Seizures and Epilepsy Flashcards

1
Q

A transient episode with signs or symptoms of abnormal excessive synchronous neuronal activity in the brain

A

Seizure

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2
Q

Physical manifestations of a seizure vary based on the pattern of network involvement in the

A

Brain

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3
Q

A seizure involving the left motor cortex will produce features characterized by

A

Excessive function of that region

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4
Q

What are the two major types of a seizure?

A

Focal or General

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5
Q

Bilateral tonic stiffening of extremities alternating with clonic jerking

A

Generalized tonic-clonic convulsion

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6
Q

Has impaired consciousness with sympathetic symptoms such as tachycardia and mydriasis

A

Generalized tonic-clonic convulsion

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7
Q

Seizure without alteration of consciousness (focal aware)

A

Simple partial seizure

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8
Q

Seizure with alteration of consciousness (focal impaired awareness)

A

Complex partial seizure

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9
Q

Focal to bilateral tonic-clonic seizure

A

Secondary generalized seizure

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10
Q

Manifestation is related to brain region involved

  • May be an aura
  • No alteration of awareness
A

Simple partial seizure

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11
Q

A simple partial seizure may progress into a

A

CPS or GTC seizure

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12
Q

A post-ictal deficit may be seen with a

A

Simple partial seizure

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13
Q

Focal-onset seizure with alteration of awareness

A

Complex partial seizure

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14
Q

Typically characterized by staring and poor/no responsiveness

A

Complex partial seizure

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15
Q

May involve gaze deviation, (forced) head deviation, or unilateral/asymmetric limb involvement

A

Complex Partial Seizure (CPS)

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16
Q

Complex partial seizures may progress to

A

GTC seizure

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17
Q

A new term for focal seizure to bilateral tonic-clonic seizure

A

Secondary generalized seizure

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18
Q

Seizure activity begins in one brain region then spreads to involve the rest

A

Secondary Generalized Seizure

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19
Q

Secondary Generalized Seizures may spread slowly starting as a

A

SPS or CPS

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20
Q

May spread fast, only manifesting as a generalized (bilateral) tonic-clonic convulsion

A

Rapidly secondary generalized seizure

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21
Q

Electrodes capture electrical activity from cortex

A

Electroencephalogram (EEG)

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22
Q

To best capture epileptiform activity, capture

A

Stage 2 sleep

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23
Q

Photic stimulation may demonstrate photosensitive epilepsies, such as

A

JME or Reflex epilepsy

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24
Q

May trigger seizures such as absence, or accentuate focal slowing

A

Hyperventilation

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25
Q

Show focal spike-and-wave activity on an EEG

A

Focal-onset seizures

26
Q

Shows generalized spike-and-wave activity on an EEG

A

Primary Generalized Seizures

27
Q

Looking for an underlying structural lesion as the source of a focal-onset seizure, e.g. stroke, tumor, hippocampal sclerosis, and many more

A

MRI of the brain

28
Q

A disorder of the brain that results in seizures that are recurrent, unprovoked, and sterotyped

A

Epilepsy

29
Q

Multiple events daily, can be over a hundred seizures per day

  • Usually lasts more than 10 seconds
  • Contribute to poor academic performance
A

Childhood absence epilepsy

30
Q

Childhood absence epilepsy is often triggered by

A

Hyperventilation

31
Q

The EEG for childhood absence epilepsy shows

A

3 Hz generalized spike-and-wave

32
Q

Characterized by brief, bizarre, and nocturnal seizures

A

Frontal Epilepsy

33
Q

Characterized by sensory based seizures

A

Parietal Epilepsy

34
Q

Characterized by seizures with formed visual phenomena

A

Occipital Epilepsy

35
Q

Nighttime focal onset or rapid secondary generalized seizure

-Most common type of childhood epilepsy

A

Benign Rolandic Epilepsy

36
Q

Characterized by speech arrest, drooling, “gurgling,” facial tonic-clonic activity, facial hemisensory

-Ages 4-15 and most common around 7

A

Benign Rolandic Epilepsy

37
Q

What does the EEG of benign Rolandic Epilepsy show>

A

Bilateral independent centrotemporal spikes

38
Q

Characterized by multiple seizure types: axial tonic, atonic, atypical absence, and more

A

Lennox-Gastaut Epilepsy

39
Q

Can start anywhere from infancy to 14 years of age, mostly commonly 2-3 years old

-More common in boys

A

Lennox-Gastaut Epilepsy

40
Q

Lennox-Gastaut Epilepsy is characterized by

A

Cognitive impaitment or regression

41
Q

What does the EEG for Lennox-Gastaut show?

A

Slow spike-and-wave

42
Q

West syndrome: combination of spasms, hypsarrhythmia, and developmental regression

-onset between 3 and 18 months

A

Infantile spasms

43
Q

Combination of spasms, hypsarrhythmia, and developmental regression

A

West syndrome

44
Q

Flexor, extensor, or flexor-extensor events occurring in clusters around sleep-wake transition

A

Infantile spasms

45
Q

EEG shows hypsarrhythmia: chaotic, high-amplitude, multifocal spikes, electrodecrement

A

Infantile Spasms

46
Q

Certain populations are more vulnerable such as children affected with trisomy 21 or tuberous sclerosis

A

Infantile Spasms

47
Q

How do we treat West Syndrome/Infantile Spasms?

A

ACTH, vigabatrin, steroids, and ketogenic diet

48
Q

A combination of increased neuronal excitability, hypersynchronization, and inability to self-terminate

A

Seizures

49
Q

Synaptic connectivity leading to propogation

A

Hypersynchronization

50
Q

Failure of negative feedback or feed forward loop

A

Inability to self-terminate

51
Q

Epilepsies with genetic underpinning encode for proteins in

A

Ion Channels

52
Q

Particularly prone to synchronized bursts of activity

A

Cerebral Cortex and Hippocampus

53
Q

The recurrence rate of single idiopathic seizures is

A

~50%

54
Q

Treatment is typically done following the

A

Second Seizure

55
Q

About 40% of patients are seizure free after one

A

AED

56
Q

What percentage of additional patients are seizure free on two AEDs?

A

20%

57
Q

Injection of an anesthetic (sodium amobarbital (Amytal) or sodium methohexital) into the right or left internal carotid artery

-Test each hemisphere for memory and language

A

Wada Test

58
Q

What is the success rate for surgery on temporal lobe epilepsy?

A

50-80%

59
Q

What is the surgical success rate for extra temporal lobe epilepsy?

A

Nearly 40%

60
Q

Traditionally defined as:

  • One continuous seizure > 30 minutes
  • OR recurrent seizures without regaining consciousness between seizures for > 30 minutes
A

Status Epilepticus

61
Q

What is the acute management for status epilepticus?

A

ABCs, IV lorazepam or diazepam, or fosphenytoin