Epilepsy Flashcards
(24 cards)
How to distinguish TP from stroke and transient ischemic attack?
-Although all of these conditions can cause headaches, aphasia, and limb weakness, muscle pain is not typical in stroke or TIA, and neurological symptoms typically localize to a single vascular territory.
- TIAs rarely cause altered mental status and unconsciousness.
____is a self-limited, focal weakness or paralysis that occurs after a(n) focal seizure (± secondary generalization)
Todd paralysis i
What is the management for a patient with post-ictal lactic acidosis?
Conservative management
LOC and post-ictal state (sleepiness, confusion) is suggestive of:
generalized seizure
Indication of eIelectroencephalography (EEG) in patients with a new-onset seizure:
If an epileptic disorder is suspected
What type of seizure is initially limited to the face and then involves the entire body?
Focal to bilateral tonic-clonic seizure
What type of seizure begins suddenly (without prodromes), is associated with jerking movements of the entire body and causes only a brief impairment of consciousness?
Generalized myoclonic seizures
Focal (partial) seizures most commonly originate in the _____
medial temporal lobe
What is the likely diagnosis in a child that presents with multiple staring episodes accompanied by head tilting and mouth chewing, followed by a transient period of confusion?
Focal impaired awareness seizures
What type(s) of seizure(s) may be treated with levetiracetam?
Focal (partial) and tonic-clonic
How do you manage chronic epilepsy/seizure disorder in a patient who is wanting to become pregnant?
Lamotrigine or levetiracetam
Status epilepticus can cause potentially irreversible tissue damage of the CNS, resulting in _________ which is often characterized by permanent neurological deficits
cortical laminar necrosis (CLN),
Which drugs are used to prevent seizure recurrence after initial treatment of status epilepticus?
- IV levetiracetam
- IV fosphenytoin
- IV valproic acid
What is the first-line therapy for aborting status epilepticus?
IV / IM benzodiazepines such as lorazepam and diazepam
Patient with frequent short episodes of staring, inattentiveness, and eyelid fluttering while maintaining muscle tone and lacking a postictal phase:
Absence seizures
______ is the drug of choice for seizure prophylaxis in childhood absence epilepsy.
Ethosuximide. It exerts its effects by blocking T-type Ca2+ channels in the thalamus
Prolonged seizure duration, closed eyes, unimpaired awareness during the event, asynchronous motor activity, lack of postictal phase, and absence of injuries indicate psychogenic nonepileptic seizures (PNES)
Psychogenic nonepileptic seizure (PNES)
Persistent status epilepticus refractory to multiple doses of IV benzodiazepines - next step?
- IV fosphenytoin
- IV valproic acid or
- IV levetiracetam
What is the next step in management of a child after a febrile seizure with no neurologic abnormalities?
Supportive care and reassurance
What can be given as symptomatic treatment for simple febrile seizures?
Acetaminophen
Patient with sequence of crying, exhalation, and breath-holding, followed by cyanosis and loss of consciousness accompanied by jerky movements due to cerebral hypoxia
Breath-holding spell
If an adult patient presents with an episode of lip smacking associated with an impaired level of consciousness and followed by by confusion, think:
Partial seizure with impaired awareness
What is the first-line anticonvulsivant in children?
Levetiracetam
Anticonvulsivants for partial and tonic-clonic seizures:
Levetiracetam, phenytoin, carbamazepine, valproic acid
