Seizures Flashcards Preview

Neurology > Seizures > Flashcards

Flashcards in Seizures Deck (32):
1

What percentage of the population will have a seizures during their lifetime?

10%

2

What is the definition of a simple partial seizure?

a seizure that begins in a focal area of the brain and does not impair awareness.

3

What is the definition of a complex partial seizure/

a seizure with a focal onset that causes an impairment in awareness

4

Where is the most common location of onset for a complex partial seizure?

temporal lobe

5

What are some typical signs of a complex partial seizure?

lip smacking, chewing movements, picking at clothes, etc.

6

How do generalized tonic-clonic seizures typically start?

with a tonic phase that lasts several seconds in which the entire body becomes stiff, followed by a clonic phase

7

True or false: the rhythmic jerking of the clonic phase tends to occur asymmetrically in the body.

false - symmetric

8

What is the classic EEG finding in absence seizures?

three-per-second generalized spike-and-wave pattern

9

Is an absence seizure focal or generalized?

generalized

10

What is the most common cause of seizures in children?

febrile

11

What is the most common cause of seizures in the elderly?

stroke

12

What genetic cause of seizures will present in childhood with essentially any seizure type, intellectual disability and an EEG with slow (1 to 2/second) spike and wave discharges?

Lennox-Gastaut syndrome

13

What genetic epilepsy syndrome will present in childhood with simple partial seizures that have a nocturnal preponderance with centrotemporal spikes on an EEG?

benign rolandic epilepsy

14

What genetic epilepsy syndrome will present in adolescence or young adulthood with myoclonic, absence, or generalized tonic-clonic seizures occurring mainly in the early morning with a 4 to 6/per second polyspike and wave pattern on EEG?

Juvenile myoclonic epilepsy

15

Todd's paralysis will typically be seen after what type of seizure?

after a secondarily generalized seizure

16

What lab abnormality will typically be seen after a tonic clonic seizure?

lactic acidosis with low bicarb

17

What is the preferred imaging modality in a patient with a first-time seizure?

MRI

18

What percentage of patients with epilepsy will have their seizures well controlled on monotherapy?

70%

19

For phenytoin: site of action, seizure type treated, and main side effects?

Na+ channel

partial

gingival hyperplasia, coarsening of facial features, ataxia

20

For carbamazepine: site of action, seizure type treated, and main side effects?

Na+ channel

partial

hyponatremia, agranulocytosis, diplopia

21

For valproic acid: site of action, seizure type treated, and main side effects?

Na+ channels, GABA receptor

partial, generalized

GI symptoms, tremor, weight gain, hair loss, hepatotoxicity, thrombocytopenia

22

For phenobarbital: site of action, seizure type treated, and main side effects?

GABA receptor

partial, generalized

sedation

23

Ethosuximide: site of action, seizure type treated, and main side effects?

T-type Ca2+ channel

Absence

GI symptoms

24

Gabapentin: site of action, seizure type treated, and main side effects?

unknown, but possibly a voltage-gated Ca2+ channel

partial

sedation, ataxia

25

Lamotrigine: site of action, seizure type treated, and main side effects?

NA+ channel, glutamate receptor

partial, generalized

Rash, Stevens-Johnson syndrome

26

Topiramate: site of action, seizure type treated, and main side effects?

NA+ channel, GABA activity

partial, generalized

word-finding difficulty, renal stones, weight loss, tingling in hands and feet

27

Tiagabine: site of action, seizure type treated, and main side effects?

GABA reuptake

partial

sedation

28

Levetiracetam: site of action, seizure type treated, and main side effects?

unknown, but possibly at synaptic vesicles

partial, generalized

insomnia, anxiety, irritability

29

Oxcarbazepine: site of action, seizure type treated, and main side effects?

Na+ channel

partial

sedation, hyponatremia

30

Zonisamide: site of action, seizure type treated, and main side effects?

unknown mech of action

partial, generalized

sedation, renal stones, weight loss

31

What are the management steps for status epilepticus?

1. ABCs, check glucose, establish IV access
2. 100 mg IV thiamine followed by D50 influsion
3. Lorazepam 0.1 mg/kg IV
4. Phenytoin 20 mk/kg IV (or fosphenytoin)
5. intubate if not already done
6. phenobarbital 20 mg/kg IV
7. induce coma with barbiturates, midazolam or propofol and institute continuous beside EEG monitoring

32

Which AED is particularly concerning for birth defects?

valproic acid (neural tube defects)