Seizures and Epilepsy Flashcards Preview

Neurology > Seizures and Epilepsy > Flashcards

Flashcards in Seizures and Epilepsy Deck (58):
1

What is a seizure?

abnormal electrical activity of the brain that involves all or limited to single part of the brain
can range from muscular convulsive activity or experiential phenomena (physical or personal)

2

What is ictal?

when person is in a seizure

3

Postictal?

how long it takes from someone to get back to normal after seizure

4

WHat is epilepsy?

recurrent seizures: 2+ unprovoked seizures

5

Normally, brain is...?

balanced between excitable and inhibited
can have seizure under appropriate circumstances

6

How does brain change overtime?

criteria for having seizures change: triggers from 4yo can be different from today's triggers

7

Seizure - RF?

family hx
head trauma
druggie
ETOH

8

How do antiepileptic drug act?

blocking initiation/spread of seizure throughout the brain

9

Seizure- cx?

unknown

10

Classification of seizure?

partial seizure
generalized seizure
status epilepticus

11

Classification of partial seizure?

simple
complex

12

Simple partial seizure?

pt is aware of seizure that is happening - conscious

13

Types of simple partial seizure?

jacksonian march
todd's paralysis

14

Jacksonian march?

motor seizure
starts in limited areas (fingers) to larger areas (arm)

15

Todd's paralysis?

temporary paresis of the area that had the seizure attack

16

Complex partial seizure?

not conscious

17

Complex partial seizure - sx/pe?

staring
automatisms -involuntary autonomic movements (lips smacking, chewing)

18

Partial seizure + secondary generalization?

starts as partial seizure but turns into a generalized seizure

19

Pt eyes blink --> lips smacking --> seizure?

partial seizure + secondary generalization

20

Partial seizure + secondary generalization - dx?

EEG

21

Generalized seizure?

seizure that is on both cerebral hemispheres
NO focal onset

22

Types of generalized seizures?

absence seizures
generalized + tonic-clonic/Grand mal
atonic
myoclonic
psychogenic

23

What is absence seizure?

loss of consciousness
NO postictal
seconds of staring
+/-chewing/smacking
100x day

24

When does absence seizure occur the most?

childhood

25

Parent gets a phone call from school that child is "daydreaming"?

Absence seizure/petit mal

26

Generalized tonic clonic seizure/grand mal?

most common in adults

27

Generalized tonic clonic seizure/grand mal - phases?

tonic
clonic
postictal

28

Generalized tonic clonic seizure - tonic phase?

ictal cry
contraction of muscles
cyanosis
sympathetic discharge (BP and pulse incr, pupils dilate)

29

Generalized tonic clonic seizure - clonic phase?

alteration of tonic-clonic-tonic phase (contraction/no contraction/contraction, etc)

30

Generalized tonic clonic seizure - postictal phase?

patient is no longer in seizure but is not "normal/self" yet
excess salvia
bladder/bowel incontinence

31

Keep in mind about generalized tonic clonic seizure?

not always in tonic-clonic-postictal phase
could be purely tonic, clonic

32

How to tell if pt is faking generalized seizure?

pt doesnt turn cyanotic

33

Atonic seizure?

sudden loss of postural muscle tone and BRIEF unconsciousness
NO postictal

34

Atonic seizure-hallmark?

head drop

35

Atonic seizure-what to be careful of?

head trauma d/t head drop

36

Myoclonic seizure?

sudden brief muscle contraction (twitch when you're falling asleep)

37

Myoclonic seizure - cx?

metabolic disorder
CNS dz

38

Pyschogenic seizure?

not a seizure that resembles a seizure

39

Status epilepticus?

continuous simple partial seizure
continuous seizure for 5-30 min

40

Status epilepticus also called?

Generalized Convulsive Status Epilepticus (GCSE)

41

Status epilepticus - cx?

anticonvuslant withdrawal
metabolic disturbances
CNS infxn

42

Neonate seizures - cx?

CNS infxn - ANY abnormality, go to ER and LP!
postpartum drug withdrawals - careful if mom is druggie
postpartum hypoglycemia - careful if mom is diabetic

43

Early childhood seizures?

seizures w/fever but NO CNS abnormalities
3mo - 5yr
peak at 18-24mo

44

Early childhood seizures - cx?

CNS infxn

45

Childhood seizure- 8-12yo cx?

generalized seizures: idiopathic, temporal lobe epilepsy, mesial temporal lobe scleorsis
partial seizures: CNS development

46

Early adulthood seizure cx?

drug abuse
head trauma

47

Older adulthood seizure x?

CNS tumor
head trauma
metabolic disturbances - ETOH, hypoglyecmia

48

What to check first w/ seizure pt?

vita signs
respiration
cardiovascular (need anything for the heart?)

49

What will rule in seizure instead of TIA, syncope, vasovagal, etc?

aura (note: also in migraines)
cyanosis (key for differentiating between fakers)
unconsciousness (but not always - simple partial seizure: they are conscious)
postictal
muscle soreness (usually tremors, tics do not cause this)
motor manifestation

50

When to do LP w/ seizures?

HIV pts
anyone who is suspicious of CNS infxn

51

Seizures - labs/imaging?

EEG
*normal? does not r/o seizure disorder

52

Generalized seizure - tx?

do not restraint
be mindful of anything thats around them that could hurt them
make sure to put them in lateral position - in case they vomit

53

Seizure - tx?

underlying condition (metabolic disturbance)
avoid triggers (lights, ETOH)
drug therapy
ketogenic diet
surgery

54

Seizure drug therapy?

prevent seizures
-recurrent
-cx cannot be corrected (known)

55

Status epilepticus - tx?

anticonvulsant therapy STAT

56

What can happen if status epilepticus is not tx ASAP?

probs of the cardiorespiratory
metabolic
irreversible neoruonal damage

57

Adult w/ new seizure - imaging?

CT to r/o tumor

58

Most likely tx for seizures?

Keppra