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Nervous System: Unit IV > Epilepsy I&II > Flashcards

Flashcards in Epilepsy I&II Deck (15)
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1

Signs/symptoms of epileptic seizures

  • symptoms often "positive phenomenon"
  • post-seizure symptoms = negative (loss of fxn)
  • epilepsy = chronicity/recurrent seizures due to underlying brain abnormality
  • types
    • partial vs. generalized
    • tonic-clonic
    • myoclonic
    • absence

2

Partial vs. Generalized Seizures

  • Partial = begins @ one are of the cortex, may remain localized or spread to varying degrees to include the whole cortex
  • Generalized = generalized @ onset; occur b/c cortex as whole is "hyper-irratable"
    • often genetic basis
    • includes absence seizures

3

DDx of causes of seizure presentation

  • syncope
    • circulatory problems
    • hematologic problems
  • movement disorders
  • stroke/TIA
  • miraine
  • sleep disorders
  • psychogenic/behavioral

4

Partial complex seizures vs. Absence seizures

  • both: period of AMS + major motor manifestations
  • partial complex seizures 
    • automatisms (chewing, picking at clothing) are common
    • followed by a post-ictal state
  • absence seizures
    • automatisms less common, but possible
    • not usually followed by a post-ictal state

5

Primary generalized tonic-clonic seizure vs. secondary generalized tonic-clonic

  • tonic-clonic seizure =
    • tonic = lose consciousness, contraction of muscles
    • clonic = contraction/relaxation of mucles leads to convulsion
  • primary = generalized seizure w/out focal starting point
  • secondary = begins as partial seizure and spreads to whole cortex

6

Characteristics of postictal period

  • negative symptoms following a seizure
  • due to neuronal exhaustion of affected brain areas + inhibitory inputs to this area

7

Epilepsy definition

underlying abnormality of the brain that predisposed person to seizures

8

Criteria used in classification of seizures

  • anatomical
    • focal
    • generalized
  • etiologic
    • structural-metabolic
    • genetic predisposition
    • unknown
  • benign vs. catastrophic

9

Focal vs. generalized seizures

  • Focal
    • Characterized according to one or more features:
      • Aura
      • Motor
      • Autonomic
      • Awareness/Responsiveness altered (Dyscognitive) or retained
  • Generalized
    • Absence
    • Myoclonic
    • Tonic clonic
    • Tonic
    • Atonic

10

Benign vs. Catastrophic seizures

  • Benign
    • Easily treated with medications
    • Normal intelligence
    • Tests are usually normal; remission may occur after teens
  • Catastrophic
    • Intractable to medications
    • Affects development with intellectual disability and shortened lifespan of child
    • EEG and MRI are abnormal 

11

Characteristics of intractable epilepsies

  • seizures which do not respond to a trial of at least 3 anticonvulsants and that approximately
  • 30% of new onset seizure patients may develop intractable epilepsy

12

Special syndromes that lead to pediatric seizures

  • febrile
  • neonatal
  • LKS

13

Non-medical tx for intractable seizures

  • ketogenic diet
  • vagal nerve stimulation
  • epilepsy surgery

14

General use for epileptic surgery

  • Used for partial epilepsies
  • Most often temporal lobe in adults and extratemporal or hemispherectomy in children
    • Lesionectomy
    • Lobectomy
    • Corticectomy
  • Not generally used for generalized seizures unless corpus callostomy 

15

Characteristics of febrile seizures

  • occurs relatively frequently in children (6 mo. - 5 yrs)
  • children w/rectal temp @ 102F or above
  • 1/25 children have a febrile seizure; >1/3 of these will have recurrent febrile seizures
    • risk factors for recurrent:
      • young age (<15 mo.) for first seizure
      • frequent fevers
      • fhx of febrile seizures
  • can be seconds to 15 min (>10 min ==> seek urgent care)
  • generally have few long-term effects