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Neurology > Seizures and Epilepsy > Flashcards

Seizures and Epilepsy Flashcards

1
Q

What is a seizure?

A

abnormal electrical activity of the brain that involves all or limited to single part of the brain
can range from muscular convulsive activity or experiential phenomena (physical or personal)

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2
Q

What is ictal?

A

when person is in a seizure

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3
Q

Postictal?

A

how long it takes from someone to get back to normal after seizure

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4
Q

WHat is epilepsy?

A

recurrent seizures: 2+ unprovoked seizures

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5
Q

Normally, brain is…?

A

balanced between excitable and inhibited

can have seizure under appropriate circumstances

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6
Q

How does brain change overtime?

A

criteria for having seizures change: triggers from 4yo can be different from today’s triggers

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7
Q

Seizure - RF?

A

family hx
head trauma
druggie
ETOH

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8
Q

How do antiepileptic drug act?

A

blocking initiation/spread of seizure throughout the brain

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9
Q

Seizure- cx?

A

unknown

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10
Q

Classification of seizure?

A

partial seizure
generalized seizure
status epilepticus

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11
Q

Classification of partial seizure?

A

simple

complex

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12
Q

Simple partial seizure?

A

pt is aware of seizure that is happening - conscious

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13
Q

Types of simple partial seizure?

A

jacksonian march

todd’s paralysis

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14
Q

Jacksonian march?

A

motor seizure

starts in limited areas (fingers) to larger areas (arm)

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15
Q

Todd’s paralysis?

A

temporary paresis of the area that had the seizure attack

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16
Q

Complex partial seizure?

A

not conscious

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17
Q

Complex partial seizure - sx/pe?

A

staring

automatisms -involuntary autonomic movements (lips smacking, chewing)

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18
Q

Partial seizure + secondary generalization?

A

starts as partial seizure but turns into a generalized seizure

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19
Q

Pt eyes blink –> lips smacking –> seizure?

A

partial seizure + secondary generalization

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20
Q

Partial seizure + secondary generalization - dx?

A

EEG

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21
Q

Generalized seizure?

A

seizure that is on both cerebral hemispheres

NO focal onset

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22
Q

Types of generalized seizures?

A 
absence seizures
generalized + tonic-clonic/Grand mal
atonic 
myoclonic
psychogenic
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23
Q

What is absence seizure?

A 
loss of consciousness
NO postictal 
seconds of staring
\+/-chewing/smacking
100x day
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24
Q

When does absence seizure occur the most?

A

childhood

25
Q

Parent gets a phone call from school that child is “daydreaming”?

A

Absence seizure/petit mal

26
Q

Generalized tonic clonic seizure/grand mal?

A

most common in adults

27
Q

Generalized tonic clonic seizure/grand mal - phases?

A

tonic
clonic
postictal

28
Q

Generalized tonic clonic seizure - tonic phase?

A

ictal cry
contraction of muscles
cyanosis
sympathetic discharge (BP and pulse incr, pupils dilate)

29
Q

Generalized tonic clonic seizure - clonic phase?

A

alteration of tonic-clonic-tonic phase (contraction/no contraction/contraction, etc)

30
Q

Generalized tonic clonic seizure - postictal phase?

A

patient is no longer in seizure but is not “normal/self” yet
excess salvia
bladder/bowel incontinence

31
Q

Keep in mind about generalized tonic clonic seizure?

A

not always in tonic-clonic-postictal phase

could be purely tonic, clonic

32
Q

How to tell if pt is faking generalized seizure?

A

pt doesnt turn cyanotic

33
Q

Atonic seizure?

A

sudden loss of postural muscle tone and BRIEF unconsciousness
NO postictal

34
Q

Atonic seizure-hallmark?

A

head drop

35
Q

Atonic seizure-what to be careful of?

A

head trauma d/t head drop

36
Q

Myoclonic seizure?

A

sudden brief muscle contraction (twitch when you’re falling asleep)

37
Q

Myoclonic seizure - cx?

A

metabolic disorder

CNS dz

38
Q

Pyschogenic seizure?

A

not a seizure that resembles a seizure

39
Q

Status epilepticus?

A

continuous simple partial seizure

continuous seizure for 5-30 min

40
Q

Status epilepticus also called?

A

Generalized Convulsive Status Epilepticus (GCSE)

41
Q

Status epilepticus - cx?

A

anticonvuslant withdrawal
metabolic disturbances
CNS infxn

42
Q

Neonate seizures - cx?

A

CNS infxn - ANY abnormality, go to ER and LP!
postpartum drug withdrawals - careful if mom is druggie
postpartum hypoglycemia - careful if mom is diabetic

43
Q

Early childhood seizures?

A

seizures w/fever but NO CNS abnormalities
3mo - 5yr
peak at 18-24mo

44
Q

Early childhood seizures - cx?

A

CNS infxn

45
Q

Childhood seizure- 8-12yo cx?

A

generalized seizures: idiopathic, temporal lobe epilepsy, mesial temporal lobe scleorsis
partial seizures: CNS development

46
Q

Early adulthood seizure cx?

A

drug abuse

head trauma

47
Q

Older adulthood seizure x?

A

CNS tumor
head trauma
metabolic disturbances - ETOH, hypoglyecmia

48
Q

What to check first w/ seizure pt?

A

vita signs
respiration
cardiovascular (need anything for the heart?)

49
Q

What will rule in seizure instead of TIA, syncope, vasovagal, etc?

A

aura (note: also in migraines)
cyanosis (key for differentiating between fakers)
unconsciousness (but not always - simple partial seizure: they are conscious)
postictal
muscle soreness (usually tremors, tics do not cause this)
motor manifestation

50
Q

When to do LP w/ seizures?

A

HIV pts

anyone who is suspicious of CNS infxn

51
Q

Seizures - labs/imaging?

A

EEG

*normal? does not r/o seizure disorder

52
Q

Generalized seizure - tx?

A

do not restraint
be mindful of anything thats around them that could hurt them
make sure to put them in lateral position - in case they vomit

53
Q

Seizure - tx?

A 
underlying condition (metabolic disturbance)
avoid triggers (lights, ETOH)
drug therapy
ketogenic diet
surgery
54
Q

Seizure drug therapy?

A

prevent seizures

  • recurrent
  • cx cannot be corrected (known)
55
Q

Status epilepticus - tx?

A

anticonvulsant therapy STAT

56
Q

What can happen if status epilepticus is not tx ASAP?

A

probs of the cardiorespiratory
metabolic
irreversible neoruonal damage

57
Q

Adult w/ new seizure - imaging?

A

CT to r/o tumor

58
Q

Most likely tx for seizures?

A

Keppra

Neurology (13 decks)

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