seizures

Question 1

type of seizure that
affects 1 area of the brain
originates in temporal lobe
preceded by aura (smell of rubber)

Answer 1

partial seizure (focal)

Question 2

type of partial seizure with intact consciousness

Answer 2

simple partial seizure

Question 3

type of partial seizure with impaired consciousness

Answer 3

complex partial seizure

Question 4

type of seizure that

is diffuse or starts in temporal lobe (partial) and becomes generalized

Answer 4

generalized seizure

Question 5

type of generalized seizure with a blank stare + smaking of lips or quiver of face

Answer 5

absence generalized seizure

Question 6

type of generalized seizure with twitching of muscle or group of muscles (repetitive jerks)

Answer 6

myoclonic generalized seizure

Question 7

type of generalized seizure with stiffening + movement

Answer 7

tonic-clonic generalized seizure

Question 8

type of generalized seizure with stiffening (no shaking)

Answer 8

tonic generalized seizure

Question 9

type of generalized seizure with dropping (looks like fainting)

Answer 9

atonic generalized seizure

Question 10

continuous seizure (>30 min) or recurrent seizures without regaining consciousness between seizures for >30 min

Answer 10

status eplipeticus

=medical emergency

Question 11

common causes of childhood seizure

Answer 11

genetic
infection (febrile)
trauma
metabolic

Question 12

common cause of adult seizure

Answer 12

brain tumor
trauma
stroke
infection

Question 13

common cause of elderly tumor

Answer 13

stroke
brain tumor
trauma
hyponatremia
infection

Question 14

disease with following characteristics:
H - Hamartomas in CNS (retina, glioneuronal = cortical tubers + skin)
A - Angiofibromas (see on face)
M - Mitral regurgitation
A - Ash leaf spots (hypomelanotic macules)
R - cardiac Rhabdomyoma
T - answer
O - autosomal dOminant
M - Mental retardation
A - renal Angiomyolipoma, Astrocytomas (subependymal giant cell)
S - Seizures, Shagreen patches

Answer 14

Tuberous sclerosis

incomplete penetrance, variable expressivity (looks different for each person)

Question 15

classic triad of tuberous sclerosis:

Answer 15

seizures
mental retardation
angiofibromas

Question 16

these mutations cause:
TSC1 gene → hamartin protein
TSC2 gene → tuberin gene

Answer 16

tuberous sclerosis

Question 17

disease that causes:
S - Sporadic (non-inherited, somatic), Stain (port-wine in V1/V2 of CN 5)
T - tram track Ca2+
U - Unilateral (ipsilateral leptominingeal angioma)
R - Retardation
G - Glaucoma (due to episcleral hemangioma), GNAQ gene (anomaly of neural crest derivatives: mesoderm/ectoderm)
E - Epilepsy

Answer 17

Sturge-Weber Syndrome

Question 18

port wine stain of ophthalmic/mandibular br. of CN 5 is seen in

Answer 18

Sturge-Weber Syndrome

Question 19

lightening pain, electric shocks along maxillary br. of CN 5 triggered by light touch (wind, bed sheets) is called

Answer 19

trigeminal neuralgia (tic douloureux)

Question 20

treatment for trigeminal neuralgia (hyperexcitable CN 5)

Answer 20

anticonvulsants:
carbamazepine
phenytoin
gabapentin
topiramate

Question 21

drug of choice for absence seizures

Answer 21

ethoSUXimide (Sucks to have Silent Seizures)

if refractory - valproic acid

Question 22

used to treat status epilepticus

Answer 22

BZD (diazepam, lorazepam)

Question 23

used to treat eclampsia (HTN + pregnant)

Answer 23

magnesium sulfate

if refractory - BZD

Question 24

additional side effects of phenytoin

Answer 24

gingival hyperplasia
Steven Johnson Syndrome
hirsutism
drug-induced lupus
megaloblastic anemia - ↓ folate absorption 
peripheral neuropathy
teratogen

Question 25

anti-epileptics that are teratogens

Answer 25

phenytoin - fetal hydantoin syndrome (cleft lip/palate, CHD, intellectual disability + developmental delay carbamazepine valproic acid - spina bifida (increase folic acid to 4 mg if still taking it)

Question 26

hepatotoxic anti-epileptics

Answer 26

valproic acid | carbamazepine

Question 27

anti-epileptic that induces P450

Answer 27

carbamezapine

Question 28

anti-epileptics that block Na channel →↓ AP in neurons

Answer 28

``` phenytoin carbamazepine valproic acid topiramate lamotrigine ```

Question 29

used to treat status epilepticus

Answer 29

stop seizure: BZD (diazepam, lorazepam) | prevent future seizure: phenytoin

Question 30

anti-epileptics that ↑GABA activity

Answer 30

``` BZD valproic acid gabapentin phenobarbital topiramate levetiracetam tiagabine vigabatrin ```

Question 31

drug of choice for generalized seizures

Answer 31

valproic acid

Question 32

drug of choice for partial seizures

Answer 32

lamotrigine

Question 33

anti-epileptics that ↓T-type Ca channel →↓ AP in neurons

Answer 33

ethosuximide phenytoin gabapentin

Question 34

treatment of tonic-clonic seizures

Answer 34

valproic acid phenytoin carbamazepine