Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adams Principles of Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

A group of somewhat diverse, age-dependent phenotypes that are characterised by generalized 2.5-4 Hz bifrontally predominant spikes or polyspike-and-slow-wave discharges that arise without underlying structural abnormalities.

A

Primary Generalized Epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical states that simulate generalized tonic-clonic seizure

A

psychogenic episodes, vasodepressor syncope, basilar artery occlusion, fainting lark

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Absence seizures are said to be “typical” if they have the following characteristics?

A

rapid onset and offset, typical three per second spike and wave, complete loss of awareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

This is the most common form of idiopathic generalized epilepsy in older children and young adults

A

Juvenile Myoclonic Epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Somatosensory seizures

A

postcentral convolution of the parietal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Olfactory hallucinations

A

parahippocampal convolution of the uncus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Visual seizures

A

striate cortex of the occipital lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Auditory hallucinations

A

superior temporal convolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

vertiginous sensations

A

superoposterior temporal region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

visceral sensations

A

middle frontal gyrus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common manifestations of frontal lobe epilepsy

A

volvular epilepsy or walking repetitively in small circles, epilepsia procursiva or running and poriomania or wandering aimlessly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common type of reflex epilepsy

A

Visual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Beneficial treatment of choice in Rasmussen Syndrome

A

high dose corticosteroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AEDs that can greatly increase the chance of breakthrough menstrual bleeding in women taking oral contraceptives

A

Phenytoin, Carbamazepine, Barbiturates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

AEDs associated with lower IQ in children

A

Sodium Valproate, Phenytoin, Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If a woman with seizure disorder has been off epilepsy medications for a time before getting pregnant and seizes during pregnancy, what is the best choice of AED?

A

Phenytoin, Levetiracetam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most frequent idosyncratic reaction to AEDs

A

Rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sequence of life-threatening events encountered in cases of convulsive status epilepticus

A

Rising temperature –> Acidosis –> Hypotension –> Renal Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Approximately how many % of all patients with epilepsy are candidates for surgical therapy?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Major source of caloric intake in epileptic patients initiated on ketogenic diet

A

80-90% Fats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

2014 ILAE new definition for epilepsy

A

A disease with either recurrent unprovoked seizures occurring at least 24 hours apart or a heightened tendency of at least 60% toward recurrent unprovoked seizures, or when an epilepsy syndrome in diagnosed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Most common non-neurologic disorder mimicking epilepsy

A

Syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MRI sequence which have shown 97% accuracy for detecting abnormalities associated with medial temporal sclerosis

A

FLAIR imaging sequence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The only condition with evidence supporting AED prophylaxis

A

high-risk head injury in the early post traumatic period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Responsible for most of the metabolism of Phenytoin

A

CYP2C9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Responsible for most of the metabolism of Carbamazepine

A

CYP3A4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

AED with multiple mechanisms of action including GABA potentiation, blocking of T-type calcium channels and blocking sodium channels

A

Valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Drug-resistant epilepsy is defined as a failure of adequate trials of ____ tolerated, appropriately chosen and used anticonvulsant drug schedules to achieve sustained seizure freedom.

A

two

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

It constitutes the most characteristic epilepsy of childhood

A

Typical absence seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

T/F: The typical absence, with or without myoclonic jerks, rarely cause the patient to fall.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

T/F: The generalized tonic-clonic seizures of Juvenile Myoclonic Epilepsy occurs upon awakening.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A particular combination of gelastic seizures and precocious puberty has been traced to this condition?

A

Hamartoma of the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

This common focal motor epilepsy is unique among the focal epilepsies of childhood in that it is self-limiting despite of very abnormal EEG pattern

A

Rolandic Epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

One of the most common viral precipitants of febrile seizures

A

Herpesvirus 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

T/F: Blood for serum levels is ideally drawn in the morning before breakfast before the first ingestion of anticonvulsant

A

True (through levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

T/F: In general, higher serum concentrations of drug are necessary for the control of focal seizures than for generalized ones.

A

True

37
Q

T/F: The patient remains apneic until the end of the clonic phase.

A

True

38
Q

T/F: It is useful to know that seizures on awakening usually signify a generalized type, whereas those occurring during the period of sleep are more often focal in nature.

A

True

39
Q

It constitutes the most characteristic epilepsy of childhood.

A

Typical absence seizures

40
Q

T/F: Akinesia or motionlessness is not unique to any seizure type

A

True

41
Q

T/F: Seizure-associated myoclonus, when occurring in isolation, is relatively benign and usually responds well to medication.

A

True

42
Q

Most common form of idiopathic generalized epilepsy in older children and young adults.

A

Juvenile Myoclonic Epilepsy

43
Q

Most common origin of focal motor seizures

A

Supplementary motor area

44
Q

T/F: Todd’s paralysis usually persists in proportion to the duration of the convulsion.

A

True

45
Q

Most frequently reported color in visual seizures.

A

Red

46
Q

Localization of vertiginous seizures

A

Superoposterior temporal region

47
Q

T/F: EEG recording during sleep is particularly helpful because of focal abnormalities in the temporal lobes in slow-wave and stage II sleep.

A

True

48
Q

These AEDs can greatly increase the chance of breakthrough menstrual bleeding in women taking oral contraceptives.

A

Phenytoin, Carbamazepine, barbiturates

49
Q

If a woman with seizure disorder has been off epilepsy medications for a time before getting pregnant and seizes during pregnancy, what is the best choice of medication?

A

Phenytoin, Levetiracetam

50
Q

Most frequent idiosyncratic reactions to the drugs used to treat epilepsy

A

Rashes

51
Q

Approximately how many % of all patients with epilepsy are candidates for surgical therapy?

A

25%

52
Q

Gene associated with Juvenile Myoclonic Epilepsy

A

GABRA1 (CACNB4)

53
Q

The most frequent cause of convulsions due to metallic poisoning in children

A

Lead (Mercury in both adults and children)

54
Q

T/F: Drug resistant epilepsy is defined as failure of adequate trials of 3 tolerated and appropriately chosen aED schedules.

A

False (2)

55
Q

Most common teratogenic effects of AEDs

A

Cleft lip and palate

56
Q

AED which may precipitate Absence and Myoclonic Seizures

A

Carbamazepine (also Phenytoin in LGS)

57
Q

Paroxysmal depolarizing shifts

A

Partial epilepsy

58
Q

Paroxysmal depolarizing shift is most likely the underlying mechanism of which seizure type?

A

Complex partial seizure

59
Q

In about 50% of patients with infantile spasms, seizures are replaced by this type of syndrome?

A

Lennox-gastaut syndrome

60
Q

Perception of unfamiliarity with previously familiar people.

A

Deja entendu

61
Q

Also called early infantile epileptic encephalopathy with suppression bursts

A

Ohtahara syndrome

62
Q

Mimic infantile spasm by semiology but with normal EEG

A

Benign myoclonus of infancy

63
Q

Refers to acquired epileptic aphasia in children

A

Landau-Kleffner syndrome

64
Q

Antibodies implicated in the pathogenesis of Rasmussen’s encephalitis.

A

GLUR3 antbodies

65
Q

Occurs with intravenous administration of phenytoin causing severe tissue injury from the constriction of blood vessels.

A

Purple glove syndrome

66
Q

T/F: Gabapentin is absorbed in a dose-dependent fashion so that a smaller proportion is absorbed at higher doses.

A

True

67
Q

What is the difference of Lamotrigine from Phenytoin and Carbamazepine in terms of mechanism of action?

A

It also inhibits glutamate release (aside fron inhibiting Na channels like phenytoin and CBZ)

68
Q

AED contraindicated if with sulfonamide allergy

A

Zonisamide

69
Q

AED banned in the US because of 30% risk of irreversible visual field constriction

A

Vigabatrin

70
Q

T/F: estrogen has proconvulsant effects and progesterone has anticonvulsant effects

A

True

71
Q

Caused by mutation in the voltage-gated potassium channel KCNQ2 gene on chromosome 20

A

Benign familial neonatal convulsions

72
Q

An early nonforced head turn localizes to

A

Ipsilateral temporal lobe

73
Q

Triad of hypotension, lipidemia and metabolic acidosis

A

Propofol infusion syndrome

74
Q

The phenytoin dosage should be increased each time by only this amount

A

25-30 mg in adults

75
Q

T/F: Phenytoin has an affinity for thyroid-binding globulin which confuses some test of thyroid function

A

True

76
Q

Most common dose-related adverse effects requiring dosage adjustment in phenytoin

A

Doplopia and ataxia

77
Q

This AED enhances slow inactivation of voltage-gated Na+ channels

A

Lacosamide (in contrast to prolongation of fast inactivation shown by other AEDs)

78
Q

Idiosyncratic toxicity of Valproate

A

Hepatotoxicity

79
Q

T/F: at 0.5 minimal alveolar concentration (MAC), the reduction in CMR is greater than the vasodilation caused by the anesthetic so the cerebral blood flow is decreased.

A

True

80
Q

T/F: Although Propofol leads to general suppression of CNS activity, excitatory effects such as twitching or spontaneous movement are occasionally observed during induction of anesthesia.

A

True

81
Q

Selective antagonist of benzodiazepine

A

Flumazenil

82
Q

T/F: phenytoin exhibit capacity-limited elimination.

A

True

83
Q

Antiepileptic drug with similar properties as tricyclic antidepressants.

A

Carbamazepine

84
Q

AED that worsen Absence and JME

A

Phenytoin, Carbamazepine

85
Q

AED not affected by enzyme inducers and inhibitors

A

Levetiracetam, Gabapentin

86
Q

AED that can potentially lead to renal stone formation

A

Zonisamide, Topiramate

87
Q

AED associated with weight loss

A

Zonisamide, Topiramate

88
Q

Treatment of choice for absence with tonic-clonic seizures

A

Valproate

89
Q

First-line broad spectrum antiseizure drug

A

Valproate

Adams Principles of Neurology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions