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20 Cards in this Set

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  • Back
what are the characteristic stats of th epidemiology of epilepsy?
~1.75 mil in the US, ~100,000 new per year in US, bimodal age peaks (infancy and over 60), onset usually before 20 (usually before 4 yo), males affected more than females
what is the common etiology of newly diagnosed epilepsy in the under 14 age group? in the over 65?
congenital disease, cerebrovascular disease
a typical abscence seizure has what characteristics?
onset bw 5 and 12, abrupt onset/recovery, short stare, impaired consciousness, normal child, 3 hz spike and wave, normal background, childhood abscence epilepsy, treat with ethosuximide
atypical abscence seizures have what characteristics?
onset under 5, gradula onset and recovery, may be long, impaired consciousness, abnormal neuro development of the child, slow spike and wave, slow background with multifocal spikes, lennox-gastaut syndrome, treat with valproic acid.
epilepsy is defined as what?
two recurrent seizures or more
differentiate between simple and complex partial epilepsies.
pt is conscious and knows everyting that is going on during simple, but not during complex.
distinguish between general and partial epilepsies.
partial is located to one particular area of brain and thus one specefic area of body. General effects the entire body
what are the systemic differential diagnoses for epilepsy?
syncope, toxin/metabolite, breath holding and hyperventilation
differentials of epilepsy that are neurogenic in nature include…?
CVD, sleep disorders, movement disorders, migraines, dementias
differentials of epilepsy that are psychogenic in nature include…?
psychogenic seizures, episodic dyscontrol, dissociative states, day dreaming, psychosis, panic attacks, malingering
what are some broad non-epileptic clues to "seizures"?
non symmetry, no warning, gradual onset, flailing motor manifestations, prolonged, non physiological spread of signs and symptoms, intensity and severity fluctuation during event, maintained responsiveness, purposeful behavior, no post ictal, resolution upon distraction
describe the typical absence seizure. What is the name of the common childhood syndrome that exhibits these? What drug is used to treat it?
abrupt onset with short stare that lasts five to ten seconds, impaired consciousness, onset between 5 and 12, 3 Hz spike and wave, usually seen when grades start to slip in school, child is normal developmentally. Childhood absence epilepsy. ethosuximide.
describe the atypical absence seizure? Syndrome associated with it? Drug?
gradual onset that may be longer than the typical, usually seen with developmentally abnormal children, EEG is slower than typical. Lennox-Gastaut syndrome. Valproic acid
what is the most common focal epilepsy and what does its seizure look like?
temporal lobe epilepsy. Usually have a visceral (commonly gastric rising) aura but may be a number of things, duration for 1 to 3 minutes, simple or complex partial seizure, stare, motor arrest pupil dilates, amnesia, automatisms, contralateral head and eye deviation, contralateral tonic or dystonic posturing.
loss of what kind of neurons result in mesial temporal lobe epilepsy syndrome? Other signs of this syndrome are?
hippocampal CA1 cells. Febrile convulsions as infant, history of seizures in the family
describe the post ictal state of a temporal lobe seizure.
variable, relaxed, automatisms, may last minutes to an hour, confusion, amnesia, possible language disturbances.
describe a focal clonic motor seizure.
in frontal lobe. It hits the motor cortex resulting in a simple partial seizure
describe assymetric tonic seizures.
in frontal lobe (usually secondary motor cortex), results in variable motor manifestations, classic is arm raised and head looking toawrds the hand (fencing posture), speech arrest or forced vocalizations
describe a frontal lobe complex partial seizure.
automatisms, vocalizations, hysterical appearance, usually in prone position,
describe status epilepticus.
seizure over 30 minutes long or 2 consequetive seizures with no resolution. Higher morbidity and mortality, seen in stroke, stopping AED's, trauma, infection, hemmorhage.