Seizures And Epilepsy

Question 1

Percentage of the population that will have at least one seizure ?

Answer 1

5-10%

Question 2

The highest incidence of seizures occurs in ?

Answer 2

Early Childhood and Late Adulthood

Question 3

Focal Seizures are usually associated with ?

Answer 3

Structural Abnormalities of the brain

Question 4

3 Characteristics of focal seizures ?

Answer 4

Jacksonian march
Todd’s paralysis
Epilepsia Partiallis Continua (often refractory to medical therapy)

Question 5

Examples of automatisms

Answer 5

chewing,lip smacking,swallowing, or more elaborate behaviors e.g running or display of emotion

Question 6

Absence seizures are usually accompanied by ?

Answer 6

Subtle, bilateral motor signs such as rapid blinking,chewing movements, or small-amplitude,clonic movements of the hands

Question 7

Tonic Contraction of the laryngeal and expiratory muscles at the onset of generalized seizures may produce ?

Answer 7

A loud moan or ictal cry

Question 8

Define Hypsarrhythmia (EEG correlate of epileptic spams)

Answer 8

Hypsarrhythmia consists of diffuse,giant slow waves with a chaotic background of irregular,mutlifocal spikes and sharp waves

Question 9

Patients with juvenile myoclonic epilepsy may also experience ?

Answer 9

Generalized tonic-clonic seizures and up to 1/3 have absence seizures

Question 10

Febrile Seizures usually occur between … and have a peak incidence between … ?

Answer 10

3 months and 5 years , 18 and 24 months

Question 11

Complex febrile seizures are characterized by ?

Answer 11

Repeated seizure activity, duration >15 minutes, or by focal features

Question 12

Which disease may account for appr. 50% of new cases of epilepsy in patients >65 years

Answer 12

Cerebrovascual disease,including subdural hematoma

Question 13

Penicillin lowers the seizure threshold in humans by which mechanism ?

Answer 13

β-lactam ring associated antagonism of GABA at its receptor

Question 14

Certain behaviors associated with psychogenic rather than epileptic seizures ?

Answer 14

pelvic thrusting,side-to-side turning of the head, asymmetric and large-amplitude shaking limb movements

Question 15

Measurement of which serum marker may help to distinguish between epileptic and psychogenig seizures ?

Answer 15

Prolactin (during the immediate 30-min postictal period)

Question 16

Generally accepted risk factors associated with reccurent seizures include (5) ?

Answer 16

Abnormal Neurologic Examination
Seizures presenitng as Status Epilepticus
Postictal Todd's paralysis
Strong Family History of Seizures
Abnormal EEG

Question 17

Important side effect of lamotrigine ?

Answer 17

Skin rash that may lead to Stevens-Johnson Syndrome if unrecognized

Question 18

A significant number of patients taking levetiracetam complain of… ?

Answer 18

Anxiety, irritability and other psychiatric symptoms

Question 19

Approximately what percentage of epileptics do not respond to treatment with a single antiepileptic drug ?

Answer 19

One-Third

Question 20

Approximately what percentage of patients treated with temporal lobectomy become seizure free ?

Answer 20

70% (another 15-25% will have at least a 90% reduction in seizure frequency)