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749 - Ex 2 > Seizures - Part I > Flashcards

Seizures - Part I Flashcards

1
Q

Seizure - definition

_____ brain dysfunction due to excessive ______ neuronal discharge

Seizure is a ____, not a disease

A

Paroxysmal

Hypersynchronous

SIGN

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2
Q

Seizure Pathophys

A

Anything that alters electrophysiology, can precipitate seizure activity

  • NT involvement (GABA, Glutamate, etc)
  • Receptor dysfunction (GABA, NMDA, etc)
  • Ion channelopathies ( Cl, K, Na, Ca, etc)
  • Ion imbalances ( Ca, Mg, Na, etc)
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3
Q

Epilepsy definition

______ seizures caused by any intracranial cause

A

Recurrent

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4
Q

Primary/idiopathic epilepsy

A
  • no identifiable pathologic cause
  • may or may not be inherited
  • Dx of exclusion
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5
Q

Familial Epilepsy

A
  • subtype of primary epilepsy
  • inherited basis
  • occurs in families
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6
Q

Secondary/Symptomatic Epilepsy

A
  • Epilepsy due to a structural brain lesion

tumor, vascular/stroke, others

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7
Q

Cryptogenic Epilepsy

A
  • Epilepsy due to a probable brain lesion, but cant be identified definitively
  • Probably Symptomatic Epilepsy
  • Lesion not apparent on imaging
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8
Q

Reactive Epilepsy

A
  • epilepsy due to the following causes:
    metabolic, toxic, infectious, or inflammatory
  • brain may return to normal once treated
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9
Q

Period of time prior to seizure activity

A

Prodrome

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10
Q

Initial manifestation of seizure (EEG activity)

Lasts mins to hours

A

Aura

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11
Q

Actual seizure event

Lasts seconds to minutes (avg 90 sec)

A

Ictus

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12
Q

Follows the seizure event

Lasts mins to hrs; occasionally days

A

Post-ictal period

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13
Q

Generalized tonic-clonic seizure

aka ‘grand-mal’

A

Appearance:

  • symmetric throughout body
  • tonic phase (rigid extension)
  • clonic phase (paddling, running)
  • chewing, facial movements, autonomic signs

*typical form of idiopathic epileptic seizures

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14
Q

(Generalized) Absence seizure

“Petit mal”

A

Appearance:

  • NOT a focal/partial seizure
  • sudden, brief loss of consciousness
  • sudden, brief loss of mm tone
  • different drug therapy than other seizure types
  • not yet recognized ini dogs
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15
Q

(Generalized) Myoclonic Seizure

A

Appearance:

  • sudden mm contraction or “jerking” movement
  • symmetric throughout body
  • consciousness is lost; but episode is so brief the loss may go unnoticed
  • may be triggered by stimuli of any type
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16
Q

Partial/focal seizures

A
  • Usually assoc’d with secondary epilepsy
  • occasionally idiopathic or familial epilepsies
  • area of body affected reflects location of seizure focus
  • motor cortex = contralateral limb/facial movements
  • occipital cortex = fly-biting, visually triggered behaviors
  • limbic system = abnormal behavior episodes
  • autonomic signs may also occur
17
Q

Simple partial seizure

A

Appearance:

  • focal motor activity
  • conscious awareness is MAINTAINED
  • unilateral facial twitching, head turn, or repetitive limb movements
  • autonomic signs may be present
  • seizure focus is in contralateral motor cortex
18
Q

Complex partial seizure

A

Appearance:
- focal motor activity
- conscious awareness is IMPAIRED
- unilateral facial twitching, head turn, or repetitive limb movements
- autonomic signs may be present
In cats, bizarre behavior may be present (hissing, growling, running)
- seizure focus in contralateral temporal lobe

19
Q

Psychomotor seizure

A

Appearance:

  • conscious awareness is IMPAIRED
  • abnormal sensory, behavioral activity (rage, hysteria, hallucinations, fly-biting)
  • seizure focus thought to be in limbic system, but may reflect occipital cortex involvement
20
Q

Single isolated seizure which ceases spontaneously

A

Self-limiting

21
Q
  • two or more seizures in a 24 hr period
  • usually requires intervention
  • may lead to status epilepticus
A

Cluster

22
Q
  • single seizure >5mins
  • > 3 seizures without return to normal consciousness
  • motor activity may dissociate from brain activity
  • true emergency
A

Status epilepticus

*Severe metabolic complications if untreated!!

If death occurs, usually from:

  • cardiac arrhythmia
  • non-cardiogenic pulmonary edema
  • renal failure
23
Q

Difficulty performing a movement

A

Dyskinesia

  • due to other involuntary movements
  • encompassess all active movement phenomena that are attributed to the basal nuclei
24
Q

Seizure = ___ origin

Dyskinesias = _____ and _____

A

cortical origin

Basal nuclei and muscle membrane disorder

25
Q

Normal vs abnormal tremors

A

Normal (physiologic)
- enhanced physiologic tremor

Abnormal (pathologic)
- tremors that impeded normal movement

26
Q

Clinical Decisions

< 6 months

A
  • anomalous/congenital cause (hydroencephalus, congenital metabolic - PSS, hypoglycemia)
  • toxins
  • infectious etiologies
  • breed related encephalitides
  • idiopathic is possible, but less likely
27
Q

Clinical Decisions

6 mo-5 years

A
  • idiopathic/inherited is most common!!
  • symptomatic, reactive causes are possible
  • rec minimum database
  • +/- advanced diagnostics
28
Q

Clinical Decisions

> 5 years

A
  • secondary (symptomatic) and cryptogenic causes are most likely
  • rec full workup (advanced imaging, CSF)
  • precede workup for min database, met screen
29
Q

Clinical Decisions

Breed predispositions

A
  • many breed predisposed to epilepsy
  • labs, GSD, Goldens, Beagles, Cocker Span, Poodles
  • many toy breeds predisposed to inflammatory encephalitides (yorkies, maltese, pug, chihuahua)

749 - Ex 2 (14 decks)

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