Lect 5 & 6 (need to relisten to 1st half of lect 5 w/szs)

Question 1

75% of pts with epilepsy can be successfully withdrawn off medication, this is called

Answer 1

remission off medication (you don’t say cure)

Question 2

what is a focal sz

Answer 2

starts at one point of brain and spreads

Question 3

what is a simple partial sz

Answer 3

a type of focal sz in which only one area is twitching with no change in awareness

Question 4

aura in a sz occurs with which type

Answer 4

simple partial (focal)

Question 5

what is a complex partial sz

Answer 5

focal but causes a change in mental status

Question 6

what 2 sz types can autonomic sz fall under

Answer 6

simple partial and complex partial

Question 7

what is the postictal state

Answer 7

follows epileptic sz and pt has altered consciousness

Question 8

name the 2 types of non-convulsive (generalized) szs

Answer 8

absence and atonic

Question 9

name the 6 convulsive szs (these are generalized or can be “secondarily generalized”)

Answer 9

tonic clonic
tonic
myoclonic(nonrhythmic jerk)
clonic
spasms
hypermotor

Question 10

convulsive sz generally have a ______ duration

Answer 10

short (with quick recovery)

Question 11

what do you treat absence/atonic sz with?

Answer 11

ethosuximide

Question 12

what do you treat focal sz with?

Answer 12

carbamazepine and oxcarbazepine

Question 13

name 5 nonepileptic events/pseudoseizures

Answer 13

febrile convulsions
breath holding spells
syncope
movement dos
tics

Question 14

what is status epilepticus

Answer 14

sz greater than 5 mins; OR longer than what is avg for the specific pt

Question 15

1st line tx for status epilepticus? (3 examples)

Answer 15

Benzos!

diazepam, lorazepam, and midazolam

Question 16

what is 2nd line tx for status epilepticus

Answer 16

ANY epileptic drug you can PUSH

phenytoin

Question 17

which antiepileptic cannot be pushed and should not be used as 2nd line?

Answer 17

lamotrigine

Question 18

what is 3rd line tx for status epilepticus

Answer 18

medically induced coma (pentobarbital)

Question 19

what is intractable epilepsy?

Answer 19

when 2 different medications have been used to try to control epilepsy without success

***if pt gets on a third med and it works, they still have intractable epilepsy

Question 20

those with intractable epilepsy are referred for a _______ work up and are eligible for….

Answer 20

presurgical

non-pharm tx including left vagus therapy, surgery, and ketogenic diet

Question 21

what does electroencephalogram (EEG) read?

Answer 21

measures the spontaneous electrical activity of the SUPERFICIAL cortex

Question 22

8% of healthy ppl have an abnormal EEG, and 20% of ppl with epilepsy have an normal EEG… the EEG is _________ and _______

Answer 22

nonspecific

nonsensitive

Question 23

what is computed tomography (CT)? what is it good for looking at?

Answer 23

uses radiation to measure the density of tissue, can show white and grey matter divisions (must be >2yo).
EXCELLENT for showing BONE and BLOOD
can also see ventricles pretty well

Question 24

what 3 dz processes can computed tomography (CT) detect well?

Answer 24

traumatic injury of head
stroke
suspected inc intercranial pressure

Question 25

_____ is excellent for showing brain tissue, but does not show bone well

Answer 25

MRI