Neurology

Question 1

Absence seizures:

- episodes usually decrease with age

Answer 1

ECG: 3-second spike and generalized wave discharge
Tx: Ethosuxamide (1st line); Valproic acid (2nd line)

Question 2

Juvenile Myoclonic Epilepsy:

- jerky movement in the a.m.

Answer 2

ECG: Irregular spike and wave pattern
Tx: Valproic acid

Question 3

West syndrome (infantile spasms)
- 75% underlying CNS disorder (MC is DS)

Answer 3

ECG: hypsarrhythmia (high voltage, slow wave, irregular)
Tx: ACTH, prednisone, vigabatrin, pyridoxine (B6)

Question 4

Partial seizure:

-focal to one part of body

Answer 4

ECG: spike and sharp wave or multifocal spike
Tx: Carbamazepine and valproic acid

Question 5

Generalized:

-affects both cerebral hemispheres

Answer 5

ECG: Anterior temporal lobe sharp waves or focal spikes
Tx: Valproic acid

Question 6

Epilepsy:

Answer 6

At least 2 unprovoked seizures occur more than 24 hours apart

Question 7

Febrile seizure:

mcc: children 9 mos-5yrs

Answer 7

-generalized tonic-clonic
> 10 minutes
> 102 with rapid rise in temp
+/- family history

Question 8

Febrile seizure: management

Answer 8

LP: if meningitis is suspected, first seizure ever, < 12 mos
Acetaminophen: fever control
- do not order EEG or neuroimaging