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X Clin Med III Final Exam > Seizures > Flashcards

Flashcards in Seizures Deck (32)
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1

What is epilepsy?

Condition in which person has recurrent seizures due to a chronic, underlying procss
At least 2-3 seizures w/o clear precipitating factors!!

2

Tonic vs clonic

Tonic: rigid posturing, continuous muscle tension
Clonic: repetitive, flexion/extension movements

3

Types of partial seizures

Simple (no loss of consciousness or memory)
Complex (consciousness or memory impaired)
Secondarily generalized

4

Impaired consciousness with complex partial seizure

Unable to respond to visual or verbal commands
Reduced awareness of ictal period
May become partial with secondary generalization

5

General description of simple partial seizure (focal aware seizure)

Depending on areas involved
Pt can interact with others during and recall events

6

Simple partial seizure affecting motor cortex

Clonic movements starting in hand or foot and progressing to involve whole limb (Jacksonian seizure)
Todd's paralysis: lasts minutes to hrs

7

Simple partial seizure affecting sensory cortex

Paresthesias, numbness of limb, face

8

Simple partial seizure affecting temporal lobe

Deja vu
Epigastric discomfort

9

Simple partial seizure affecting occipital lobe

Flashing lights
Visual changes

10

Most common type of seizure in adults with epilepsy

Complex partial seizure

11

Phases of complex partial seizure

May start with aura (psychic sx)
Ictal phase: sudden behavioral arrest or motionless stare and then automatisms (involuntary, automatic behaviors like chewing, swallowing, emotions, hand movements etc)
Posticital: HA, confusion, amnesia, somnolence

12

Generalized seizures

Bilateral electrical discharge arising from both cerebral hemispheres simultaneously

13

Absence (petit mal) seizure

Characterized by sudden brief LOS without loss of postural control
5-10 sec
No postictal confusion!!

14

EEG pattern of absence seizure

Generalized spike and wave pattern

15

Most common type of seizure due to metabolic problems

Tonic clonic (grand mal)

16

What is the typical grand mal seizure?

Sudden LOC, fall to ground
Tonic phase (tonic contractions like body rigid or jaw clench or eyes roll back)-increase BP and HR
Clonic phase (muscle groups relax and contract and may froth)- 30 sec to 3 min
Postictal phase (minutes to hours with confusion or sleepiness)

17

Generalized myoclonic seziure

Sudden, brief generalized muscular contraction of limbs and trunk

18

Most common times to see generalized myoclonic seizures

Metabolic disorders
Degenerative CNS diseases
Anoxic brain injury

19

Benign form of myoclonus

Sudden jerking movements experienced as fall asleep

20

Atonic seizure

Sudden loss of postural tone for about 1-2 sec (briefly impair consciousness, no postictal confusion, can fall to ground)
Usually associated with another form of epilepsy

21

Tonic seizure

Typically, sudden stiffening of body with loss of balance
Very brief

22

Association with tonic seizures

Significant brain disease (poor prognosis)

23

Labs to do with a seizure

CBC, Ua
CMP
Serum Mg
Toxicology
Syphilis screen

24

Imaging for all new onset seizures

Cranial CT or MRI
CXR

25

Key diagnostic test for seizures

EEG

26

Tests for pts with refractory seizures

PET or single photo emission tomography (SPECT)

27

When to call 911 with a seizure

Person does not have epilepsy
Longer than 5 min
Second seizure before recover
Regular breathing not return
DM
In water
Pregnany
If they were injured

28

Status epilepticus

Continous seizures or recurrence without gaining consciousness
Medical emergency! (heart and lung probs, metabolic derangements, hyperthermia, brain damage after 2 hrs)

29

Tx of status epilepticus

IV access (anticonvulsant-lorazepam or diazepam or phenytoin)
50% glucose, narcotic antagonist or thiamine

30

How to start AED therapy

Usually with 1 drug and titrated upwards