Seizure/EEG 3

Question 1

15 y/o has hx of seizures beginning at 9 y/o.
Seizures followed by prolonged motor or sensory deficits lasting days-wks. Pattern of seizures and focal deficits have changed over time.
Pt also has hemicranial HAs. No family hx of similar sxs.
Dx?

Answer 1

Mitochondrial encephalopathy, lactic acidosis, and stroke

Question 2

Medication for adequate initial tx of absence seizures in children?

Answer 2

Valproate

Question 3

Gelastic (sudden burst of energy, usually in form of laughing or crying) seizures associated w/ which brain foci?

Answer 3

Hypothalamus

Question 4

Increase in beta frequency during awake EEG caused by which meds?

Answer 4

Sedatives

Question 5

Most common EEG finding in metabolic encephalopathy

Answer 5

Generalized slowing

Question 6

15 y/o pt w/ partial, complex seizures w/ secondary generalization, mental retardation, and adenoma sebaceum.
Dx?

Answer 6

Tuberous sclerosis

Question 7

Pt w/ history of depression and well-controlled epilepsy responded to bupropion after failing on several antidepressants. PT had not tried imipramine, nortriptyline, duloxetine, and selegiline. No seizures have occurred on buproprion 100 mg BID. Insurance recommends changing meds d/t reduced seizure threshold w/ bupropion. Appropriate response?

Answer 7

Continue bupropion

Question 8

54 y/o pt w/ gastric ulcer undergoes emergent surgery and 30 hrs post-op becomes confused, agitated, and responds to internal stimuli and suffers generalized tonic-clonic seizure.
Dx?

Answer 8

Delirium tremens

Question 9

A child w/ intellectual disability is free of seizures, but develops epilepsy in adolescence. Pattern of onset is often seen with?

Answer 9

Autism spectrum d/o