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Flashcards in Neuro Lecture 1 Deck (80):
1

One organ without pain receptors?

Brain

2


Three divisions of the nervous system 



Central Peripheral Enteric


3

Which cranial nerves aren't peripheral nerves?

CN II (optic) because they are surrounded by dura mater

4

Which has more neurons, enteric or spinal cord?

Enteric

5

What neurotransmitter does the enteric nervous systemic use?

Serotonin

6

what deals with neurology disorders commonly diagnosed in childhood? Ex- cerebral palsy

Child neurology

7

If a child has a tremor, whom should they be seen by?

An adult neurologist

8

How are most diagnoses made?

By history

9

laboratory, diagnostic, and imaging findings must be...

clinically correlated

10

In neurology do you diagnose based on labs?

No, must all be clinically correlated

11

What is a seizure?

Hypersynchronous brain activity

12

What is epilepsy?

An abnormally low seizure threshold.
A tendency for “unprovoked” seizures

13

How many people will have a seizure in their lifetime?

10%

14

Is a seizure caused by strobe lights provoked or unprovoked?

Unprovoked

15

What age ranges are more prone to seizures?

under 2 and over
65 years

16


Why are males at more risk for seizures?



Less neurons since testosterone kills brain cells


17

What is remission in epilepsy?

Gone 2-5 years without a seizure (includes being on meds)

18

What diet can help with seizures that aren't controlled by meds?

ketogenic

19

What is the difference b/w generalized and focal seizures?

Focal is on one part of the brain, generalized is throughout

20

What does convulsive mean?

Involve positive motor activity

21

simple partial seizure

starts in a locus and spreads contiguous

22

What type seizure that spreads to a non-contiguous area. Change in mental status (90% of time), look like staring spells.

Complex partial seizure

23

What type seizure is a focal motor seizure. Ex- rhythmic jerking on their hand. There is a simple partial seizure in the motor strip.

Simple partial seizure

24

What is a simple partial seizure in a non-motor area called? Ex- see sparkling lights, weird feelings they can't tell the difference b/w big and little things.

An aura

25

Is an aura a feeling you get before a seizure?

No, it is a seizure going on

26

What are the 2 types of generalized seizures?

Non-convulsive
Convulsive

27

What are seizure where a person then totally falls limp to the ground. Absence seizure of the muscles.

Atonic generalized seizure

28

What does a clonic seizure look like?

Rhythmic jerking movements

29

What is a single non-rhythmic jerk?

Myoclonic

30

What type generalized convulsive seizure is often found in infants, looks like colic?

Spasm

31

What type seizure is usually at night and is bicycling in bed with an outstretched arm.

Hypermotor

32

What do secondarily generalized convulsive seizures look like?

GTC (generalized tonic clonic seizures)

33

Does an EEG diagnose epilepsy?

No, history does

34

How many people will become epileptic sometime in their life?

3%

35

How are EEGs described?

Nonspecific and nonsensitive

36

What does the EEG record?

Superficial cortex

37

Where will an EEG not capture seizures?

In sulci or deeper in the brain

38

What type seizures can has normal or abnormal EEGs?

focal onset

39

what type seizures are typically long? (>20 sec)

Focal seizures

40

What type seizures are typically short? (<20 seconds)

generalized seizures

41

which type seizures tend to morph?

Focal onset seizures

42

What is the phase after a seizure where a patient is confused, sleepy, can't talk?

post-ictal state

43

What type epilepsy usually has a post-ictal phase?

Focal-onset

44

If someone has a starting spell, what are 2 types seizures they could have?

Complex partial (focal)
absence (generalized)

45

Kid is constantly falling?

Atonic seizure

46

What med is only used for atonic and absence epilepsy?

ETS (Ethosuximide)

47

2 meds only used for partial onset seizures?

CBZ (carbamazepine)
OXC (Oxcarbazepine)

48

Will you get a mixture of focal and generalized seizures?

No, very rare

49

What happens if you give CBZ to a person with generalized seizures?

status epilepticus

50

what is a seizure that is too long?

status epilepticus

51

What is the first line treatment for status epilepticus ?

Benzos- if at home DZP (rectal gel)
if in hosptial- LZP (lorazepam)

52

What is second line treatment for status epilepticus?

Any appropriate anti-epileptic drug you can push

53

What 2 drugs can't you push therefore can't give for status epilepticus?

Phenytoin (PHT)
lamotrigine (LTG)

54

what does lamotrigine given too fast lead to?

Steven-Johnson's syndrome

55

What can phenytoin given through IV lead to?

Heart stopping (alkaline solution)

56

how long about does it take for anti-epileptic drugs to be therapeutic once given?

20 minutes or so

57

What is the 3rd line treatment for status epilepticus?

Coma (about 1/3 of these kids will never come out)

58

If someone presents seizing, what should you assume?

Status epilepticus

59

What can the benzos suppress and lead to having to do what?

Suppress breathing, have to intubate

60

Which seizure types can go into status epilepticus?

All of them

61

What things can look like seizures but aren't?

Provoked convulsions
febrile convulsions (type of provoked)
Tic disorders
self stimulation
movement disorders
migraine variants
pseudoseizure (stress rxn)
Syncope

62

If two appropriate anticonvulsant medications at reasonable doses have not controlled the seizures, what is this called?

Intractable seizure

63

What do you do for people with intractable epilepsy?

Pre surgical workup, Video EEG and high- resolution MRI of the brain.
May be candidates for epilepsy surgery or vagal nerve stimulation (VNS) therapy

64

What does VNS do?

Stimulates the left vagus nerve then actively stimulates the brain stem and cause changes in neurotransmitter concentration. Makes about 1/3 of patients seizure free

65

If a person failed two meds, then a third med worked, what is it classified as?

Intractable epilepsy in remission.

66

What is catamenial epilepsy?

Have an increase in seizures 3 days before menstrual period.

67

What drug is a strong mood destabilizer?

Levetiracetam (levetiRageAttack)

68

Do P450 inducers affect peak?

No

69

What do P450 inducers affect?

1/2 life and averages become shorter

70

If you take a medication with carbamazepine what might need to happen?

Need to take that other med more times a day

71

What is a potent P450 inducer?

Carbamazepine

72

How will carbamazepine affect OCPs?

reduces 1/2 life

73

What is ethosuximide used for?

Absence and atonic seizures

74

What are some side effects of ethosuximide?

N/V/D abdominal cramping
tastes really bad, most kids can't keep it down
(remember "sucks")

75

What is the most potent mood stabilizer?

Lamotrigine

76

What does the same thing as carbamazepine but with fewer sider effects?

Oxcarbazepine

77

What drug causes gingival hyperplasia? and hirsutism?

Phenytoin

78

What drug will lower your IQ by 10-20 points? Also is an appetite suppressant.

Topiramate (Topamax)

79

What drug is an appetite inducer? Also causes polycystic ovaries.

Valproic acid

80

What is like topamax, but less side effects?

Zonisamide (but is an aromatic sulfa drug)