Seizures Flashcards
(22 cards)
What is a partial seizure?
Focal to one part of the body: arm, leg
What can a partial seizure be further classified as?
Simple or complex
What is unique about a simple partial seizure?
Intact consciousness
What is unique about a complex partial seizure?
loss or alteration of consciousness
What is a tonic-clonic seizure?
Generalized seizure with vary phases of muscular rigidity followed by jerking of the muscles for several minutes
What is Tonic?
Muscular Rigicity
What is Clonic?
Muscular jerking
What is an absence (petit-mal) seizure?
consciousness is impaired only briefly: pt often remains upright and gives a normal appearance or stares off into space
What age group are absence (petit-mal) seizures common in?
Children
What are common causes of Generalized Tonic-clonic seizures?
Hyponatremia or hypernatremia
Hypoxia
Hypoglycemia
CNS infections/anatomic abnormalities
Hypocalcemia
Uremia: elevated Cr
Hepatic Failure
Alcohol, Barbiturate and benzodiazepine withdrawal
Cocaine toxicity
Hypomagnesemia
What is Epilepsy?
Seizures of unclear etiology: if there is a clear cause it is not epilepsy
How do you treat Status Epilepticus?
1) Benzodiazepine
2) Fosphenytoin, Levetiracetam or valproic acid
3) Phenobarbital
4) General Anesthesia
What is the best initial therapy for a persistent seizure?
IV benzodiazepine: Lorazepam or Diazepam
What is the final drug option for an unresolving seizure?
Neuromuscular blockers: Succinylcholine, Vecuronium or Pancuronium
What are indications to start Antiepileptic Drugs (AED) after a single seizure?
Presents in status epilepticus or with focal neuro signs
abnormal EEG or lesion on CT
Fam Hx of seizures
Uncorrectable causes: Stroke, tumor, anatomic brain defect
What are the best AEDs in pregnancy?
Levetiracetam and Lamotrigine
What AED is typically used first for Epilepsy?
Levetriacetam: due to having the fewest side effects
What is the best treatment for Absence Seizures?
Ethosuximide
What is the standard of care for duration of seizure treatment?
Wait until 2 years of seizure-free
What is the best way to tell if there is the possibility of seizure recurrence?
Sleep deprivation EEG
What AED has the highest risk of Hyponatremia?
Carbamazepine
What AED can be altered by OCP use?
Lamotrigine: Estrogen increases metabolism to ineffective levels
