Seizures/Syncope Flashcards
epilepsy is defined as
2 or more unprovoked seizures and ti is fairly commen.
what kind of seizures are best detected on a single EEG
petit mal
percent positive for epilepsy with 3 sleep deprived EEGs:
85%
although the EEG is an important tool in the dx of eplilepsy, the single most important information is
history of the events, preferably by a witness.
What are the two broad categories of seizures
partial and generalized seizures
define a partial seizure, and what specific types of seizures does that encompass
seizure activity begins on one side of the brain
simple partial
complex partial
secondarily generalized (partial onset)
define a generalized seizure, and what specific types of seizures dos that encompas
seizure activity primarily starts on both sides absence tonic-clonic myoclonic tonic clonic atonic
different seizures?
different drugs
seizures and the localizing side
If there is too much electrical activity on the Right, it pushes activity to the L.. see weird things on the L. (so eyes drift to the left, head turns to the left) This differs from stroke.
focal motor or sensory activity NO LOC, last seconds, no post ictal state
simple partial seizure
nonresponsive staring, possible preceding aura, automatisms, LOC, lasts 1-3 min, post ictal state
complex partial seizure
b/l tonic-clonic activity, LOC, lasts 1-3 min, postictal state, spreads
secondary generalized seizure
non responsive staring, rapid blinking, chewing, clonic hand motions, LOC, lasts 10-30 sec, no postictal state
Absence seizure
b/l extension followed by symmetrical jerking of extremities, LOC, lasts 1-3 min, postictal state
tonic clonic
sudden loss of muscle tone, head drops, pt collapses LOC variable duration, post ictal state
atonic
breif rapid symmetrical jerking of extremities and/or torso, LOC lasts
myoclonic
partial/secondary generalized drugs
phenytoine, carbamazepine, valproate, phenobarbital gabapentin, lamotrigine, topiramate, gabatril oxcarbasepine, leviteracetam, zonisamide, lacosamide, perampanel, vigabatrin
Drugs tath overlap that treat partial onset and primary generalized
valproate and lamotrigine
older drugs come w/ baggage
bone loss, gum thickening, cognitive side effects
newer drugs
in general as efficacious, but fewer side effects
primarily generalized drugs
ethosuxamide, valproic acid, lamotrigine, leviteracetam, zonisamide, perampanel
status epilepticus
condition characterized by prolonged seizure, generally greater than 10 minutes, or repeated seizures without recovery in between.
General principles in the treatment of pt with epilepsy
try to use monotherapy
consider drug interactions (OC’s with carbamaezepine)
consider long term side effects (bone loss w/ carbamazepime or phenytoin)
women and epilepsy
valproate bad
AEDs are folate depleting.
Syncope vs seizure
Syncope
=LOC that isn’t a seizure.
pallor, sweating, abnormal head sensation, lightheadedness, positionally related, slow onset. breiv unconsciousness
Seizure
=urinary or bowel incontinence, tongue injury, tonic/clonic movements, postictal state, may or may not have warning.
