seizures/sleep Flashcards
Unconsciousness
Convulsions
Muscle rigidity
Grand Mal Seizure
Brief loss of consciousness
Absence Seizure
Repetitive jerking movements
Clonic Seizure
Sporadic jerking movements
Myoclonic Seizure
Muscle stiffness
Rigidity
Tonic Seizure
Loss of muscle tone
Atonic Seizure
Seizure spreads from distal limb to ipsilateral face.
Jacksonian march
Jacksonian march
Seizure spreads from distal limb to ipsilateral face.
Jerking, muscle rigidity, spasms, head-turning
Unusual sensations affecting vision, hearing, smell, taste or touch
simple partial seizure
Lip smacking, chewing fidgeting, walking and other repetitive, involuntary but coordinated movements
An aurora is often present
Involves the temporal lobe
Complex partial seizure
Electroencephalogram –helps determine ___
Generalized seizures
Simple partial seizure
Complex partial seizure
Electroencephalogram –helps determine the type of seizure
Generalized seizures – generalized spikes and slow waves
Simple partial seizure – focal rhythmic discharges may be present
Complex partial seizure – interictal spikes with slow waves
- generalized spikes and slow waves
- focal rhythmic discharges may be present
- interictal spikes with slow waves
Generalized seizures – generalized spikes and slow waves
Simple partial seizure – focal rhythmic discharges may be present
Complex partial seizure – interictal spikes with slow waves
Midazolam Phenytoin Carbamazepine Valproate Phenobarbital
Anticonvulsants
Status epilepticus
A life-threatening neurologic disorder defined as 5 minutes or more of a continuous seizure activity or several clinical seizures without return to baseline in between
Treatment Status epilepticus
Medications
What are first line?
Other 3
Benzodiazepines are first line- Diazepam, Lorazepam, Midazolam
Anticonvulsant agents – Phenytoin, Fosphenytoin
Barbiturates – Phenobarbital
Anesthetics – Propofol
med for absence seizures
ethosuximide or valproic acid
IV tx for seizures
Diazepam or lorazepam IV till seizure stops; loading dose of phenytoin or fosphenyntoin also given
Which type of seizure is associated with generalized spikes and slow waves?
Generalized seizure
What is the first line treatment for a patient in status epilepticus?
Barbiturates – Diazepam
Does the term tonic refer to jerking movements or muscle stiffness?
muscle stiffness
In the event of syncope, …
position the patient on the ground, with the legs slightly elevated or leaning forward, head between the knees for 10 to 15 minutes
status epilepticus- rapid tx of potential etiologies
thiamine followed by glucose and naloxone
non REM stages
4 stages; 3 and 4 are termed delta sleep
depression and sleep
fragmented sleep, decreased total sleep time, quicker onset of REM and a shift of REM to earlier in the night
manic d/o and sleep
total sleep time is decreased with a shortened REM latency and increased REM activity
hypersomnia
- kind of pts
excessive daytime sleepiness
sleep apnea, narcolepsy, nocturnal myoclonus
parasomnia
abnormal sleep behaviors during sleep; sleep terrors, nightmares, sleep walking, enuresis
nightmares occur when
REM
sleep terrors happen when
stage 3 and 4 delta sleep
sleepwalking occurs when
stage 3 and 4 delta sleep in the first third of night and with REM sleep later in the night
childhood enuresis occurs when
3-4 hrs of bedtime but not limited to a particular stage of sleep
important factors in a history with sleep disorders
depression, alcohol abuse, heavy smoking, inappropriate use of sedatives or stimulants, uremia, asthma, hypothyridism
dextroamphetamine and modafinil
stimulant for narcolepsy
nocturnal myoclonus tx
clonazepam
sleep terror and sleepwalking tx
benzo
epileptogenic focus
partial seizure
3 second spike and wave discharge
childhood absence epilepsy
10 Hz activity during __ phase and slow waves during ___ phase
tonic
clonic
increase in slow frequency rhythms and/or loss of nml higher frequency rhythms
focal non-epileptiform seizure
generalized spikes and associated slow waves
non convulsive generalized seizure
rhythmic discharge with slow onset; nml ictally
simple seizure
fast, synchronus potentials in large number of neurons in somewhat discrete part of brain
focal epileptiform seizure
diffuse abnormally slow rhythms or bilateral slowing of normal rhythm
diffuse non-epileptiform seizure
diffuse alpha waves, non responsive to external stimuli
coma