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Foundations II (Cholley) > Seizures - Mr. Black > Flashcards

Seizures - Mr. Black Flashcards

1
Q

Define: seizure

A

Sudden change in cortical electrical activity manifested through transient sensory, motor, or behavioral changes

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2
Q

Define epilepsy

A

Recurrent

- Can have more than 1 type of seizure

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3
Q

Define status epilepticus

A

Epileptic seizure activity continues or is on repeat w/out regaining consciousness

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4
Q

Define: aura

A

Sensation experienced before onset of d/o

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5
Q

Define: automatism

A

Automatic, involuntary movement during a seizure

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6
Q

Define: ictal

A

Period during a sudden attack

- pre or post

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7
Q

What is the 4th most common neuro problem?

A

Epilepsy

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8
Q

Specific incidence depends on what?

A

The type of seizure d/o

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9
Q

How do you classify seizure disorders?

A
  • Partial (focal) –> simple or complex
  • Generalised: absence, tonic clonic, myoclonic, clonic, tonic
  • Uknown
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10
Q

What is the difference btwn simple & complex partial seizures?

A

Simple:

  • Retains awareness
  • Sensory, motor, autonomic, psychic

Complex:

  • Altered awareness
  • Dyscognitive
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11
Q

What is the difference btwn partial (focal) & generalised seizures?

A

Partial: Activity starts in 1 area of brain
Generalised: Activity involves both hemispheres of brain

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12
Q

What are the causes of epilepsy? What is the most common?

A

“VITAMIN D”

  • Vascular
  • Idiopathic (MC!)
  • Trauma
  • Alzheimers
  • Metabolic
  • Infection
  • Neoplasm
  • Drugs
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13
Q

What is the most common seizure imitator?

A

Syncope

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14
Q

What are important components to history when evaluating someone w/ a seizure?

A
  • Alcohol/drug abuse
  • Hx of head trauma
  • Family hx

*Obtain eyewitness to account the attack

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15
Q

What are 3 diagnostic studies used?

A
  1. EEG
  2. Neuroimaging (CT/MRI) *MRI better at soft-tissue visualization
  3. Labs (CBC, CMP, PRL, CK, toxicology)

+/- EKG
+/- LP

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16
Q

Does a normal EEG exclude the dx of epilepsy?

A

NOPE!

*Serial EEGs increase yield

17
Q

What can cause a provoked seizure?

A
  • Alcohol
  • Lack of sleep
  • Drugs
  • Metabolic
  • Fever
  • Infectious
18
Q

What is the difference btwn provoked vs unprovoked?

A

Unprovoked will be recurrent –> epilepsy –> generalised or focal seizures

19
Q

What are the sx of focal (simple partial) seizures?

A
  • No alteration of awareness

- Sx depend on site of cerebral origin: Can be sensory, motor, autonomic, psychic

20
Q

What are sx of focal (complex partial) seizures?

A
  • Impairment of awareness
  • Purposeless automatisms
  • Postictal confusion +/- tiredness
21
Q

What types of seizures are motor?

A
  • Myoclonic
  • Tonic clonic
  • Atonic
22
Q

What type of seizure is non-motor?

A

Absence

23
Q

What are sx of absence seizures?

A
  • Abrupt onset & recovery
  • Sudden staring w/ impaired awareness
  • Eyelid flutter/minor automatisms
24
Q

Absence seizures are most common in….

A

Children

25
Q

What is seen on EEG for absence seizures?

A

3 Hz spike-&-slow wave pattern

26
Q

What are sx of myoclonic seizures?

A
  • No alteration of awareness
  • Sudden, brief muscle contractions - “jerks” - typically affect arms
  • Multiple or in clusters
27
Q

Tonic-clonic seizures consist of what 4 components?

A
  • Aura
  • Tonic phase
  • Clonic phase
  • Postical phase
28
Q

What are sx of atonic seizures? AKA - “Drop seizures”

A
  • Awareness is difficult to assess

- Sudden loss of control of the muscles, esp. the legs –> collapsing to ground

29
Q

What type of generalized seizure has the worst prognosis?

A

Atonic

30
Q

What seizures syndromes are seen in infancy & children?

A
  • Infantile spasms/west syndrome
  • Lennox-Gastaut syndrome
  • Benign Rolandic epilepsy
  • Febrile seizures
31
Q

What is the most common seizure in children under 5?

A

Febrile

32
Q

What are characteristics of febrile seizures?

A
  • Accompanied by fever
  • Boys > girls
  • “Simple” febrile seizures are most common & last less than 15 mins
33
Q

What are AAP guidelines for eval of simple febrile seizures?

A
  • EEG, blood tests, neuroimaging should NOT be performed
  • LP should be performed in children w/ s/s of meningitis
  • If labs are performed, should focus on the cause of FEVER
34
Q

What are characteristics of status epilepticus?

A
  • Medical emergency

- Prolonged seizure state ( > 5 minutes* OR 2 or more seizures w/out full recovery btwn seizures)

35
Q

What is the #1 cause of status epilepticus in seizure pts?

A

Non-compliance w/ antiepileptic meds

36
Q

What are the basics of seizure management?

A
  • Determine type of seizure
  • Determine risk of recurrence
  • r/o secondary causes
  • Consult/refer to neuro
  • Antiepileptic drugs are NOT recommended after just 1 seizure*
37
Q

What is the tx of status epilepticus?

A

ABCs + IV Ativan

Foundations II (Cholley) (25 decks)

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