Idiopathic Epilepsy Flashcards

(37 cards)

1
Q

what is a cluster seizure?

A

two or more seizures occurring within 24 hours

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2
Q

what is the prodromal phase?

A

altered behavior hours before seizure

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3
Q

what is a generalized seizure?

A

generalized neuronal hyper-excitability encompassing the entire cerebral cortex
both hemispheres

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4
Q

what is a focal seizure?

A

neurons of specific region of brain are involved in seizure focus
can affect any part of body, but head most often

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5
Q

what is the pathogenesis of seizures?

A

not completely understood
an imbalance in excitatory and inhibitory neurotransmission

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6
Q

what is the genetic mode of transmission of idiopathic epilepsy?

A

autosomal recessive
more than one gene involved

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7
Q

what is the age of onset of idiopathic epilepsy?

A

10 months- 5 years

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8
Q

for what ages should you do an MRI for onset of seizures?

A

less than a year
more that five years

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9
Q

what metabolic testing should you do for a dog with new onset of seizures?

A

CBS, chemistry profile, urinalysis
bile acid stimulation test
ammonia

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10
Q

what are some indications for starting an anticonvulsive medication?

A

status epilepticus
cluster seizures
intracranial lesion
increasing seizure activity with shortening interictal interval

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11
Q

what is the breakdown of categories of causes of status epilepticus?

A

40% idiopathic epilepsy
40% symptomatic (intracranial) epilepsy
20% reactive (extra-cranial) epilepsy

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12
Q

what are some at home options for cluster events?

A

rectal diazepam
intranasal diazepam
intranasal midazolam
rectal levetiracetum
pulse therapy levetiracetum

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13
Q

what is the mechanism of action of phenobarbital?

A

effects post synaptic barbituate receptor in presence of GABA
prolongs opening of chloride channels: hyperpolarization of cell membrane

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14
Q

what is the mechanism of action of bromide?

A

hyperpolarization of post-synaptic membrane via accumulation within cells

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15
Q

what is the mechanism of action of levetiracetam?

A

modulates release of neurtotransmitters via selective binding to the SVA2 protein

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16
Q

what is the mechanism of action of zonisamide?

A

blocks T-type calcium channels
inhibits voltage-gated sodium channels
enhances GABA release
inhibits glutamate release

17
Q

what is the mechanism of action of pregabalin?

A

binds to CaVa2 unit of the calcium channel
reduced calcium influx diminishes excitatory neurotransmitter release

18
Q

which medication has liver side effects as a concern?

A

phenobarbital

19
Q

which medication should you not give to cats?

A

potassium bromide

20
Q

what interactions do cannabinoids have?

A

inhibition of cytochrome P450 cytochrome oxidase
interference of diazepam derivatives and most likely also phenobarbital

21
Q

what is the mechanism of action of ketogenic diets?

A

ketone bodies have anti-epileptic properties
fatty acids metabolized into ketone bodies when low amount of carbohydrates
dogs easily become ketotic
medium chain triglycerides more easily produce ketone bodies in dogs

22
Q

what are the negative prognostic factors for seizure control?

A

presence of cluster seizures
age at presentation
duration of seizure disorder

23
Q

what are the clinical manifestations of generalized seizures?

A

tonic-clonic
tonic
clonic
myoclonic

24
Q

is glutamate excitatory or inhibitory?

25
what channels does glutamate control?
sodium/calcium channels
26
which breeds are especially predisposed to seizures?
belgian shepherd border terrier finnish spitz irish wolfhound italian spinone petite basset griffon de vendeen labrador retriever
27
what are the potential causes of primary epilepsy?
idiopathic hereditary
28
what is the half life of phenobarbital?
dog: 24-48 hours cat: 34-43 hours low protein diet decreases
29
how is bromide excreted?
renal
30
what are the side effects of levetiracetam?
rarely weakness rarely sedation very rarely excitement
31
how is levetiracetam metabolized?
minimal hepatic renal excretion
32
how is zonisamide cleared?
hepatic- not P450 renal excretion
33
is zonisamide used for emergency therapy?
no- maintenance only
34
how is pregabalin cleared?
excreted unchanged through kidneys
35
how do ketogenic diets act to decrease seizures?
ketone bodies anti-epileptic fatty acids and medium chain triglycerides produce ketone bodies also decanoic acid
36
what is decanoic acid?
non-competitive AMPA receptor antagonist: inhibition of excitatory neurotransmission
37
are dogs that present at a very young age or old age less responsive to medications?
very young age