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neurology FA > seizures (and treatment) > Flashcards

seizures (and treatment) Flashcards

1
Q

Seizures?

A

characterized by synchronized, high-frequency neuronal firing. Variety forms

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2
Q

Seizures - types

A
  1. partial (focal)
  2. generalized
  3. partial that secondary generalize
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3
Q

partial vs generalized seizures

A

partial: affect single area of the brain
generalized: diffuse

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4
Q

partial (focal) seizures - most commonly originate in

A

medial temporal lobe

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5
Q

partial (focal) seizures - often preceded by

A

seizure aura

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6
Q

partial (focal) seizures - types

A
  1. simple partial

2. complex partial

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7
Q

simple partial seizures - characteristics

A

CONSCIOUSNESS INTACT

motor, sensory, autonomic, psychic

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8
Q

complex partial seizure - characteristics

A

IMPAIRED CONSCIOUSNESS

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9
Q

simple vs partial seizure according consciousness

A

simple - intact

complex - impaired

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10
Q

generalized seizures - types

A
  1. absence
  2. myoclonic
  3. tonic clonic
  4. tonic
  5. atonic
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11
Q

absence seizure is also called

A

petit mal

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12
Q

absence (petit mal) seizure - characteristics

A

3 hz, no postictal confusion,

blank stare

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13
Q

myoclonic seizure - characteristics

A

quit, repetitive jerks

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14
Q

tonic-clonic seizure is also called

A

grand mal

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15
Q

tonic-clonic (grand mal) seizure - characteristics

A

alternating stiffening and movement

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16
Q

tonic seizure - characteristic

A

stiffening

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17
Q

atonic seizure - characteristics

A 
drop seizures (falls to floor) 
commonly mistaken for fainting
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18
Q

epilepsy - definition

A

a disorder a recurrent seizures

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19
Q

epilepsy with fever?

A

FEBRILE SEIZURES ARE NOT EPILEPSY

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20
Q

status epilepticus?

A

continuous or recurring seizure(s) that may result in brain that variably defined as >10-30 min

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21
Q

status epilepticus - duration

A

> 10-30 min

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22
Q

causes of seizures in children

A
  1. genetic
  2. infection (febrile)
  3. trauma
  4. congenital
  5. metabolic
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23
Q

causes of seizures in adults

A
  1. tumor 2. trauma 3. stroke 4. infection
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24
Q

causes of seizures in elderly

A
  1. stroke 2. tumor 3. trauma 4. metabolic 5. infection
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25
Generilized seizures - types and characteristics
1. absence (petit mal) - 3 hz, no postictal confusion, blank stare 2. myoclonic - quick, repetitive jerks 3. tonic clonic (grand mal) - alternating stiffening and movement 4. tonic - stiffening 5. atonic - drop seizures (falls to floor), commonly mistaken for fainting
26
generalized epilepsy - mistaken for fainting
atonic
27
seizures - often preceded by aura
partial
28
epilepsy drugs?
1. ethosuximide 2. benzodiazepines 3. phenyntoin 4. carbamazepine 5. valproic acid 6. gabapentin 7. phenobarbital 8. topiramate 9. lamotrigine 10. levetiracetam 11. tiagabine 12. vigabatrin
29
ethosuximide - mechanism of action
blocks thalamic T-type Ca2+ channels
30
ethosuximide blocks ..... T-type Ca2+ channels (area)
thalamic
31
ethosuximide - clinical use
1st line for absence
32
ethosuximide - side effects
1. GI 2. fatigue 3. headache 4. urticaria | 5. Stevens-Johnson
33
epilepsy - benzodiazepines - drugs
1. lorazepam | 2. diazepam
34
epilepsy - benzodiazepines - clinical use
1. 1st line for acute status epilepticus | 2. also for eclampsia seizure
35
eclampsia seizure - 1st line
MgS04
36
epilepsy - benzodiazepines - side effects
1. sedation 2. respiratory depression 3. tolerance 4. dependence
37
phenytoin - mechanism
Na+ channel inactivation | ZERO kinetic order
38
Fosphenytoin?
phenytoin for parental use
39
phenytoin for parental use
Fosphenytoin
40
Phenytoin - side effects
A. Neurologic 1. nystagmus 2. diplopia 3. ataxia 4. sedation 5. peripheral neuropathy B. Dermatologic 1. gingival hyperplasia 2. hirsutism 3. Stevens-Johnson syndrome 4. DRESS syndrome C. Musculosceletal: 1. SLE like syndrome 2. osteopenia D. Hematologic: Megalobl anemia E. Reproductive: teratogenesis (fetal hydantoin syndrome) F. Other: c P-450 induction
41
phenytoin - pharmatokinetic characteristic
zero order kinetics
42
phenytoin - clinical use
1. simple seizure 2. complex seizure 3. tonic clonic seizure (1st line) 4. status epilepticus (1st line for prophylaxis)
43
carbamazepine - mechanism
Na+ channel inactivation
44
carbamazepine - clinical use
1. simple seizure (1st line) 2. complex seizure (1st line) 3. tonic clonic 4. 1st line for trigeminal neuralgia
45
Carbamazepine - side effects
1. diplopia 2. ataxia 3. blood dyscrasias (agranulocytosis, aplastic anemia) 4. liver toxicity 5. teratogenesis 6. induction of P-450 7. SIADH 8. Stevens-Johnson syndrome
46
Valproic acid - mechanism of action
1. Na+ channel inactivation | 2. increase GABA concentration by inhibiting GABA transaminase
47
Valproic acid - contraindicated in
pregnancy
48
Valproic acid - side effects
1. GI 2. distress 3. rare but fatal hepatotoxicity (messure LFTs) 4. teratogenesis (neural tube defects) 5. tremor 6. weight gain 7. pancreatitis
49
Valproic acid - clinical use
1. simple 2. complex 3. tonic-clonic (1st line) 4. absence 5. myoclonic 6. bipolar disorder 7. migraine prophylaxis
50
gabapentin - mechanism
1. primarily inhibits high voltage activated Ca2+ channels | 2. designed as GABA analogs
51
gabapentin - clinical use
1. simple seizures 2. complex 3. peripheral neuropathy 4. postherpetic neuralgia
52
Gabapentin - side effects
sedation | ataxia
53
phenobarbital - clinical use
1. simple 2. complex 3. tonic clonic 4. 1st line in neonates
54
phenobarbital - side effects
1, sedation 2. tolerance 3. dependence 4. induction of P-450 5. cardiorespiratory depression
55
topiramate - mechanism
1. blocks Na+ channels | 2. increase GABA action
56
topiramate - clinical use
1. simple 2. complex 3. tonic - clonic 4. migraine prevention 5. idiopathic intracranial hypertension (pseudotumor cerebri)
57
topiramate - side effects
1. sedation 2. mental dulling 3. kidney stones 4. weight loss
58
lamotrigine - mechanism
blocks voltage gated Na+ channels
59
lamotrigine - side effects
Steven Johnson Syndrome
60
lamotigine - how to avoid Steven Johnson Syndrome
must be titrated slowly
61
lamotigine - clinical use
1. simple seizure 2. complex 3. tonic-clonic 4. absence
62
levetiracetam - mechanism of action
unknown. may modulate GABA and glutamine release
63
levetiracetam - clinical use
1. simple seizure 2. complex 3. tonic-clonic
64
tiagabin - mechanism of action
increases GABA by inhibiting reuptake
65
tiagabin - clinical use
1. simple seizure | 2. complex
66
vigabatrin - mechanism of action
increase GABA by IRREVERSIBLY inhibiting GABA tranasmaminase
67
vigabatrin - clinical use
1. simple seizure | 2. complex
68
epilepsy drug that induce P-450
1. phenytoin 2. Carbamazepine 3. phenobarbital
69
trigeminal neuralgia - 1st line treatment
carbamazepine
70
eplepsy drugs with nystagmus
phenytoin
71
eplepsy drugs with diplopia
phenytoin and carbamazepine
72
eplepsy drugs with sedation
1. benzodiazepines 2. phenytoin 3. gabapentin 4. topiramate 5. phenobarbital
73
eplepsy drugs with ataxia
gabapentin, phenytoin and carbamazepine
74
eplepsy drugs that inhibit Na+ channels
1. phenytoin 2. carbamazepine 3. valproic acid 4. topiramate 5. lamotrigine
75
eplepsy drugs with Steven Johnson syndrome
1. phenytoin 2. carbamazepine 3. Lamotrigine 4. ethosuximide
76
eplepsy drugs - 1st line for absence
ethosuximide
77
eplepsy drugs - status epilepticus 1st line
acute - benzodiazepines | prophylaxis - phenytoin
78
1st line treatment for tonoclonic seizures
1. Phenytoin | 2. Valproic acid

neurology FA (31 decks)

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