seizures/sleep

Question 1

Unconsciousness
Convulsions
Muscle rigidity

Answer 1

Grand Mal Seizure

Question 2

Brief loss of consciousness

Answer 2

Absence Seizure

Question 3

Repetitive jerking movements

Answer 3

Clonic Seizure

Question 4

Sporadic jerking movements

Answer 4

Myoclonic Seizure

Question 5

Muscle stiffness

Rigidity

Answer 5

Tonic Seizure

Question 6

Loss of muscle tone

Answer 6

Atonic Seizure

Question 7

Seizure spreads from distal limb to ipsilateral face.

Answer 7

Jacksonian march

Question 8

Jacksonian march

Answer 8

Seizure spreads from distal limb to ipsilateral face.

Question 9

Jerking, muscle rigidity, spasms, head-turning

Unusual sensations affecting vision, hearing, smell, taste or touch

Answer 9

simple partial seizure

Question 10

Lip smacking, chewing fidgeting, walking and other repetitive, involuntary but coordinated movements
An aurora is often present
Involves the temporal lobe

Answer 10

Complex partial seizure

Question 11

Electroencephalogram –helps determine ___
Generalized seizures
Simple partial seizure
Complex partial seizure

Answer 11

Electroencephalogram –helps determine the type of seizure
Generalized seizures – generalized spikes and slow waves
Simple partial seizure – focal rhythmic discharges may be present
Complex partial seizure – interictal spikes with slow waves

Question 12

• generalized spikes and slow waves
• focal rhythmic discharges may be present
• interictal spikes with slow waves

Answer 12

Generalized seizures – generalized spikes and slow waves
Simple partial seizure – focal rhythmic discharges may be present
Complex partial seizure – interictal spikes with slow waves

Question 13

Midazolam
Phenytoin
Carbamazepine
Valproate
Phenobarbital

Answer 13

Anticonvulsants

Question 14

Status epilepticus

Answer 14

A life-threatening neurologic disorder defined as 5 minutes or more of a continuous seizure activity or several clinical seizures without return to baseline in between

Question 15

Treatment Status epilepticus
Medications
What are first line?
Other 3

Answer 15

Benzodiazepines are first line- Diazepam, Lorazepam, Midazolam
Anticonvulsant agents – Phenytoin, Fosphenytoin
Barbiturates – Phenobarbital
Anesthetics – Propofol

Question 16

med for absence seizures

Answer 16

ethosuximide or valproic acid

Question 17

IV tx for seizures

Answer 17

Diazepam or lorazepam IV till seizure stops; loading dose of phenytoin or fosphenyntoin also given

Question 18

Which type of seizure is associated with generalized spikes and slow waves?

Answer 18

Generalized seizure

Question 19

What is the first line treatment for a patient in status epilepticus?

Answer 19

Barbiturates – Diazepam

Question 20

Does the term tonic refer to jerking movements or muscle stiffness?

Answer 20

muscle stiffness

Question 21

In the event of syncope, …

Answer 21

position the patient on the ground, with the legs slightly elevated or leaning forward, head between the knees for 10 to 15 minutes

Question 22

status epilepticus- rapid tx of potential etiologies

Answer 22

thiamine followed by glucose and naloxone

Question 23

non REM stages

Answer 23

4 stages; 3 and 4 are termed delta sleep

Question 24

depression and sleep

Answer 24

fragmented sleep, decreased total sleep time, quicker onset of REM and a shift of REM to earlier in the night

Question 25

manic d/o and sleep

Answer 25

total sleep time is decreased with a shortened REM latency and increased REM activity

Question 26

hypersomnia | - kind of pts

Answer 26

excessive daytime sleepiness | sleep apnea, narcolepsy, nocturnal myoclonus

Question 27

parasomnia

Answer 27

abnormal sleep behaviors during sleep; sleep terrors, nightmares, sleep walking, enuresis

Question 28

nightmares occur when

Answer 28

REM

Question 29

sleep terrors happen when

Answer 29

stage 3 and 4 delta sleep

Question 30

sleepwalking occurs when

Answer 30

stage 3 and 4 delta sleep in the first third of night and with REM sleep later in the night

Question 31

childhood enuresis occurs when

Answer 31

3-4 hrs of bedtime but not limited to a particular stage of sleep

Question 32

important factors in a history with sleep disorders

Answer 32

depression, alcohol abuse, heavy smoking, inappropriate use of sedatives or stimulants, uremia, asthma, hypothyridism

Question 33

dextroamphetamine and modafinil

Answer 33

stimulant for narcolepsy

Question 34

nocturnal myoclonus tx

Answer 34

clonazepam

Question 35

sleep terror and sleepwalking tx

Answer 35

benzo

Question 36

epileptogenic focus

Answer 36

partial seizure

Question 37

3 second spike and wave discharge

Answer 37

childhood absence epilepsy

Question 38

10 Hz activity during __ phase and slow waves during ___ phase

Answer 38

tonic | clonic

Question 39

increase in slow frequency rhythms and/or loss of nml higher frequency rhythms

Answer 39

focal non-epileptiform seizure

Question 40

generalized spikes and associated slow waves

Answer 40

non convulsive generalized seizure

Question 41

rhythmic discharge with slow onset; nml ictally

Answer 41

simple seizure

Question 42

fast, synchronus potentials in large number of neurons in somewhat discrete part of brain

Answer 42

focal epileptiform seizure

Question 43

diffuse abnormally slow rhythms or bilateral slowing of normal rhythm

Answer 43

diffuse non-epileptiform seizure

Question 44

diffuse alpha waves, non responsive to external stimuli

Answer 44

coma