Seizures/Syncope

Question 1

epilepsy is defined as

Answer 1

2 or more unprovoked seizures and ti is fairly commen.

Question 2

what kind of seizures are best detected on a single EEG

Answer 2

petit mal

Question 3

percent positive for epilepsy with 3 sleep deprived EEGs:

Answer 3

85%

Question 4

although the EEG is an important tool in the dx of eplilepsy, the single most important information is

Answer 4

history of the events, preferably by a witness.

Question 5

What are the two broad categories of seizures

Answer 5

partial and generalized seizures

Question 6

define a partial seizure, and what specific types of seizures does that encompass

Answer 6

seizure activity begins on one side of the brain

simple partial
complex partial
secondarily generalized (partial onset)

Question 7

define a generalized seizure, and what specific types of seizures dos that encompas

Answer 7

seizure activity primarily starts on both sides
absence
tonic-clonic
myoclonic
tonic
clonic
atonic

Question 8

different seizures?

Answer 8

different drugs

Question 9

seizures and the localizing side

Answer 9

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.

Question 10

focal motor or sensory activity NO LOC, last seconds, no post ictal state

Answer 10

simple partial seizure

Question 11

nonresponsive staring, possible preceding aura, automatisms, LOC, lasts 1-3 min, post ictal state

Answer 11

complex partial seizure

Question 12

b/l tonic-clonic activity, LOC, lasts 1-3 min, postictal state, spreads

Answer 12

secondary generalized seizure

Question 13

non responsive staring, rapid blinking, chewing, clonic hand motions, LOC, lasts 10-30 sec, no postictal state

Answer 13

Absence seizure

Question 14

b/l extension followed by symmetrical jerking of extremities, LOC, lasts 1-3 min, postictal state

Answer 14

tonic clonic

Question 15

sudden loss of muscle tone, head drops, pt collapses LOC variable duration, post ictal state

Answer 15

atonic

Question 16

breif rapid symmetrical jerking of extremities and/or torso, LOC lasts

Answer 16

myoclonic

Question 17

partial/secondary generalized drugs

Answer 17

phenytoine, carbamazepine, valproate, phenobarbital gabapentin, lamotrigine, topiramate, gabatril oxcarbasepine, leviteracetam, zonisamide, lacosamide, perampanel, vigabatrin

Question 18

Drugs tath overlap that treat partial onset and primary generalized

Answer 18

valproate and lamotrigine

Question 19

older drugs come w/ baggage

Answer 19

bone loss, gum thickening, cognitive side effects

Question 20

newer drugs

Answer 20

in general as efficacious, but fewer side effects

Question 21

primarily generalized drugs

Answer 21

ethosuxamide, valproic acid, lamotrigine, leviteracetam, zonisamide, perampanel

Question 22

status epilepticus

Answer 22

condition characterized by prolonged seizure, generally greater than 10 minutes, or repeated seizures without recovery in between.

Question 23

General principles in the treatment of pt with epilepsy

Answer 23

try to use monotherapy
consider drug interactions (OC’s with carbamaezepine)
consider long term side effects (bone loss w/ carbamazepime or phenytoin)

Question 24

women and epilepsy

Answer 24

valproate bad

AEDs are folate depleting.

Question 25

Syncope vs seizure

Answer 25

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.