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Adult Neuro > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (19):
1

Seizure definition

abnormally excessive or synchronous neuronal activity in the brain
*on the EEG: will look normal unless having an active seizure

2

Epilepsy definition

recurrent, unprovoked seizures (>/= 2)

3

2 Seizure classifications, further classifications

1. Primary generalized (all parts of cortex simultaneously)
2. Partial-onset (starts in one region, w/wo spread)

* further classified as insidious or symptomatic

4

Types and description of primary generalized seizures

1. Generalized tonic-clonic (GTC)
2. Absence seizures (staring spells- peds)
3. Myoclonic seizures (shaking)
4. Tonic Seizures (rigid)

5

Types of Partial Onset seizures

1. Simple partial seizures (SPS) - doesn't spread
2. Complex partial seizures (CPS)- spreads

6

Location related seizure: Temporal Lobe
- time frame
- what it starts with
- what happens when it's over

- lasts 1-3mins
- Starts with oral movements (chewing, lip smacking)
- lethargy afterwards

7

Location related seizure: Frontal Lobe
- time frame
- when does it occur
- afterwards

- lasts 10-15s
- usually when a person is waking up
- may have vocalizations, no auras
- no lethargy phase afterwards

8

Location related seizure: Occipital Lobe
- what is associated with these

aura

9

Location related seizure: Parietal Lobe
- where it originates
- what is associated with it

- originates in hippocampus
- associated with sensory aura

10

Medical Treatment

Antiepileptic drugs - will cycle through drugs until they can prevent a seizure

11

Why do you want to prevent a seizure

disturbance to the brain and some damage!
in GTCs increase in CPK after seizure

12

Surgery: Temporal lobe

easiest, accessible,

13

Surgery: Vascular malformations, low grade tumors

easy enough, can go in and deal with it (not as easier as temporal lobe surgery)

14

Surgery: Corpus Callostomy

if seizures are so bad they will consider doing this

15

Surgery: Hemisppherectomy

If seizures are so bad they will consider this (gets performed more often in children

16

Surgery: Gamma knife radiosurgery

clinical trials

17

Surgery: Brain stimulation

clinical trials
only works if pt has partial onset (specific location)
when they sense it is starting, the simulation is applied to shift electrical activity in the brain

18

What is the least harmful procedure for pregnancy when you have seizures

- get seizures under control with 1 medication; control should be at its best (seizure during pregnancy is very harmful)
- do not change medication after conception

19

What to do if pt has a seizure in clinic

1. put pt into supine (nothing in the mouth, no turning head)
2. Time the seizure
3. make astute observations (what were they doing when it started, what happened when it started, what happened during it, how did it end)
4. Call RR team or 911
5. Postictal time (time of unconsciousness afterwards)