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Neuro > Final > Flashcards

Final Flashcards

1
Q

What is the pathophysiology of seizures?

A

Shift in the normal balance of excitation and inhibition w/in CNS

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2
Q

What factors affect seizures/epilepsy?

A

Endogenous factor
Epileptogenic factors
Precipitating factors

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3
Q

What types of seizures occur in late infancy/early childhood?

A

Febrile seizures

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4
Q

At what age do well-defined epilepsy syndromes present?

A

Childhood

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5
Q

When do epilepsies secondary to acquired CNS lesions begin to predominate?

A

Adolescence/early adult adulthood

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6
Q

When is CVA disease a cause of seizures?

A

Older patients

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7
Q

What are common causes of seizures regardless of age?

A

Metabolic disturbances
Hypo/hyperglycemia
Renal failure
Hepatic failure

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8
Q

What are drugs that induce seizures?

A 
Beta lactams
Quinolones
Alkylating agents
Antimalarials
Meperidine
Tramadol
Psychotropics
Theophylline
Drugs of abuse
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9
Q

Where are focal seizures?

A

Asymmetric in one hemisphere

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10
Q

What is the characteristic of focal aware seizures?

A

No loss of consciousness

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11
Q

What are focal aware with motor onset?

A

May present with motor function

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12
Q

What are focal aware with non-motor onset?

A

May present with an alteration in sensation, emotions, thinking, or experiences

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13
Q

What is a Jacksonian march?

A

Tingling in fingertips, to hands or to entire arm

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14
Q

What is Todd’s paralysis?

A

Affected side of the body is numb/tingling for part or rest of the day after seizure

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15
Q

What is focal impaired awareness seizures?

A

Transient loss of awareness/consciousness

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16
Q

How do focally impaired awareness seizures typically begin?

A

With an aura

17
Q

What are focally impaired awareness seizures associated with?

A

Postictal amnesia

18
Q

Where do generalized seizures occur?

A

Bilateral in both hemispheres

19
Q

What are the types of generalized seizures?

A 
Absence (atypical/typical)
Tonic-clonic
Pure tonic
Pure Clonic
Atonic
Myoclonic
20
Q

What is an typical absence seizure characterized by?

A

Sudden, brief lapses of consciousness w/o loss of postural control
Only lasts for seconds

21
Q

Is there any postictal confusion with absence seizures?

A

No

22
Q

What are the characteristics of atypical absence seizures?

A

Longer lapse of consciousness
Less abrupt onset and cessation
More obvious motor signs

23
Q

What are stereotypical seizures with convulsive episodes?

A

Tonic-clonic

24
Q

What are the phases of tonic-clonic seizures?

A

Initial phase is tonic contraction
After 10-20 seconds, seizure evolves into clonic phase
Ictal phase lasts < 1 min
Postictal phase characterized by unresponsiveness (minutes to hours) and possible bladder/bowel incontinence

25
Q

What is the characteristic of a pure clonic seizure?

A

Clonic jerking accompanied by a loss of consciousness

26
Q

What are the characteristics of a pure tonic seizure?

A

Continuous muscle contractions

Accompanying respiratory arrest results in cyanosis

27
Q

What diagnostic test are used in the diagnosis of epilepsy?

A

Serum prolactin levels (elevated following tonic-clonic seizures)
EEG

28
Q

What are the treatment goals of epilepsy

A

No seizure, no SE, and an optimal QOL

29
Q

What is the most common and severe form of SE?

A

GCSE (tonic clonic)

30
Q

What is the relation to type I GCSE and lesions?

A

Not associated with structural lesions

31
Q

What is the relation to type II GCSE and lesions?

A

Associated with structural lesions

32
Q

What are most episodes of epilepsy d/t?

A

Acute anticonvulsant QD
Metabolic disorder or concurrent illness
Progression of a pre-existing neurologic disease

33
Q

What are the major causes of GCSE in infants < 1 yo?

A

Acute encephalopathy

Metabolic disorders

34
Q

What are the major causes of GCSE in younger patients?

A

Nonspecific illness such as fever and/or viral illness

35
Q

What is the major cause of GCSE in adults

A

CVA disease
WD of anticonvulsants
Low anticonvulsant serum concentrations

36
Q

What are medications associated with decreased seizure threshold?

A

WD of anticonvulsants, benzos, barbiturates, opioids
Abx - B-lactams, carbapenems, quinolones, INH, metro
Analgesics - meperidine, tramadol, fentanyl
Antidepressants, Li
Antiarrhythmics
Immunomodulatory and alkylating agents

Neuro (13 decks)

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