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Flashcards in Seizures & Epilepsy Deck (43)
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1

Definition of seizure

abnormal, synchronized excessive discharge from an aggregate of CNS neurons

2

Highest RF for chronic seizure disorder

penetrating head trauma

3

Precipitating factors of seizure

sleep deprivation, stress, extreme fatigue, drug/etoh withdrawal, fever, cocaine use

4

Causes of seizures in neonatal/early infancy

CNS infection
postpartum drug withdrawal (mother using drugs/etoh)
hypoglycemia

5

Causes of seizures in late infancy/early childhood

febrile seizures
CNS infection

6

Causes of seizures in childhood

develop "epilepsy"
idiopathic
temporal lobe

7

Causes of seizures in adolescence

CNS lesions
head trauma
illicit drug use

8

Causes of seizures in adults

cerebral vascular disease
trauma
tumor
metabolic disturbances (ethos withdrawal, uremia, hepatic failure, hypoglycemia)

9

ictal, post-ictal states

ictal: seizure state
post-ictal: symptomatic time frame after seizure

10

RF of seizures

head trauma, stroke, CNS infection, electrolyte or metabolic disturbances, drugs, alcohol, FHX

11

Most common type of seizure

complex partial

12

PE work up of seizure

- Search for signs of systemic illnesses (liver, renal)
- Signs of head trauma
- CV (heart, carotid arteries)
- Complete neuro exam: mental status, visual fields, motor/sensory fx, DTRs, gait, coordination

13

Lab/imaging in seizure work up

CBC, Chem 20, toxicology, lumbar puncture (if suspect infx or if has HIV), EEG, CT/MRI

14

Definition of epilepsy

recurrent seizures; 2 or more unprovoked seizures

15

partial vs generalized seizures

partial = limited to discrete region of brain
generalized = whole brain

16

partial seizure where consciousness is fully preserved

simple partial

17

partial seizure where consciousness is impaired

complex partial

18

febrile seizures

- 3 mon to 5 yrs old
- occurs when temp rising
- typically isolated event, brief, symmetric
- likely to recurr

19

First priority in treating possible seizure

STABILIZE - look at vitals, respiration, CV

20

DDX of possible seizure

vasovagal reaction, MI, TIA, migraine

21

What is the best imaging for detection of cerebral lesions in epilepsy?

MRI > CT

22

Mainstay tx for seizures

anti-epileptic drugs

o Generalized: Levetiracetam (Keppra), Valproic acid or lamotrigine
o Absence: Ethosuximide
o Partial: Carbamazepine, phenytoin, lamotrigine and topiramate

23

When should anti-epileptic drugs be started?

- recurrent seizures of unknown cause
- cause can't be treated
- usually not for single seizure unless thought to be epileptogenic

24

How to discontinue antiepileptic meds?

most patients with complete control of seizures for significant time may d/c

withdraw very slowly over 2-3 months

25

What kind of diet may help seizures?

ketogenic diet

26

"Jacksonian March"

simple partial seizure that begins in small area and progresses to larger area (fingers to arm)

27

"Todd's Paralysis"

localized paresis for minutes to hours in involved region after simple partial seizure

28

partial seizure with secondary generalization

begins as partial seizure and propagates throughout cortex to become generalized

29

How are partial seizures treated?

Carbamazepine, Phenytoin, Iamotrigine, Topiramate

30

5 types of generalized seizures

absence, myoclonic, grand mal, tonic, atonic