Epileptic seizures diagnostic approach and classification

Question 1

What is the definition of a seizure?

Answer 1

Transient and involuntary change in behaviour or neurologucal status due to he abnormal activity of populations of CNS neurons

Question 2

What does hypersycnchronous mean?

Answer 2

All neurons firing at the same time

Question 3

what is the definition of epilepsy?

Answer 3

2 or more seizures 48 hrs apart

Question 4

How long (generally) does a seizure need to go on before you can see brain pathology?

Answer 4

30 minutes

Question 5

How long does a seizure have to go on for before you decide that the brain probably can’t stop that seizure itself?

Answer 5

About 10 mins. Needs intervention

Question 6

What is the definition of cluster seizuring?

Answer 6

2 or more seizures in 24 hours

More difficult to treat

Question 7

What are the 4 parts/stages of seizuring?

Answer 7

prodrome

Aura

Ictus

Post-ictal

Question 8

What is prodrome?

Answer 8

Behaviour changes that occur hours or days before the seizure

Question 9

What is aura?

Answer 9

Sensory experience pre sensory/focal onset seizures e.g. perceived smell or eeling of deja vu. dif to proove in animals

Question 10

What is post ictal?

Answer 10

Neurological status alterations hours or days after the seizure

Question 11

What is ictus?

Answer 11

The seizure event itself

Question 12

What are the three general classifications of seizures?

Answer 12

Self-limiting

Clustered or continuous

Reflexive

Question 13

Self limiting and continuous/clustered can both be generalised or focal

Answer 13

:)

Question 14

What are reflexive seizures?

Answer 14

Seizures which have a precipitating stimulus

Question 15

What is syncope?

Answer 15

NOT the same as a seizure

Partial or complete loss of consciousness

Lack of motor activit

No post-ictal signs

Short duration

Question 16

What things commonly stimulae narcolepsy?

Answer 16

Excitement, food, pharmacology

Question 17

What 4 things can mimic epilepsy but are not?

Answer 17

Syncope, narcolepsy, pain, bestibular syndrome

Question 18

What are clonic movements?

Answer 18

Rhythmic muscle contractions

Question 19

How long do seizures normally last?

Answer 19

Around 1 min

Question 20

Do most recurrent seizures respond to anti epilepic drugs?

Answer 20

yars

Question 21

What are the four classifications of epilepsy by aetiology?

Answer 21

Symptomatic or secondary seizure

Reactive seizure

Idiopathic/primary epilepsy

Possible symptomatic/cryptogenic epilepsy

Question 22

What is the cause of symptomatic/secondary seizure?

Answer 22

Structural brain lesion

Question 23

What is the cause of reactive seizures?

Answer 23

Metabolic or toxic

Question 24

What is the cause of idiopathic/primary epilepsy seizures?

Answer 24

Unknown, probably genetic

Question 25

What age of dogs generally present with epilepsy?

Answer 25

6 months to 6 years

Question 26

beagles, GSDs, labradors, Golden retrievers often get \*\*\*\* seizures

Answer 26

generalised

Question 27

Viszlas, springer spaniels, standard poodles often get \*\*\*\*\*\* seizures

Answer 27

Focal seizures with or without generalization

Question 28

Which breed of foals often gets congential seizures which they then grow out of?

Answer 28

Arabs

Question 29

What are the main causes of seizures in adult horses?

Answer 29

Strucural or metabolic brain disease Migrating parasite/previous trauma Intra-carotid injection! Iatrogenic

Question 30

What age group might you be more suspicious of metabolic cause e.g. PSS, hypoglycaemia, or infectious disease?

Answer 30

Less than 6 months

Question 31

Which age group might you suspect idiopathic epilepsy, inflammatory/infectious?

Answer 31

6 months to 6 years

Question 32

Which age group might you be most suspicious of neoplasia as a cause for seizures?

Answer 32

Ovver 6 years

Question 33

The disease onset and progression can give you clues as to the atiology

Answer 33

h

Question 34

lateralising signs in the neuro exam is mroe likely to be intracranial or extracranial cause?

Answer 34

Intra cranial

Question 35

If there are symmetrical abnormalities on the neuro exam it is likely to be..

Answer 35

Something affecting the brain as a whole eg Toxic, metabolic, some infectious causes Hydrocephalus

Question 36

If you have a normal neuro exam you might suspect..

Answer 36

Idiopathic epilepsy Could be wax/wane metabolic disease

Question 37

The following conditions would probably give you symmetrical-generalised onset or assymetical-focal onset? Idiopathic epilepsy Metabolic Toxic Degenerative Hydrocephalus Trauma Midline structural problems

Answer 37

Symeetrical-generalised onset as affect whole brain

Question 38

The following conditions would probably give you symmetrical-generalised onset or assymetical-focal onset? Inflammatory/infectious Neoplasia Anomalies Trauma Cryptogenic and idiopathic

Answer 38

Assymetrical focal seizure

Question 39

What tests would you want to do in a patient that you suspect has an extra cranial cause for its epilepsy?

Answer 39

CBC Biochem Possibly ammonia Resting bile acids Urinalysis Blood pressure in mature animals

Question 40

How would you work up a suspected intracranial case?

Answer 40

Advanced brain imaging CSF tap to look at WBCs, protein content Possibly positive brain imaging for infectious agents