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Flashcards in Seizure treatment Deck (11)
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1

Which its may not need to be treated with seizure meds/

Simple pediatric febrile seizure

Seizure following withdrawal from medication (e.g. benzodiazepine)

Some benign pediatric epilepsies

2

Who should be treated with seizure?

Epilepsy: patient who has ≥2 unprovoked seizures Those with 1 seizure who are at high risk for recurrence Those with 0 seizures who are at high risk for seizure

3

Who are those with 1 seizure at high risk for recurrence?

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4

What should be done after the first seizure?

•Careful history and physical

•MRI brain with contrast

•EEG

•Other targeted testing as appropriate

5

Who are at risk for pts with 0 siezures?

Hemorhagges- at high risk may want to treat 

6

What should meds be stopped?

idiopathic etiology

normal mentation 

normal neurologic 

seizure free interval greater than 2 years 

7

When should you not stop seizure medication?

abnormal neurologic exam 

EEG abnormalities 

8

When does breakthrough seizures happen?

•Missed doses of medications (Or low serum drug) level

•Alcohol

•Sleep loss

•Illness (UTI, URI, etc.)

•Medications can lower seizure threshold

•Tramadol (Ultram)

•Buproprion (Wellburtin)

•Clozapine (Clozaril)

9

What is treatment failure?

•Patient continues seizing after trials of 2 seizure medications

•Consider ketogenic diet (children) or epilepsy surgery

10

When does seizure frequency in women?

•Twofold increase in seizure frequency during phase of menstrual cycle.  ~1/3 of women with intractable epilepsy

•Estrogen, pro-convulsant

•Progesterone: anticonvulsant

•Drug level fluctuations based on hormonal phase

11

What are the teratogenic effects of women on seizure medication?

•Cardiac septal defects (ASD)

•Nerve tube defects

•Spina bifida

•Cleft lip/palate

•Urogenital defects

•Treat with folate 0.4-5 mg/day

•*MIDLINE DEFECTS*