres simultaneously

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13
Q

Absence (petit mal) seizure

A

Characterized by sudden brief LOS without loss of postural control
5-10 sec
No postictal confusion!!

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14
Q

EEG pattern of absence seizure

A

Generalized spike and wave pattern

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15
Q

Most common type of seizure due to metabolic problems

A

Tonic clonic (grand mal)

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16
Q

What is the typical grand mal seizure?

A 
Sudden LOC, fall to ground
Tonic phase (tonic contractions like body rigid or jaw clench or eyes roll back)-increase BP and HR
Clonic phase (muscle groups relax and contract and may froth)- 30 sec to 3 min
Postictal phase (minutes to hours with confusion or sleepiness)
17
Q

Generalized myoclonic seziure

A

Sudden, brief generalized muscular contraction of limbs and trunk

18
Q

Most common times to see generalized myoclonic seizures

A

Metabolic disorders
Degenerative CNS diseases
Anoxic brain injury

19
Q

Benign form of myoclonus

A

Sudden jerking movements experienced as fall asleep

20
Q

Atonic seizure

A

Sudden loss of postural tone for about 1-2 sec (briefly impair consciousness, no postictal confusion, can fall to ground)
Usually associated with another form of epilepsy

21
Q

Tonic seizure

A

Typically, sudden stiffening of body with loss of balance

Very brief

22
Q

Association with tonic seizures

A

Significant brain disease (poor prognosis)

23
Q

Labs to do with a seizure

A 
CBC, Ua
CMP
Serum Mg
Toxicology
Syphilis screen
24
Q

Imaging for all new onset seizures

A

Cranial CT or MRI

CXR

25
Q

Key diagnostic test for seizures

A

EEG

26
Q

Tests for pts with refractory seizures

A

PET or single photo emission tomography (SPECT)

27
Q

When to call 911 with a seizure

A 
Person does not have epilepsy
Longer than 5 min
Second seizure before recover
Regular breathing not return
DM
In water
Pregnany
If they were injured
28
Q

Status epilepticus

A

Continous seizures or recurrence without gaining consciousness
Medical emergency! (heart and lung probs, metabolic derangements, hyperthermia, brain damage after 2 hrs)

29
Q

Tx of status epilepticus

A 
IV access (anticonvulsant-lorazepam or diazepam or phenytoin)
50% glucose, narcotic antagonist or thiamine
30
Q

How to start AED therapy

A

Usually with 1 drug and titrated upwards

31
Q

Drug to use with all types of seizures

A

Valproic acid

32
Q

Surgical tx for refractory seizures

A

Temporal lobectomy
Lesionectomy
Corpus callostomy
Vagal nerve stim (implantable pacemaker for partial seizures)

X Clin Med III Final Exam (6 decks)

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