Seizures Flashcards
What is the concept of kindling in regards to seizures?
seizures beget seizures
What is the irritative zone?
area of cortex that generates interictal spikes
What is the ictal onset zone?
area of cortex where seizures are generated
What is an epileptogenic lesion?
structural abnormality that is direct cause of epileptic seizures
What is a symptomatogenic lesion?
area of the brain that first manifests seizure symptoms
What is the functional deficit zone?
cortical area of nonepileptic dysfunction
What is the epileptogenic zone?
area of brain necessary and sufficient for initiating seizures; removal or disconnection required for amelioration of seizures
What is Todd’s paralysis? What causes it?
post ictal paralysis, could be due to decreased glucose or increased lactate
What EEG findings are seen on Absence seizures?
3 Hz Spike and Wave
What does pathology show on mesial temporal lobe sclerosis?
hippocampal atrophy with gliosis and neural loss in CA1, CA4, and dentate gyrus
What is West’s syndrome?
infantile spasms; repeated extension and flexion of the neck, trunk, and extremities
What is characterizes West’s syndrome (infantile spasms) on EEG?
hypsarrhythmia (chaotic background with random high voltage, slow spike and wave)
What is the treatment for infantile spasms (West syndrome)?
ACTH, vigabatrin, and ketogenic diet
What are Benign epilepsy of childhood with Rolandic spikes? What is the typical clinical course?
focal motor seizures typically of the face during sleep-wake transitions; conscious but aphasic post ictally
remits spontaneously by adolescences
What is Juvenile myclonic epilepsy?
myoclonus in the morning without loss of consciousness, affects upper > lower
What is the inheritance pattern of Juvenile myoclonic epilepsy?
Autosomal dominant
What is the treatment of juvenile myoclonic epilepsy?
valproic acid for life
What characterizes Lennox-Gastaut syndrome?
multiple seizure types with mental retardation
What surgical options are available for patients with Lennox Gastaut syndrome?
VNS and corpus callosotomy
What is the mechanism of action of phenytoin?
Na Channel blockade
There are many side effects to phenytoin. What are some of the most serious ones?
Steven Johnson syndrome, cerebellar degeneration
What is the mechanism of action of Carbamazepine/Oxacarbazepine?
Na channel blockade
What are the side effects of Carbemazepine/Oxacarbazepine?
Pancytopenia and SIADH
What is the MOA of Lacosamide?
Na channel blocker
