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Paige: Neuro! > Seizures > Flashcards

Flashcards in Seizures Deck (45)
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1
Q

when are seizures more prevalent during the lifespan?

A

early childhood and late adulthood

2
Q

do you lose consciousness in a simple partial seizure?

A

no

3
Q

do you lose consciousness in a complex partial seizure?

A

yes

4
Q

may be motor, sensory, autonomic, psychic but without loss of consciousness

A

simple partial seizures

5
Q

what do simple partial seizures usually look like?

A

clonic with repetitive flexion/extension

6
Q

what is it called when motor activity begins distally, then spreads to the whole extremity?

A

jacksonian march

7
Q

what is it called when there is a local paresis that lasts minutes to hours?

A

todd’s paralysis

8
Q

what is it called when a seizure lasts hours to days?

A

epilepsia partialis continua

9
Q

what other symptoms can you have during a simple partial seizure?

A

changes in somatic sensations, vision, equilibrium, ANS, and odd feelings

10
Q

what is it called when focal activity progresses to loss of contact with the environment (e.g. a stare or amnesia)?

A

complex partial seizure

11
Q

what are the stages of a complex partial seizure?

A
  1. aura of “feeling funny”
  2. ictal stage with involuntary behaviors
  3. post ictal confusion
12
Q

how long does a complex partial seizure last

A

seconds to hours

13
Q

what type of seizure is a complex partial seizure, and where in the brain is it most likely to occur?

A

tonic-clonic;

frontal lobe

14
Q

are both hemispheres involved with a simple partial seizure?
what about a complex partial seizure?

A

no with simple;

yes with complex

15
Q

what is it called when electrical impulses occur simultaneously in both brain hemispheres?

A

generalized seizure

16
Q

which type of generalized seizure is a brief LOC without loss of postural control that usually lasts a few seconds

A

absence seizure (petit mal)

17
Q

when do absence seizures usually occur in the lifespan?

A

onset in childhood and remisses in childhood

18
Q

what is different about an atypical absence seizure?

A

symptoms last longer, may have more motor features, may be associated with another brain abnormality (like a delay), and are harder to treat

19
Q

which type of seizure is most common when due to a metabolic derangement?

A

generalized tonic-clonic seizure (grand mal)

20
Q

are patients more or less likely to have an aura with a generalized tonic-clonic seizure?

A

less likely - usually happens suddenly

21
Q

what are the symptoms of a tonic-clonic seizure?

A

tonic activity, a change in respiration (e.g. cyanosis), sympathetic symptoms.
then clonic activity, a post-ictal state (unresponsive) and a post-seizure state (HA, aches)

22
Q

what does an EEG look like during the tonic phase of a seizure?

A

increased low voltage with high amplitude spikes

23
Q

what does an EEG look like during the clonic phase of a seizure?

A

spike and wave activity

24
Q

which type of seizure involves a loss of motor tone for 1-2 seconds, followed by a brief LOC without post-ictal confusion?

A

atonic seizures

25
Q

which type of seizure involves a brief contraction or jerk and is seen in brain injuries?

A

myoclonic seizures

26
Q

what type of seizure in adolescence involves a bilateral jerk with maintained consciousness, is benign, and is worse when sleepy?

A

juvenile myoclonic epilepsy

27
Q

which type of seizure is seen in children with developmental delay, trauma, infx, or neural injuries and is usu. associated with impaired cognitive fn?

A

lennox gastaut syndrome

28
Q

with which seizure will you see hippocampal sclerosis on MRI?

A

mesial temporal lobe epilepsy

29
Q

the influx of what two ions might induce seizures?

A

Ca and Na

30
Q

what type of seizure occurs in 3mo-5y/os, is usually recurrent, and is associated with infections?

A

febrile seizures

31
Q

what are the causes of seizures if the onset is in adulthood?

A
CVA (50%!), 
trauma, 
CNS tumors, 
degen diseases, 
medical problems
32
Q

when you get an EEG, what is a montage?

A

you assess brain waves in different situations

33
Q

what level might be elevated in the first 30 mins of a seizure?

A

prolactin

34
Q

what is a psychogenic seizure?

A

not epileptic behavior, but seen with stress.

involves head turning, twitching, shaking, pelvic thrust, and no LOC

35
Q

which meds are first line for seizures?

A

phenytoin [dilantin],
valproic acid [depakote],
carbamazepine [tegretol]

36
Q

what 3 conditions is gabapentin [neurontin] used for?

A

partial seizures,
post herpetic neuralgia,
neuropathic pain

37
Q

what 5 conditions do you use pregabalin [lyrica] for?

A
partial seizures, 
post herpetic neuralgia, 
neuropathic pain in diabetes, 
neuropathic pain in spinal cord, 
fibromyalgia
38
Q

which drug has hirsituism (or whatever) as a side effect?

A

phenytoin

39
Q

when should you stop a seizure drug treatment?

A

if pt is low risk, had one seizure and then was seizure free, has a normal exam and a normal EEG

40
Q

status epilepticus is a medical emergency - what causes it?

A

metabolic problems, drugs, CNS infx or tumor, head injury, refractory epilepsy

41
Q

what are the normal aspects of the status epilepticus?

A

may range from T-C seizure to more subtle movements (like eye movement)

42
Q

what aspects of a status epilepticus make it a medical emergency?

A

CV implications, hyperthermia, metabolic derangements, and CNS injury may occur

43
Q

how do you treat status epilepticus?

A

benzos, diazepam, midazolam.
phenytoin.
phenobarbitol.
anesthesia.

44
Q

what kinds of surgery could you perform for refractory epilepsy?

A

temporal lobectomy,
focal lesion removal,
corpus callosectomy

45
Q

what surgery can you do to increase the seizure threshold?

A

vagal nerve stimulator