Epilepsy

Question 1

seizure without LOC

Answer 1

partial seizure

Question 2

brain area involved for seizure

Answer 2

cortex

Question 3

location for partial seizure

Answer 3

specific cortical area

Question 4

seizure w/ rhythmic contractions/jerking of R face/arm/leg - where is the seizure? what type of seizure?

Answer 4

L frontal motor cortex seizure - simple partial

Question 5

seizure with LOC

Answer 5

complex seizure

Question 6

complex seizure location

Answer 6

medial temporal lobe or hippocampus

Question 7

seizure where pt can’t follow commands and has no recollection afterward

Answer 7

complex partial

Question 8

symptoms initiating a partial siezure

Answer 8

aura

Question 9

non-convulsive generalized seizure

Answer 9

absence seizure (aka petit mal)

Question 10

generalized tonic clonic seizure

Answer 10

violent jerking of limbs with LOC (aka grand mal)

Question 11

tonic phase of seizure

Answer 11

sudden stiffness from muscle contraction, patient may cry out

Question 12

clonic phase of seizure

Answer 12

rhythmic/forceful jerking of limbs/face, tongue biting

Question 13

bladder incontinence seen in which phase of seizure

Answer 13

post-ictal

Question 14

global synchronous cortical discharge from diffuse cortical disinhibition (ex: via permanent brain injury or metabolic disorders)

Answer 14

primarily generalized seizures

Question 15

cortical discharge begins at a focus (site of lesion)

Answer 15

secondarily generalized seizures

Question 16

episodic jerking or thrashing without any spontaneous discharge

Answer 16

pseudoseizures

Question 17

diagnostic testing for seizures/epilepsy

Answer 17

MRI and EEG

Question 18

ideal body position for person who is seizing

Answer 18

roll to side for adequate airway maintenance

Question 19

concerning metabolic issues causing a seizure

Answer 19

hypoglycemia, CNS infection, uncontrolled HTN

Question 20

anti-convulsant side effects at high drug levels

Answer 20

confusion, somnolence, ataxia, nystagmus, dysarthria/dysmetria

Question 21

anti-convulsant side effects at low drug levels

Answer 21

teratogenicity

Question 22

continuous seizure or series of repeated seizures for > 30 min

Answer 22

generalized tonic-clonic status epilepticus

Question 23

status epilepticus can result in

Answer 23

brain damage from persistent cortical electrical discharges

Question 24

anticonvulsants of choice for status epilepticus

Answer 24

benzos - lorazepam or diazepam

Question 25

Loyola’s protocol for treating status epilepticus

Answer 25

1st: lorazepam 0.1 mg/kg (4-8 mg) as an IV bolus, repeat in 5-10 min if needed

Followed by loading w/:
- fosphenytoin 20 phenytoin equivalents (PE)/kg IV, no faster than 150 mg/min
OR
- phenytoin 20 mg/kg IV, given in saline no faster than 50 mg/min.