Seizures & Syncope (Hon)

Question 1

Epilepsy

Answer 1

2 or more unprovoked seizures

Question 2

Which seizure has the greatest possibly of being caught on the first/a single EEG?

Answer 2

petit mal (90%)

Question 3

How many times is it recommended to do an EEG to pick up a seizure?

Answer 3

3 sleep-deprived EEG’s; most seizures are going to be missed on the first EEG

Question 4

Does a normal EEG exclude the presence of epilepsy?

Answer 4

No; the single most important information is history** of events (preferred by witness)

Question 5

What is the single most important information needed to diagnose epilepsy?

Answer 5

history** of events (preferred by witness)

Question 6

Simple partial seizure

Answer 6

originates on one side of the brain; there is focal motor and sensory activity; NO loss of consciousness and typically last seconds and there is NO post-ictal state; patient typically awake and can talk to you and aware of what they see

Question 7

Seizure characterized by focal motor and sensory activity; NO loss of consciousness and typically last seconds and there is NO post-ictal state?

Answer 7

Simple partial seizure

Question 8

Complex partial seizure

Answer 8

originates on one side of the brain; there is nonresponsive staring and automatism with loss of consciousness; typically last 1-3 mins and there is a post-ictal state

Question 9

Seizure characterized by nonresponsive staring and automatism with loss of consciousness; typically last 1-3 mins and there is a post-ictal state?

Answer 9

Complex partial seizure

Question 10

Secondary generalized partial seizures

Answer 10

originates on one side of the brain and travels to the c/l side; bilateral tonic-clonic activity, loss of consciousness; last 1-3 mins and there is a post-ictal state

Question 11

Seizure characterized by bilateral tonic-clonic activity, loss of consciousness; last 1-3 mins and there is a post-ictal state?

Answer 11

Secondary generalized partial seizures

Question 12

Generalized absence seizure

Answer 12

originates on both sides of the brain; non responsive staring, rapid blinking and chewing with clonic hand motions; there is loss of consciousness that lasts about 10-30 seconds; there is no post-ictal state (abrupt onset and abrupt cut off)

Question 13

Is there a post-ictal state in generalized absence seizures?

Answer 13

no; there is no post-ictal state (abrupt onset and abrupt cut off)

Question 14

Seizure characterized by non responsive staring, rapid blinking and chewing with clonic hand motions and a loss of consciousness that lasts about 10-30 seconds; there is no post-ictal state (abrupt onset and abrupt cut off)?

Answer 14

Generalized absence seizure

Question 15

Generalized tonic-clonic seizure

Answer 15

originates on both sides of the brain; b/l extension followed by symmetrical jerking of extremities, loss of consciousness; last 1-3 mins and there is a post-ictal state

Question 16

Seizure characterized by b/l extension followed by symmetrical jerking of extremities, loss of consciousness; last 1-3 mins and there is a post-ictal state?

Answer 16

Generalized tonic-clonic seizure

Question 17

Generalized atonic seizure

Answer 17

originates on both sides of the brain; sudden loss of muscle tone, head drops or patient collapses, loss of consciousness for a variable duration and there’s a post-ictal state

Question 18

Seizure characterized by sudden loss of muscle tone, head drops or patient collapses, loss of consciousness for a variable duration and there’s a post-ictal state?

Answer 18

Generalized atonic seizure

Question 19

Generalized myoclonic seizure

Answer 19

originates on both sides of the brain; brief, rapid symmetrical jerking of extremities and/or torso with loss of consciousness that last a few seconds; has a minimal post-ictal state

Question 20

Seizure characterized by brief, rapid symmetrical jerking of extremities and/or torso with loss of consciousness that last a few seconds; has a minimal post-ictal state?

Answer 20

Generalized myoclonic seizure

Question 21

What drug is used for absence seizures only?

Answer 21

ethosuxamide; T-type Ca2+ channel blocker on presynaptic neuron

Question 22

Status Epilepticus

Answer 22

prolonged seizure (greater than 10 mins) or repeated seizures without recovery in between

Question 23

Transient global amnesia

Answer 23

sudden, temporary isolated episode of memory; no other neurological signs or symptoms; patient knows self and close friends and family but may not recognize others; resolves and usually doesn’t recur