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KT Neuro Block 5 > Seizures: Slattery, Prunuske > Flashcards

Seizures: Slattery, Prunuske Flashcards

1
Q

What is a seizure?

A

Transient, due to excessive or synchronous neural activity of the brain.

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2
Q

What is the most common cause of a seizure?

A

Idiopathic

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3
Q

What are some causes of provoked seizures?

A

Metabolic disturbances, infections, focal neurological lesions, medication withdrawal, Toxins (ex. alcohol)

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4
Q

What is usually done in the ER with a first seizure?

A

Neuroimaging

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5
Q

What is done clinically for all patients?

A

EEG

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6
Q

What is needed for the diagnosis of Epilepsy?

A

2 unprovoked seizures at least 24 hours apart.

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7
Q

What does it mean that Epilepsy is a “primary seizure disorder?”

A

The seizure itself is the problem, as opposed to being caused by something else

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8
Q

What are the two big general categories of seizures and how do they differ?

A

Focal and Generalized. Focal is in one hemisphere, generalized is in both.

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9
Q

What is the difference between a simple and complex seizure?

A

Simple: no alteration of consciousness, Complex: impaired or loss of consciousness

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10
Q

In a focal (partial) seizure of the frontal lobe, what happens to the arms? Head?

A

Contralateral arm extension, ipsilateral arm flexion

Contralateral eye deviation and head turning

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11
Q

What is meant by absence?

A

Staring or trance-like state

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12
Q

what is the difference between tonic and atonic?

A

Tonic: stiffening, atonic: loss of muscle tone

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13
Q

What is meant by myoclonic?

A

sudden muscle jerks

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14
Q

What is Status Epilepticus?

A

> 5 min of continuous seizure activity,
or
Recurrent seizure activity without recovery to baseline between seizures

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15
Q

How do you treat Status Epilepticus?

A

IV Benzodiazepine (Lorazepam)

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16
Q

What are the drugs of choice for focal, local (simple partial) seizures?

A

Carbamezepine and Levetiracetam

17
Q

What are the drugs of choice for Focal, with contralateral propagation or secondary generalization (complex partial)?

A

Carbamezepine and Levetiracetam

18
Q

What is the drug of choice for Generalized non-convulsive (absence)?

A

Ethosuximide

19
Q

What are the drugs of choice for Convulsive (tonic-clonic, atonic, others)?

A

Valproic Acid and Levetiracetam

20
Q

Do you retain awareness in a simple partial seizure?

A

Yes

21
Q

In the grand scheme of things, what is the pathogenesis of a seizure?

A

Too much excitation, too much Glutamate, too little GABA

22
Q

An increase of what extracellularly can decrease neuronal hyper polarization?

A

K+

23
Q

What may increase neuronal excitability?

A

A decrease in extracellular Ca+ and Mg2+

24
Q

What is a paroxysomal depolarization shift?

A

High frequency burst of action potentials

25
Q

What is an Interictal spike?

A

The initial spike that starts the seizure course, followed by a decrease of activity.

26
Q

What does the location of an interictal spike tell us?

A

The location of the interictal spike helps localize the brain region from which seizures originate in a given patient

27
Q

What are the two things we can do via anti-seizure drugs?

A
  1. decreases in the effectiveness of GLU transmission and/or

2. increases in the effectiveness of GABA transmission will prevent/treat seizure

28
Q

What is the molecular target for Levetiracetam?

A

Synaptic vesicle proteins (SV2A) in both Glutamate and GABA presynaptic neurons

29
Q

What are the two molecular targets for Valproic acid?

A

NMDA receptor and GABA transaminase

30
Q

What drug works on the GAT-1 GABA transporter on a glia cell?

A

Tiagabine

31
Q

What drugs work on the AMPA receptor on the postsynaptic cell of glutamate transmission?

A

Phenobarbitol and Topiramate

32
Q

Where does Ethosuximide work?

A

VG Ca+ channels (presynaptic Glutamate neuron)

33
Q

Where does Carbamazepine work?

A

VG Na+ Channels presynaptic Glutamate neuron

KT Neuro Block 5 (17 decks)

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