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Neurology > Seizures and Epilepsy > Flashcards

Seizures and Epilepsy Flashcards

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1
Q

What is a seizure?

A

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)

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2
Q

What is ictal?

A

when person is in a seizure

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3
Q

Postictal?

A

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

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4
Q

WHat is epilepsy?

A

recurrent seizures: 2+ unprovoked seizures

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5
Q

Normally, brain is…?

A

balanced between excitable and inhibited

can have seizure under appropriate circumstances

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6
Q

How does brain change overtime?

A

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

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7
Q

Seizure - RF?

A

family hx
head trauma
druggie
ETOH

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8
Q

How do antiepileptic drug act?

A

blocking initiation/spread of seizure throughout the brain

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9
Q

Seizure- cx?

A

unknown

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10
Q

Classification of seizure?

A

partial seizure
generalized seizure
status epilepticus

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11
Q

Classification of partial seizure?

A

simple

complex

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12
Q

Simple partial seizure?

A

pt is aware of seizure that is happening - conscious

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13
Q

Types of simple partial seizure?

A

jacksonian march

todd’s paralysis

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14
Q

Jacksonian march?

A

motor seizure

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

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15
Q

Todd’s paralysis?

A

temporary paresis of the area that had the seizure attack

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16
Q

Complex partial seizure?

A

not conscious

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17
Q

Complex partial seizure - sx/pe?

A

staring

automatisms -involuntary autonomic movements (lips smacking, chewing)

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18
Q

Partial seizure + secondary generalization?

A

starts as partial seizure but turns into a generalized seizure

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19
Q

Pt eyes blink –> lips smacking –> seizure?

A

partial seizure + secondary generalization

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20
Q

Partial seizure + secondary generalization - dx?

A

EEG

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21
Q

Generalized seizure?

A

seizure that is on both cerebral hemispheres

NO focal onset

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22
Q

Types of generalized seizures?

A 
absence seizures
generalized + tonic-clonic/Grand mal
atonic 
myoclonic
psychogenic
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23
Q

What is absence seizure?

A 
loss of consciousness
NO postictal 
seconds of staring
\+/-chewing/smacking
100x day
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24
Q

When does absence seizure occur the most?

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

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