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Neuro Module > Seizures & Epilepsy > Flashcards

Seizures & Epilepsy Flashcards

1
Q

Definition of seizure

A

abnormal, synchronized excessive discharge from an aggregate of CNS neurons

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2
Q

Highest RF for chronic seizure disorder

A

penetrating head trauma

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3
Q

Precipitating factors of seizure

A

sleep deprivation, stress, extreme fatigue, drug/etoh withdrawal, fever, cocaine use

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4
Q

Causes of seizures in neonatal/early infancy

A

CNS infection
postpartum drug withdrawal (mother using drugs/etoh)
hypoglycemia

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5
Q

Causes of seizures in late infancy/early childhood

A

febrile seizures

CNS infection

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6
Q

Causes of seizures in childhood

A

develop “epilepsy”
idiopathic
temporal lobe

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7
Q

Causes of seizures in adolescence

A

CNS lesions
head trauma
illicit drug use

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8
Q

Causes of seizures in adults

A

cerebral vascular disease
trauma
tumor
metabolic disturbances (ethos withdrawal, uremia, hepatic failure, hypoglycemia)

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9
Q

ictal, post-ictal states

A

ictal: seizure state

post-ictal: symptomatic time frame after seizure

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10
Q

RF of seizures

A

head trauma, stroke, CNS infection, electrolyte or metabolic disturbances, drugs, alcohol, FHX

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11
Q

Most common type of seizure

A

complex partial

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12
Q

PE work up of seizure

A
  • Search for signs of systemic illnesses (liver, renal)
  • Signs of head trauma
  • CV (heart, carotid arteries)
  • Complete neuro exam: mental status, visual fields, motor/sensory fx, DTRs, gait, coordination
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13
Q

Lab/imaging in seizure work up

A

CBC, Chem 20, toxicology, lumbar puncture (if suspect infx or if has HIV), EEG, CT/MRI

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14
Q

Definition of epilepsy

A

recurrent seizures; 2 or more unprovoked seizures

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15
Q

partial vs generalized seizures

A 
partial = limited to discrete region of brain
generalized = whole brain
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16
Q

partial seizure where consciousness is fully preserved

A

simple partial

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17
Q

partial seizure where consciousness is impaired

A

complex partial

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18
Q

febrile seizures

A
  • 3 mon to 5 yrs old
  • occurs when temp rising
  • typically isolated event, brief, symmetric
  • likely to recurr
19
Q

First priority in treating possible seizure

A

STABILIZE - look at vitals, respiration, CV

20
Q

DDX of possible seizure

A

vasovagal reaction, MI, TIA, migraine

21
Q

What is the best imaging for detection of cerebral lesions in epilepsy?

A

MRI > CT

22
Q

Mainstay tx for seizures

A

anti-epileptic drugs

o Generalized: Levetiracetam (Keppra), Valproic acid or lamotrigine
o Absence: Ethosuximide
o Partial: Carbamazepine, phenytoin, lamotrigine and topiramate

23
Q

When should anti-epileptic drugs be started?

A
  • recurrent seizures of unknown cause
  • cause can’t be treated
  • usually not for single seizure unless thought to be epileptogenic
24
Q

How to discontinue antiepileptic meds?

A

most patients with complete control of seizures for significant time may d/c

withdraw very slowly over 2-3 months

25
Q

What kind of diet may help seizures?

A

ketogenic diet

26
Q

“Jacksonian March”

A

simple partial seizure that begins in small area and progresses to larger area (fingers to arm)

27
Q

“Todd’s Paralysis”

A

localized paresis for minutes to hours in involved region after simple partial seizure

28
Q

partial seizure with secondary generalization

A

begins as partial seizure and propagates throughout cortex to become generalized

29
Q

How are partial seizures treated?

A

Carbamazepine, Phenytoin, Iamotrigine, Topiramate

30
Q

5 types of generalized seizures

A

absence, myoclonic, grand mal, tonic, atonic

31
Q

Most common type of seizure in CHILDREN

A

absence (petit mal)

32
Q

absence seizure

A
  • only last few seconds
  • brief lapses of consciousness w/o loss of posture or post-ictal confusion
  • TX: Ethosuximide
33
Q

tonic-clonic more commonly known as _______.

A

grand mal seizure

34
Q

3 phases of grand mal seizure

A

1) Tonic: muscle contraction, ictal cry, foaming of mouth, sympathetic effects (BP, pulse, pupils dilate)
2) Clonic: alternate contraction & relaxation
3) Post-ictal: regains consciousness, confusion, unresponsive

35
Q

atonic seizures

A

sudden loss of postural muscle tone with brief impairment of consciousness for a few seconds

usually head drop, if longer fall risk

36
Q

myoclonic seizure

A

sudden brief muscle contraction involving part or all of body

37
Q

psychogenic seizure

A

non-epileptic behaviors that resemble a seizure

38
Q

Definition of status epilepticus

A

continuous seizure or recurrent seizures without return to baseline between them

39
Q

Prolonged seizure of status epilepticus may cause what?

A

cardiorespiratory compromise, metabolic derangement, irreversible neuro damage

40
Q

Common cause of status epilepticus

A

anticonvulsant withdrawal or noncompliance

others: CNS infection, tumor, drug toxicity, metabolic

41
Q

Status epilepticus treatment

A

IMMEDIATE anticonvulsant

1) IV Lorazepam
2) Phenytoin if seizure continues

Ultimately anesthesia to shut off CNS

42
Q

Imaging for febrile seizures

A

No imaging needed, plus CT not good for < 18 yo

If inconsistent hx or PE do lumbar puncture

43
Q

Febrile seizure treatment

A

Reassurance and parent education

Tylenol and ibuprofen to control fevers

Neuro Module (13 decks)

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