SA seizures

Question 1

What is a seizure?

Answer 1

A transient ocurence of signs and symptoms due to abnormal excessive or synchronous neuronal activity of the brain

Question 2

Seizures localise to which part of the neural system

Answer 2

Forebrain

Question 3

What is the pathophysiology of a seizure?

Answer 3

Imbalance in excitation and inhibition (excessive excitation or decreased inhibition)

Question 4

What are the four phases of a seizure?

Answer 4

Prodrome, aura, ictal and post-ictal

Question 5

Describe the prodromal phase of a seizure.

Answer 5

Clingy, stay in a certain spot, quiet or agitated. The predictors of a seizure.

Question 6

Describe the aura phase of a seizure.

Answer 6

Initial manifestation of a seizure - shows abnormal sensation

Question 7

Describe the ictal phase of a seizure.

Answer 7

Involuntary muscle tone/ movement, abnormal behaviour or sensation

Question 8

How long does the ictal phase of a seizure usually last?

Answer 8

1-1.5 minutes

Question 9

Catching flies is an example of what phase of a seizure?

Answer 9

Ictal

Question 10

Describe the post-ictal phase of a seizure.

Answer 10

Unusual behaviour or neurological deficits lasting minutes to days

Question 11

During a generalised seizure a dog will be conscious and unconscious?

Answer 11

Unconsciousness - disturbance in both hemispheres of the forebrain!!

Question 12

Tonic-clonic

Answer 12

Paddling both legs, sustained and regular

Question 13

Tonic

Answer 13

Muscle contraction and recumbency

Question 14

Clonic

Answer 14

Spasmodic contractions

Question 15

Myoclonic

Answer 15

Sudden brief single or group movement - jerk seizure

Question 16

Atonic

Answer 16

Sudden loss of muscle tone

Question 17

During a focal seizure will a dog be conscious or unconscious?

Answer 17

Conscious unless complex

Question 18

What would occur with a motor focal seizure?

Answer 18

Episodic, focal motor contraction - ie one muscle/ area

Question 19

What may occur with an autonomic focal seizure?

Answer 19

Eg drooling (RARE)

Question 20

What may occur with a behavioural focal seizure?

Answer 20

Anxious, restless, fly catching, circling

Question 21

What differentials may be investigated in suspected seizure cases?

Answer 21

Narcolepsy, neuromuscular collapse, syncope, movement disorders, metabolic disease, vestibular disease

Question 22

Which breeds may be predisposed to movement disorders?

Answer 22

Doberman, english bull dogs, boxers

Question 23

Hyperkanaesia

Answer 23

Episodic falling - progressive increase in tone of pelvic-thoracic limbs, hunched spine and fall over

Question 24

Dyskinesia

Answer 24

Epileptoid cramping - falling and cramping - border terriers

Question 25

What are the three causes of epileptic seizures in small animals?

Answer 25

Reactive (metabolic and toxic effects), idiopathic and structural (intracranial or cerebral pathology)

Question 26

Name a breed predisposed to idiopathic seizures.

Answer 26

Collies

Question 27

What constitutes a tier one idiopathic epilepsy diagnosis?

Answer 27

>2 seizures 24h apart, 6m-6y, no other abnormalities, familial history

Question 28

What constitutes a tier two idiopathic epilepsy diagnosis?

Answer 28

Tier 1 + normal post-prandial BAST, normal MRI, CSF analysis

Question 29

What constitutes a tier three idiopathic epilepsy diagnosis?

Answer 29

Tier 1+2 + EEG abnormalities

Question 30

Define status epilepticus.

Answer 30

Where epileptic fits follow one another without recovery of consciousness between them. >5 mins or >2 seizures without full recovery.

Question 31

Define a cluster seizure.

Answer 31

Two or more seizures occurring within 24 hours but with the patient regaining consciousness between the seizures.

Question 32

What criterion would be used to determine when to start epileptic treatment?

Answer 32

Underlying cause, status epilepticus/ cluster seizures, interictal period <6m, post-ictal severe or >24h, seizure frequency/ duration increasing within 3 icteral events, seizures within 1 m of traumatic event

Question 33

MOA phenobarb. Side effects.

Answer 33

Augments inhibitory effects of GABA. | Side effects: sedation, ataxia, PUPDPP, hepatotoxic, haematological effects

Question 34

MOA KBr. Side effects.

Answer 34

Preferential GABA movement and effect. | Side effects: sedation, ataxia, pelvic limb weakness

Question 35

Which species should KBr NOT be used in?

Answer 35

Cats!! Causes eosinophilic bronchitis and respiratory fatalities

Question 36

MOA Imepitoin. Side effects.

Answer 36

Benzodiazepine partial agonists of GABAa. | Side effects: Sedation, ataxia, PUPDPP, hepatotoxic, haematological abnormalities

Question 37

What AEDs are licensed in dogs?

Answer 37

Phenobarb, bromide, imepitoin

Question 38

What AEDs are licensed in cats?

Answer 38

NONE

Question 39

What side effects may be associated with levetiracetem?

Answer 39

Sedation - minimal

Question 40

What side effects may be associated with Zonisamide?

Answer 40

Ataxia, sedation, dry eye, inappetence

Question 41

MOA levetiracetam

Answer 41

Neuromodulation/ reduced NT release

Question 42

MOA Zonisamide

Answer 42

Suppressed hypersynchronisation of neuronal activity

Question 43

Which AED requires level monitoring?

Answer 43

Phenobarbitone

Question 44

Which AED is ONLY licensed as a monotherapy?

Answer 44

Imepitoin - not licensed for structural or cluster seizures

Question 45

After how long can a sustained seizure lead to neuronal damage?

Answer 45

>30 minutes

Question 46

Describe the emergency dosing of a dog with diazepam.

Answer 46

Give if seizure is over 1 minute (1mg/kg)