Final Flashcards

(36 cards)

1
Q

What is the pathophysiology of seizures?

A

Shift in the normal balance of excitation and inhibition w/in CNS

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2
Q

What factors affect seizures/epilepsy?

A

Endogenous factor
Epileptogenic factors
Precipitating factors

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3
Q

What types of seizures occur in late infancy/early childhood?

A

Febrile seizures

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4
Q

At what age do well-defined epilepsy syndromes present?

A

Childhood

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5
Q

When do epilepsies secondary to acquired CNS lesions begin to predominate?

A

Adolescence/early adult adulthood

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6
Q

When is CVA disease a cause of seizures?

A

Older patients

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7
Q

What are common causes of seizures regardless of age?

A

Metabolic disturbances
Hypo/hyperglycemia
Renal failure
Hepatic failure

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8
Q

What are drugs that induce seizures?

A
Beta lactams
Quinolones
Alkylating agents
Antimalarials
Meperidine
Tramadol
Psychotropics
Theophylline
Drugs of abuse
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9
Q

Where are focal seizures?

A

Asymmetric in one hemisphere

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10
Q

What is the characteristic of focal aware seizures?

A

No loss of consciousness

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11
Q

What are focal aware with motor onset?

A

May present with motor function

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12
Q

What are focal aware with non-motor onset?

A

May present with an alteration in sensation, emotions, thinking, or experiences

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13
Q

What is a Jacksonian march?

A

Tingling in fingertips, to hands or to entire arm

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14
Q

What is Todd’s paralysis?

A

Affected side of the body is numb/tingling for part or rest of the day after seizure

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15
Q

What is focal impaired awareness seizures?

A

Transient loss of awareness/consciousness

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16
Q

How do focally impaired awareness seizures typically begin?

17
Q

What are focally impaired awareness seizures associated with?

A

Postictal amnesia

18
Q

Where do generalized seizures occur?

A

Bilateral in both hemispheres

19
Q

What are the types of generalized seizures?

A
Absence (atypical/typical)
Tonic-clonic
Pure tonic
Pure Clonic
Atonic
Myoclonic
20
Q

What is an typical absence seizure characterized by?

A

Sudden, brief lapses of consciousness w/o loss of postural control
Only lasts for seconds

21
Q

Is there any postictal confusion with absence seizures?

22
Q

What are the characteristics of atypical absence seizures?

A

Longer lapse of consciousness
Less abrupt onset and cessation
More obvious motor signs

23
Q

What are stereotypical seizures with convulsive episodes?

24
Q

What are the phases of tonic-clonic seizures?

A

Initial phase is tonic contraction
After 10-20 seconds, seizure evolves into clonic phase
Ictal phase lasts < 1 min
Postictal phase characterized by unresponsiveness (minutes to hours) and possible bladder/bowel incontinence

25
What is the characteristic of a pure clonic seizure?
Clonic jerking accompanied by a loss of consciousness
26
What are the characteristics of a pure tonic seizure?
Continuous muscle contractions | Accompanying respiratory arrest results in cyanosis
27
What diagnostic test are used in the diagnosis of epilepsy?
Serum prolactin levels (elevated following tonic-clonic seizures) EEG
28
What are the treatment goals of epilepsy
No seizure, no SE, and an optimal QOL
29
What is the most common and severe form of SE?
GCSE (tonic clonic)
30
What is the relation to type I GCSE and lesions?
Not associated with structural lesions
31
What is the relation to type II GCSE and lesions?
Associated with structural lesions
32
What are most episodes of epilepsy d/t?
Acute anticonvulsant QD Metabolic disorder or concurrent illness Progression of a pre-existing neurologic disease
33
What are the major causes of GCSE in infants < 1 yo?
Acute encephalopathy | Metabolic disorders
34
What are the major causes of GCSE in younger patients?
Nonspecific illness such as fever and/or viral illness
35
What is the major cause of GCSE in adults
CVA disease WD of anticonvulsants Low anticonvulsant serum concentrations
36
What are medications associated with decreased seizure threshold?
WD of anticonvulsants, benzos, barbiturates, opioids Abx - B-lactams, carbapenems, quinolones, INH, metro Analgesics - meperidine, tramadol, fentanyl Antidepressants, Li Antiarrhythmics Immunomodulatory and alkylating agents