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Critical Care I > Seizures & Epilepsy Lecture > Flashcards

Seizures & Epilepsy Lecture Flashcards

1
Q

difference between seizures and Epilepsy

A

Seizure is single 24 hour period of provoked/unprovoked episodes

Epilepsy is 2 or more unprovoked seizure episodes

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2
Q

simple partial - what type of seizure?

A

Partial (focal) seizure

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3
Q

what type of seizure? - complex partial

A

Partial (focal) seizure

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4
Q

what type of seizure?- secondarily GTC

A

Partial (focal) seizure

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5
Q

eyes deviated to one side, what does this tell us

A

maybe dealing with a focal seizure

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6
Q

eyes looking forward, what does this tell us

A

maybe dealing with a generalized seizure

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7
Q

what type of seizure? - GTC

A

Generalized seizure

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8
Q

what type of seizure? - Absence

A

Generalized seizure

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9
Q

what type of seizure? - Myoclonic

A

Generalized seizure

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10
Q

what type of seizure? - clonic

A

Generalized seizure

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11
Q

what type of seizure? - Tonic

A

Generalized seizure

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12
Q

what type of seizure? - Atonic

A

Generalized seizure

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13
Q

what kind of seizure where they just drop to the floor from loosing all muscle tone (typically need the helmet to prevent more trauma)

A

Atonic

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14
Q

what term describes

Motor or sensory
No alteration in consciousness
often describes an “aura”

A

Simple

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15
Q

What type of seizure descriptor

Alteration in consciousness

May be able to continue activity, but with slowed response time

often involves staring or automatisms

duration 25 sec to 3 min

A

Complex

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16
Q

weakness of one extremity (usually one sided) brief and temporary

A

Todd’s paralysis -

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17
Q

what seizure type can be mistaken for ADHD

A

Absence seizures

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18
Q

Drug of choice for absence seizures

A

Ethosuximide

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19
Q

why do you medicate for absence seizures

A

the more they happen the more likely they are to have a generalized tonic clonic

seizures can effect development

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20
Q

stiffening of all extremities without the clonic phase

A

tonic

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21
Q

brief shock little jerks of extremities

can occur in clusters

with or without postictal confusion

A

myoclonic

22
Q

these seizures have postictal confusion, somnolence, with or without transient local deficit

A

generalized tonic clonic

23
Q

bowel/bladder incontinence

seizure

A

generalized tonic clonic

24
Q

tongue biting

seizure

A

generalized tonic clonic

25
Q

EEG for absence seizure

A

3 Hz spike and wave

26
Q

occur in clusters upon awakening

seizure

A

Infantile spasms

27
Q

contraction of trunk with extension of arms most common

seizure

A

infantile spasms

28
Q

treatment for infantile spasms

A

ACTH or Vigabatrin

29
Q

classification of epilepsy due to known abnormality on MRI or lab studies

A

symptomatic

30
Q

classification of epilepsy due to unknown cause, MRI and labs all normal

A

Cryptogenic

31
Q

classification of epilepsy due to unknown cause, MRI and labs all normal

A

Cryptogenic (we think we know the cause, but we dont really know the cause)

32
Q

what class of seizure is absence

A

idiopathic

33
Q

when is the best time to obtain a EEG after a seizure like event

A

1-2 weeks

so swelling has time to resolve for best results

34
Q

malformation of cortical development could lead to what type of seizure

A

focal

35
Q

Tuberous Sclerosis leads to what type of seizures

A

multi-focal

36
Q

what imaging and tests for seizures

A

EEG - what type of seizure

MRI- is there a cause

37
Q

labs to order for status epilepticus treatment (0-4 min)

A

blood glucose
chemistry to include Ca, Mg, Ph, CBC,
consider anemia of chronic disease levels

38
Q

labs to order for status epilepticus treatment (0-4 min)

what else should be done?

A

blood glucose
chemistry to include Ca, Mg, Ph, CBC,
consider anemia of chronic disease levels

vitals
ekg monitoring
o2
oral airway
suctioning
39
Q

status epilepticus treatment for 5-9 min

A

PIV with NS

Treat hypoglycemia, hypocalcemia, hypomagnesemia

Ativan 0.1mg/kg and repeat in 2-3 min to max of 8mg

40
Q

status epilepticus treatment for 10-30 min

A

fosphenytoin 20mg/kg (150mg/min max)

repeat fosphenytoin 5-10mg/kg if persists

call for EEG and alert ICU

likely to require pressor support

41
Q

31-60 min status epilepticus treatment

A

phenobarbital 20mg/kg (max rate 100mg/min)

Consider valproic acid 20mg/kg

Drips:
Pentobarbital coma - 5-10mg/kg load until burst suppression then 0.5-5mg/kg/hr

Diazepam drip 2mg/kg/hr

versed drip 0.2mg/kg load then 0.05-0.5mg/kg/hr

Propofol: 1-2mg/kg iv bolus and repeat if needed. Infuse 5-10mg/kg/hr

Taper drips slowly

42
Q

what qualifies as refractory epilepsy and what are other management techniques

A

tried 3 or more AEDs daily and still having seizures

Try
Vagus nerve stimulator
ketogenic diet
surgical if focal

43
Q

ages and peak ages for febrile seizures

A

6mos and 5 yrs

peak at 18mos

44
Q

most febrile seizures are

A

simple febrile

45
Q

what qualifies febrile seizures as complex

A

greater than 15 min
recurs within 24 hours
focal

46
Q

temp for a simple febrile seizure

A

greater than 101.5

47
Q

what age group would you get an LP for a febrile seizure workup

A

<3 months - yes
6-18 mos - maybe
> 18 mos - no

2-5% of kids with meningitis present with fever and a seizure

48
Q

seizure rescues

A

rectal Diastat

intranasal midazolam

49
Q

prognosis of febrile seizures vs infantile spasms

A

2% of febrile will continue with epilepsy

infantile spasms - almost half will battle life long with neuro deficits and learning impairments.

50
Q

psychogenic non-epileptiform seizures diagnosis

A

EEG

51
Q

definition of status epilepticus

A

> 30 min continuous

Critical Care I (27 decks)

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