Thursday, 8-25-Seizures and Syncope-Hon Flashcards
epilepsy is defined as ___
2 or more UNPROVOKED seizures
In regards to the % positive findings for epilepsy on a SINGLE EEG:
All types= \_\_\_ % Generalized tonic-clonic= \_\_\_% Petit mal (with Hyperventilation)=\_\_\_ % Partial seizure= \_\_\_%
all types=40%
Generalized tonic-clonic=20%
Petit mal=90%
Partial=30%
the percent positive for epilepsy (all types) with 3 sleep-deprived EEGs: ___ %
85%
although the EEG is an important tool in the dx of epilepsy, the single most important information is ___
history of the events-prefereably by witnesses
These types of seizures have seizure activity that begins on 1 side of the brain
Partial seizures
Simple partial, complex partial, and secondarily generalized (partial onset)
Secondary generalized seizures starts on 1 side then spreads to both sides. It is categorized as a ___ seizure
partial or partial onset
absence (petit mal), tonic-clonic, tonic, clonic, atonic, clonic-tonic-clonic are all examples of ___ seizures
Generalized seizures –> starts on both sides of the brain
___ seizures are focal motor or sensory activity, no loss of consciousness, lasts seconds, no post-ictal state
simple partial
___ seizures are characterized by non responsive staring, possible preceding aura, automatisms, loss of consciousness, lasts 1-3 mins, post-ictal state
complex partial
__ seizures are bilateral tonic-clonic activity, loss of consciousness, lasts 1-3 minutes, post-ictal state
secondary generalized
__ seizures include non responsive staring, rapid blinking, chewing, clonic hand motions, loss of consciousness, lasts 10-30 seconds, no post-ictal state
absence (petit mal)
generalized
___ seizures include bilateral extension followed by symmetrical jerking of extremities, loss of consciousness, lasts 1-3 mins, post-ictal state
tonic-clonic
generalized
__ seizures has sudden loss of muscle tone, head drops, or pt collapses, loss of consciousness, variable duration, post-ictal state
atonic
generalized
___ seizures are brief, rapid symmetrical jerking of extremities and/or torso, loss of consciousness, lasts
myoclonic
generalized
These drugs are for both primary generalized as well as partial onset seizures:
Valproic acid Lamotrigine Topiramate Leviteracetam Zonisamide Perampanel
This drug is used for absence seizures only
ethosuxamide
___ is a condition characterized by prolonged seizure (generally greater than 10 minutes) or repeated seizures without recovery in between
status epilepticus
pallor, sweating, abnormal head sensation, lightheadedness, positionally-related, slow onset, and brief unconsciousness are characteristic of:
Syncope
urinary or bowel incontinence, tongue injury, tonic/clonic movements, and postictal state are characteristic of :
seizure
Describe the tx of status epileptics:
- A,B,C’s, Establish IV
- Try to gain a history-? seizures previously, allergies to seizure meds
- Labs: Accuchek, CBC, Chem panel, Drug levels
- Non contrast CT of the head
- Give benzodiazepine (lorazepam 2-4 mg IV) –> BUYS TIME, but must give longer lasting AED
This drug for status epilepticus requires that you intubate the pt first, in anticipation of respiratory depression
phenobarbital
if unsuccessful in tx of status epileptics, you can try ___ continuous IV drip (pt must be intubated)
midazolam or propofol
what is the last resort for treating status epilepticus?
Pentobarbital coma
What are some general principles in tx of pts with epilepsy?
- Try to use mono therapy
- Consider drug interactions –> OCs with carbamazepine
- Consider long-term side effects –> bone loss with carbamazepine or phenytoin
You want to avoid this AED in pregnancy
Valproic acid
