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51 Cards in this Set

  • Front
  • Back
What is the underlying cause of seizures?
Abnormal, sudden electrical activity of the brain.
Define epilepsy.
Symptom of many diseases manifesting as recurrent seizures.
What is the time period defining neonates
0 to 1 months
Majority of seizures seen in neonates is what kind of seizure?
Partial seizure
List possible seizure manifestations for neonates. x8
1. Versive

2. Behavioral arrest
3. Autonomic changes
4. Tonic posturing (varies)

5. Clonic
6. Automaticism (esp. mouth)
7. Myoclonic
8. Electrical seizures
In neonates, symptoms are NOT seizures if: x3
1. Clonus movement is stopped by changing the position of the limb/joint.

2. Clonus movementis stopped if limb/joint is touched.

3. Tonic posturing is stopped if is stopped by turning baby's head.
List the etiology of seizures for neonates. x7
Inborn errors of metabolism
Intracranial hemorrhage
Imbalance of electrolytes

Congenital malformaitons
In neonate seizures, prognosis is only dependent on what?
Cause (etiology)
What is the primary AED tx for neonatal seizures? x4
1. Phenobarbital
2. Phenytoin/Fosphenytoin
3. Diazepam
4. Lorazepam
Describe Simple Febrile Seizures
- Initial sign
- Duration
- Frequency
- Character
- Post ictal
Initial rise of temperature

Less than 15 minutes

Once a day

Generalized seizure

Describe Complex Febrile Seizures
- Initial sign
- Duration
- Frequency
- Character
- Post ictal
Initial Rise of Temperature

Greater than 15 minutes

Flurry (more than one in 24h)

Some components of partial seizure.

Todd's paralysis
Describe the risk of recurrent febrile seizures.
33% increase after 1st one

50% increase after 2nd one
What type of seizures would you expect during early childhood?
Childhood Absence seizures

Benign Rolandic seizures
What type of seizure conditions do you expect in infants?
Febrile seizures
Infantile seizures
Lennox-Gastaut seizures
50% of patients with this condition progress to Lennox-Gastaut seizures.
Infantile spasms
50% of tuberous sclerosis patients have this.
Infantile spasm
Describe the management of febrile seizures.
1. Always check for meningitis
2. Do a LP if under 2 y.o.
3. Seizure workup if any risk factors.
What type of imaging should you use for febrile seizures?
Nothing. Do No imaging
What type of AED's should you use for febrile seizures.
Simple Febrile seizures - nothing

Prolonged Febrile seizure - Diastat

Increased risk of afib seizures - chronic AED tx
Prognosis for Infantile Spasms
100% poor
List the classic triad for infantile spasms.

Mental retardation

Myoclonic seizures
Medications and options for Infantile Spasms.
1st line: ACTH/Corticosteroid

2nd line: AED


What are the characteristics for Lennox Gastaut? x3
1. Mixed seizures
(Tonic and Absence most common)

2. Mental retardation

3. EEG pattern of slow spike & wave (1.5 Hz to 2.5 Hz)
What is the meds treatment for Lennox Gastaut?
Polypharmacy approach:

Valproic Acid


Ketogenic diet
Inheritance of typical absence seizures.

Strong family history
T/F - Typical absence seizures have aura associated with it.

No aura.
Abrupt beginning and end.
EEG of Typical Absence seizure.
3 Hz with Normal background
Typical Absence Seizures can be induced how?

Photic stimulation
Imaging for typical absence seizure.
None necessary
Onset of typical absence seizures.
5 to 12 years old
Onset of atypical absence seizures.
< 5 years old
EEG of atypical absence seizure.
< 2.5 Hz

Slow background
Compare neurologic development of patient with typical vs. atypical absence seizure.
Typical - normal

Atypical - abnormal
Imaging for atypical absence seizure.
MRI necessary
Differentiate between absence seizures vs. partial complex seizures.

Shorter in duration
No aura
No postictal
Induced by HV/photostimulation

Partial complex seizures:

Greater than 1 min
Not induced by HV/photic
Treatment for absence seizures
Ethosuximide (typical)
Valproic acid
(typical with GTC and with atypical)

Avoid these treatments with absence seizures.
Inheritance of Benign Rolandic Epilepsy
Benign Rolandic Epilepsy:

- onset
- frequency
2 - 12 years old
(but does not go beyond 16)

Remits spontaneously
EEG of benign rolandic epilepsy
Temporal-central spikes
Benign Rolandic epilepsy:

- characters
Nocturnal GTC seizures

Diurnal simple seizures
Benign Rolandic epilepsy:

- aura
- postictal


(usually to one side in gums, tongue, or cheek)
Medication treatment for benign rolandic epilepsy.
Most MD's don't treat, but can use

What are the seizures prevalent in childhood and adolescence?
Juvenile absence epilepsy

Juvenile myoclonic epilepsy
Juventile absence epilepsy:

- onset
- symptoms
12 to 20 years old

Absence seizures
T/C seizures

NO myoclonic jerks
T/F - Myoclonic seizures can be seen in juvenile absence seizures.

Only T/C seizures
Medication of Juvenile Absence Seizures.


Valproic acid or Lamotrigine
What is the classical sign for Juvenile Myoclonic epilepsy?
AM myoclonic jerks

preceding GTC
Treatment of Juvenile Myoclonic epilepsy.
Valproic acid alone

or with
Lamotrigine and Topiramate
What condition requires a life long treatment?
Juvenile Myoclonic epilepsy
What induces juvenile myoclonic epilepsy?
Sleep deprivation / fatigue
Flickering lights
Early awakening