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37 Cards in this Set
- Front
- Back
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Name the paroxysmal (episodic) disorders in neurology
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1. migraine
2. syncope 3. dizziness 4. Seizure |
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On a single EEG with an epileptic patient what are the most common % positive findings
How many EEG's does it take to get 85% positive for epilepsy finding? |
Only 40% chance going to catch it unless it is Petit mal (Absence) seizure
1. Petit mal (w/HV) 90% 2. PArtial: 30% 3. Tonic clonic: 20% - takes 3 sleep deprived studies |
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What is the most important information for diagnosis of epilepsy?
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HISTORY of the events (prefer witness)
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What are the two broadest forms of seizures
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Classified as partial and generalized
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What does partial seizure mean?
What does generalized seizure mean? |
Begins on one side of the brain
Generalized- start on both sides simultaneously |
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Name the partial seizures
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1. simple
2. complex 3. secondarily generalized |
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Describe the characteristics of simple partial seizure
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focal motor or sensory activity, no LOC, lasts seconds, no post ictal state
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Adult epilepsy is almost always due to what broad class of seizures?
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Partial seizure due lesion from stroke, tumor
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seizure with
focal motor or sensory activity, no LOC, lasts seconds, no post ictal state (no speech loss afterwards) |
simple partial
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Describe the characteristics of complex partial seizure
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nonresponsive staring, possible preceding aura, automatisms, LOC lasts 1-3 mins, post ictal state
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seizure with
nonresponsive staring, possible preceding aura, automatisms, LOC lasts 1-3 mins, post ictal state |
complex partial seizure
Complex with Consciousness |
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secondary generalized partial seizure characteristics
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Bilateral tonic- clonic activity, LOC, lasts 1-3 min. post ictal state
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Name the four main types of generalized seizures
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1. Absence
2. Tonic-clonic 3. Atonic 4. Myoclonic |
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Describe the characteristics of absence (petit mal) seizures
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nonrepsonsive staring, rapid blinking, chewing, clonic hand motions, LOC, lasts 10-30 sec, no post-ictal state
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seizure with
nonrepsonsive staring, rapid blinking, chewing, clonic hand motions, LOC, lasts 10-30 sec, no post-ictal state |
absence seizure
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Seizure of tonic clonic type
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bilateral extension followed by symmetrical jerking of extremities, LOC, lasts 1-3 min, postictal state
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bilateral extension followed by symmetrical jerking of extremities, LOC, lasts 1-3 min, postictal state
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tonic-clonic type seizure
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Describe atonic seizures... what do these kids usually have?
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kids with helmets
Sudden loss of muscle tone, head drops, or patient collapses, LOC, variable duration, post‐ictal state |
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Describe myoclonic seizures
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Brief, rapid symmetrical jerking of
extremities and/or torso, LOC, lasts < few seconds, minimal post‐ictal state |
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Brief, rapid symmetrical jerking of
extremities and/or torso, LOC, lasts < few seconds, minimal post‐ictal state |
moyoclonic seizures
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In tonic clonic seizures... what phase is when there is jerking?
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clonic
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In tonic clonic seizures what phase is it called when there is generalized stiffening of the back and limbs?
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tonic
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What are the main antiepileptic drugs for partial seizures?
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1. Phenytoin
2. Carbamazepine 3. Valproic acid 4. Phenobarbital |
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Which drugs can be used for both left and right column seizures?
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1. Valproic acid
2. Lamotrigine 3. Topiramate |
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What is the primary generalized seizure type of medication used for patients
a. absense only b. absense or primary tonic- clonic |
a. ethosuxamid (absence only)
b. valproic acid (gold standard) |
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What do you call a condition characteriezed by prolonged seizure (>10 mins) or repeated seizures without recovery in between?
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Status epilecticus
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What do you do to treat a pt. who is status epilepticus?
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ABC's establish IV
- history, allergies Labs- accucheck, CBC, chemistry panel, drug levels - Non contrast CT head - benzodiazepine (lorazepam 2-4 mg IV) |
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What are the general principles in the treatment of patients with epilepsy?
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1. monotherapy
2. remember oral contraceptives w/ carbamazepine 3. bone less with carbamazepine and phenytoin |
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What drugs are absolutely contraindicated in pregnant?
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VALPROIC ACID, but drug of choice is one that works
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Compare contrast seizure vs. syncope
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seizures can have- Urinary or bowell loss, tongue injury, tonic/clonic movements, postictal state
Syncope often slow onset and brief unconsciousness |
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Cerebral aneurysm, subarachnoid hem
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sudden HA, need CT with lumbar
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HTN, hemiparesis, stroke, diabetic
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aspirin, diclopidine (anti platelets), agrodox
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AFIB, aseptal defect
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coumadin
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Red flags that its not HA
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>50 first HA, fever, weakness on one side, seizure with HA
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Pass out, stiff 3-4 mins then sleepy for 5 mins after
Pass out confused for 30 mins |
seizure
seizure |
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Raise right arm lose awareness and goes on for 2 yrs and go to ER after stiffness and LOC (partial or generalized)
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partial seizure and then had complex partial that secondarily generalized
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Stroke is Sudden onset or gradual ...
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stroke (as in lightning
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