4.4I Neuro Status Epilepticus Gab

Front 1

Defination of status epilepticus? (C 394, Dunn 674)

Back 1

- 2 or more seizures without full recovery between seizures
- five mins of continue convulsive seizures
- if seizure on arrivial in ED likely to have been for >20min

Front 2

Causes of status epilepticus? (D674)

Back 2

- anticonvulsant withdrawal
- other drug withdrawl (alcohol, benzo, baclofen)
- Cerebrovascular event
- metabolic (hypoglycaemia, hyponatremia, hypocalcaemia)
- trauma
- drug toxicity (TCA, Clozapine, theophyline)
- CNS infection (encephalitis especially)
- tumour

Front 3

Features of pseudoseizures? (Dunn 674)

Back 3

- non-synchronous out of phase movements
- side to side head movements
- bizzard pelvic thrusting
- eyes look away from examiner
- cyanosis absent
- crying, yelling, screaming
- little or no post ictal
- positive avoidance manoeuvres e.g arm drop, resistance to eye open
Lab: abscent met acidosis and serum prolactin elevation

Front 4

Benzodiazepines dose for seizure? (diazepam, midazolam, clonazepam)

Back 4

Diazepam: 0.1-0.3 mg/kg IV or 0.3-.0.5mg/kg PR as undiluted
Midazolam: 0.1-0.3 mg/kg IV or IM
Clonazepam 0.008-0.016mg/kg IV

Front 5

Which is not true for phenytoin? (Dunn676)
a. as 2nd line agent if benaodiazepam failed
b. less effective to ETOH withdrawl seizure
c. Incompatiable with dextrose and most other drugs
d. loading dose 15-20mg/kg up to 1-1.5g
e. Cause hypertension and trachycardia

Back 5

e. Phenytoin contains alcohol and propylene glycol - cause local pain, responsible for cardiovascular toxicity hypotension and bradycardia

Front 6

Drugs that do not reduce phenytoin level?
a. Ciprofloxacin
b. Rifampicin
c. Carbamazepine
d. Alcohol
e. Erythromycin

Back 6

e. erythromycin - cause increase phenytoin level instead of decrease it

Front 7

Steve Johnson syndrome is related to which anticovulsants?
a. Clonazepam
b. Carbamazepine
c. Phenobarbitone
d. Sodium Valproate
e. Gabapentin

Back 7

b carbamazepine