Seizures: Classification and Syndromes Flashcards
A patient was brought to the OPD with history of seizures. His mother showed you a video recording of seizure episode where you noticed fairly symmetric, bilateral, synchronous, semirhythmic jerking of the upper and lower extremities, with
elbow flexion and knee extension. What are these?
● A. Partial seizures
● B. Tonic seizures
● C. Clonic seizures
● D. Atonic seizures
● E. Astatic seizures
C. Clonic seizures
A patient presented to you with history of seizures. On further inquiry you find that there is no history of aura, motor involvement, and postictal confusion. His EEG revealed spike and wave at exactly 3/sec. These features are most consistent which of the following?
● A. Uncal seizures
● B. Mesial temporal seizures
● C. Absence seizures
● D. Partial seizures
● E. Grand mal seizures
● C. Absence seizures
What is the most common cause of intractable temporal lobe epilepsy?
● A. Absence seizures
● B. Uncal epilepsy
● C. Mesial temporal sclerosis
● D. Superior temporal gyrus syndrome
● E. Temporal lobe hemorrhagic contusion
C. Mesial temporal sclerosis
A patient with recently diagnosed epilepsy presented to the OPD for follow-up. During the review of the radiology, the clinician notices hippocampal atrophy on MRI. What is the most likely diagnosis?
● A. West syndrome
● B. Lennox Gustate syndrome
● C. Mesial temporal lobe epilepsy
● D. Juvenile myoclonic epilepsy
● E. Uncinate seizures
C. Mesial temporal lobe epilepsy
A patient with known case of temporal lobe epilepsy presents with kakosmia. This subtype of seizures is classified as?
● A. Uncinate seizures
● B. Complex seizures
● C. Focal seizures
● D. Sensory seizures
A. Uncinate seizures
Factors that lower the seizure threshold (make it easier to provoke a seizure) include sleep deprivation, hyperventilation, photic stimulation, infection, metabolic disturbances, and head trauma. Todd’s paralysis is a phenomenon that occurs after seizure activity. Which of the following is true regarding Todd’s paralysis?
● A. Partial or total paralysis usually occurs in areas involved in a partial seizure
● B. It occurs more commonly in nonstructural lesion
● C. The paralysis usually resolves over days to weeks
● D. Postictal aphasia or hemianopia are not included in this
● E. All of the above are true
A. Partial or total paralysis usually occurs in areas involved in a partial seizure
A patient presents in neurosurgical emergency with complaint of first occurrence of focal seizure with retained consciousness (simple partial seizure). As a rule of thumb, what is the cause of such seizure?
● A. Metabolic cause
● B. Insult to brain within previous 2 weeks
● C. Structural lesion within brain
● D. Febrile seizure
● E. None of the above
C. Structural lesion within brain
Tonic–clonic seizure is a type of motor seizure which is a generalized seizure that evolves from tonic to clonic motor activity. A patient presenting with other type of motor seizure in which there is shock-like body jerks (one or more in succession) with generalized EEG discharges is said to have which
type of seizure?
● A. Clonic
● B. Tonic
● C. Myoclonic tonic clonic
● D. Myoclonic
● E. Myoclonic-tonic
D. Myoclonic
A patient with known family history of seizure is presented with complex partial seizure that begins with arrest and stare, and oroalimentary and complex automatism signs with posturing of arm. This seizure activity lasts for 1 to 2 minutes and
there is preictal olfactory aura for few seconds as well. He is suspected to have mesial temporal lobe epilepsy or mesial temporal sclerosis. Which of the following will help in the diagnosis in this case?
● A. MRI of brain showing hippocampal atrophy and signal alteration with ipsilateral dilatation of temporal horn of lateral ventricle
● B. Unilateral or bilateral independent anterior temporal EEG spikes with maximal amplitude in basal electrodes
● C. PET scan showing hypometabolism in temporal lobe
● D. Neuropsychological testing showing memory dysfunction specific to involved temporal lobe
● E. All of the above
E. All of the above
A patient with strong family history of epilepsy presents with history of myoclonic jerks on waking up in morning. EEG shows poly spike discharges and MRI shows no structural lesion. The patient is suspected to have a generalized epilepsy syndrome with generalized tonic clonic and absence types in
addition to the type mentioned above. What is this syndrome called?
● A. West syndrome
● B. Lennox–Gastaut syndrome
● C. Juvenile myoclonic epilepsy
● D. Temporal lobe syndrome
● E. Juvenile tonic clonic epilepsy
C. Juvenile myoclonic epilepsy
Which of the following is true regarding West syndrome?
● A. It is a seizure disorder that typically begins in first year of life
● B. It consists of recurrent gross fixation and occasionally extension of trunks and limbs
● C. It is usually associated with mental retardation with EEG showing interictal hypsarrhythmia or modified hypsarrhythmia
● D. Seizures usually respond dramatically to ACTH or corticosteroids
● E. All of the above
E. All of the above
Hippocampus is composed of Ammon’s horn and dentate gyrus. The dorsal hippocampus subserves aspects of spatial memory, verbal memory, and learning conceptual information. Hippocampal sclerosis can cause which of the following?
● A. Total memory impairment
● B. Loss of all functions of basal ganglia
● C. Olfactory loss
● D. Intractable temporal lobe epilepsy
● E. All of the above
D. Intractable temporal lobe epilepsy
Following are motor seizures except?
● A. Tonic
● B. Gelastic seizures
● C. Clonic
● D. Atonic
● E. Epileptic spasms
B. Gelastic seizures
Symptomatic seizure also known as secondary seizure results from structural abnormality within the brain. Which of the following is included in this type of seizure?
● A. Cavernous malformation
● B. Stroke
● C. Brian tumor
● D. Mesial temporal sclerosis
● E. All of the above
E. All of the above
Mortality in patients with epilepsy is 2 to 4 times that of general population. Which of the following deaths are directly related to seizure?
● A. Status epilepticus
● B. Accidents during seizure activity
● C. Suicides
● D. Sudden unexplained death in epilepsy
● E. All of the above
A. Status epilepticus
