B7.053 Prework 1: Seizures and Epilepsy Flashcards

1
Q

convulsions

A

involuntary synchronous movement of the limbs
-stiffening: tonic
-semi-rhythmic movements: clonic
often associated with loss of consciousness

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2
Q

syncope

A

loss of consciousness with loss of postural muscle tone (falling)
often associated with brief convulsions
spontaneous recovery

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3
Q

cause of syncope

A

usually caused by transient hypotension

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4
Q

signs that favor syncope over seizure

A
syncope associated event:
-prolonged standing
-Valsalva
-pain, blood
presyncope symptoms (tunnel vision)
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5
Q

signs that favor seizure over syncope

A
focal onset (e.g. head turning at onset)
tongue biting
prolonged unconsciousness
postictal confusion
incontinence
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6
Q

seizure

A

clinical manifestations of abnormal synchronous discharge of cerebral cortical neurons
often manifested by convulsions

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7
Q

types of focal onset (partial) seizures

A
  • with retained awareness
  • with impaired awareness
  • focal to bilateral tonic-clonic
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8
Q

what is another name to focal to bilateral tonic clonic seizures

A

secondary generalized

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9
Q

why can hypoglycemia lead to seizures

A

neurons depolarize due to decreased energy generation

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10
Q

types of generalized onset seizures

A
motor
-tonic-clonic
-myoclonic
-other
nonmotor (absence)
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11
Q

epilepsy

A

intrinsic tendency of the brain to have seizures

2 or more unprovoked seizures

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12
Q

features of focal epilepsies

A

localization related

  • focal onset seizures
  • localized EEG abnormalities
  • usually acquired (something happened to a portion of the brain)
  • cryptogenic vs non-cryptogenic
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13
Q

common locations of focal epilepsies

A
  1. temporal lobe
    - mesial temporal sclerosis
  2. frontal lobe
    - supplementary motor
  3. parietal lobe
  4. occipital lobe
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14
Q

etiologies of focal epilepsies

A
a structural lesion
most often cryptogenic
common visible lesions
-post traumatic scarring
-tumor
-old stroke
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15
Q

features of generalized epilepsies

A

non localization related

  • generalized onset seizures
  • bilateral symmetric EEG abnormalities
  • often genetic
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16
Q

genetic causes of generalized epilepsy

A

childhood absence
juvenile absence
juvenile myoclonic epilepsy

17
Q

diffuse brain damage at a young age

A

infantile spasms

lennox gaustat syndrome

18
Q

diagnostic approach to patient with apparent seizure

A

was it a true seizure?
was it provoked?
does the pt have epilepsy

19
Q

epilepsy treatments

A

AEDs
epilepsy surgery
electrical stimulation of the nervous system

20
Q

how to select and AED

A

some drugs only prevent focal onset seizures
some drugs only prevent generalized onset
some prevent both

21
Q

narrow spectrum AEDs

A

focal onset only

  • phenytoin
  • phenobarbital
  • carbamazepine
  • oxcarbazepine
  • gabapentin
  • pregabalin
  • lacosamide
  • vigabatrin
  • ethosuximide (generalized absence only)
22
Q

broad spectrum AEDs

A

focal and generalized onset

  • valproic acid
  • lamotrigine
  • topiramate
  • zonisamide
  • levetiracetam
  • clonazepam
  • rufinamide