CH15: EPILEPSY Flashcards by Robert Sarmiento

how many percent of patients with absence are completely motionless during the attack (p. 336)

10%

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For absence, rarely seizures begin before 4 years of age or after puberty (p. 336)

TRUE

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Difference between childhood and adolescence absence seizure (p. 336)

Persistence into adulthood

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EEG finding in absence seizur (p. 336)

Generalized 3 per second spike and wave

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EEG finding in atypical absence seizure (p. 337)

Long runs of slow spike and wave activity

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EEG finding in Lennox- Gestaut syndrome (p. 337)

1-2 Jz spike and wave

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Lennox Gastaut preceded by this condition in early life (p. 337)

Hypsarrhythmia

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Hypsarrhythmia+ mental development arrest + hypsarrhythmia (p. 337)

West syndrome

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most common form of idiopathic generalized epilepsy in older children and young adults (p. 337)

Juvenile Myoclonic Epilepsy

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EEG findings in JME (p. 337)

4-6 Hz irregular polyspike activity

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JME impairs intelligence (p. 337)

FALSE

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Drug of choice for JME (p. 337)

Valproic Acid

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Drug of choice for JME, but child- bearing age (p. 337)

Levetiracetam, Lamotrigine

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Drugs that exaggerate seizures in JME (p. 337)

Carbamazepine and Phenytoin

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Olfactory hallucination localization (p.339)

Inferior and medial part, temporal lobe

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Gustatory hallucination localization (p.339)

Insula and parietal operculum

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Most frequent reported color during visual seizure (p. 339)

Red

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Auditory hallucination localization (p. 339)

Superior temporal convulsion

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Vertiginous sensation localization (p. 339)

Superoposterior temporal region

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pathologic findings of Infantile spasms (p. 343)

Cortical dysgenesis

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common precipitant of Febrile seizure beacause of its tendency to cause high fever (p. 344)

Herpesvirus 6

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EEG findings in epilepsia partialis continue (p. 345)

repetitive slow- wave or sharp waves or spikes over the central areas of the contralateral hemisphere

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EPC- resistant or not to treatment? (p. 345)

RESISTANT TO TREATMENT

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EPC + progressive hemiparesis (p. 345)

Rasmussen Syndrome

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Antibodies in Rasmussen encephalitis (p. 345)

Anti- GluR3

A single EEG tracing obtained during the interictal state is abnormal to some degree in what percentage of patients (p. 348)

30% to 50%

gross and microscopic CNS findings in brains of patients with epilepsy (p. 349)

NORMAL

loss of neurons in what part of the hippocampus in MTS (p. 349)

CA1

overall concordance of primary epilepsies (p. 349)

70% monozugotic, 30% dizygotic

problematic channel in AD nocturnal frontal lobe epilepsy (p. 350)

nicotinic acetalcholine receptor subinit

problematic channel in generalized epiilepsy with febrile seizures plus (p. 350)

neuronal sodium channel

problematic channel in benign familial neonatal convulsions (p. 350)

two different potassium channels

problemattic hcannel in JME and childhood absence (p. 350)

brain GABA

progressive myoclonic epilepsy, problematic cystatin B (p. 350)

Unverricht- Lundborg disease

progressive myoclonic epilepsy, tyrosine phophate B (p. 350)

Lafora body disease

sudden myoclonic jerk of the head and arms leading to flexion or extension of the body (p. 353)

Infantile spasms

bilateral slow waves and multifocal spikes in EEG (p. 354)

West syndrome

myoclonic focal seizures, loss of function mutation in SCN1A in most cases (p. 354)

Dravet Syndrome

most common lesions underlying status epilepticus in late adult life (p. 355)

Previous infarcts

seizure from advanced Alzheimers (p. 355)

10%

Most common metallic poison causing seizures: childhood (p. 356)

Lead

Most common metallic poison causing seizures: adulthood (p. 356)

Mercury

cephalosporin if excessive dosage can cause status epilepticus (p 356)

Cefipime

2 drugs induced unheralded single convulsion if administered too quicklu or in excessive doses (p. 356)

Lidocaine and Aminophylline

Anticonvulsant but causes myoclonic phenomena upon withdrawal (p. 356)

Propofol

Rate of seizures post stroke (p. 357)

how many percent of women who became pregnant have no change in seizure frequency (p. 357)

2/3

Safe drugs in breast feeding (p. 357)

Carbamazepine, Phenytoin, VPA

Drugs increased in breast milk (p. 357)

Pb, Primidone, Ethosoxumide, Zonisamide, BZD

Vitamin K given at 8th month or before birth due to coagulopathy due to this AED (p. 357)

Phenobarbital

Most common teratogenic effect of AED (p. 357)

Cleft lip and palate

General risk of major copngenital effect with AED vs no AED (p. 357)

4-5% from 2-3%

shortened nose, philtrum or inner canthal distance (p. 357)

midface hypoplasia

decrease in IQ by 9 points (p. 358)

Valproate

highest risk and significant dose effect for an individual for fetal malformation (p. 358)

Polytherapy

AED for patient not having AED for a long time but had seizure during pregnancy (p. 358)

PHY LEV

induce hepatic enzymes, if on pills should be given higher doses (p. 358)

PHY, CBZ, TPR

dose of magnesium in patients with eclampsia (p. 358)

10gm IM, 5g IM q4

percent of patients controlled seizures on one drug (p. 359)

70%

drug that will not have linear kinetics once concentration exceeds 10mg/ml (p. 361)

PHY

drug inducing its own metabolism (p. 361)

CBZ

Antibiotic causes accumulation of PHY and Pb (p. 362)

Chloramphenicol

Antibiotic causes accumulation of CVZ (p. 362)

Erythromycin

Drugs causing breakthrough menstrual bleeding in women taking OCP (p. 362)

PHY, CBZ, Barbiturates

Aromatic drugs responsible for skin erruptions (p. 362)

PHY. CBZ, Pb, Primitone, LMT

Polymorphisms associated with increased risk of skin reactions (p. 362)

HLA B 1502

Relapse rate is lower in patients with absence and generalized- onset than in patients with focal seizures (p. 362)

TRUE

SE of PHY (p. 363)

gum hypertrophy, breast enlargement

Phenytoin hypersensitivity signs (p. 363)

Rash, fever, lymophadenopathy, eisinophilia, blood dyscrasia

PHY not given with this drugs because of undesirable reactions (p. 363)

Disulfiram, Chloramphenicol, Sulfamethizole, Cyclophosphamide, Warfarin

drug acting on glutamic acid decarboxylase and sodium channel (p. 365)

Valproate

drug inhibits GABA transaminase (p. 365)

Vigabatrin

drug inhibitor of GABA reuptake (p. 365)

Tiagabine

AED induces renal stones in 1.5% of population (p. 366)

Topiramate

AED, works on voltage- gated sodium channel, renally excreted, prolong PR interval, worsen heart failure (p. 366)

Lacosamide

Two frugs known to produce absence status (p. 366)

Valproate and Clonazepam

Drug of choice for infantile spasms (p. 366)

ACTH or Vigabatrin

Volatile anesthetic used in circumstances of SE (p. 368)

Isoflurane

Ketogenic diet is main treatment for children with what deficiency syndrome (p. 369)

GLUT 1 deficiency syndrome