Neuro Exam 1: Paroxsymal Disorders

Front 1

What is syncope?

Back 1

transient loss of consciousness and postural tone from brain hypoperfusion lasting only seconds

Front 2

What is pre-syncope?

Back 2

light headedness, visual changes and buckling of the knees

Front 3

Syncope is secondary to __

Back 3

hypotension

Front 4

What is a normal variant mechanism that causes syncope?

Back 4

Vasovagal

Front 5

What are two pathological mechanisms of hypotension causing syncope?

Back 5

Cardiogenic
Orthostatic

Front 6

What are some causes of vasovagal syncope?

Back 6

micturtion/defecation/cough
carotid sinus hyptersensitivity
noxious stimulus

Front 7

Most syncope is __

Back 7

Vasovagal

Front 8

What causes cardiogenic syncope?

Back 8

MI, arrhythmias, valvular outflow obstruction

Front 9

What are some causes of orthostatic hypotension?

Back 9

Autonomic failure
Volume depletion
Meds

Front 10

Define seizure

Back 10

a paroxysmal pathological discharge of neurons which results in a stereotypical behavior or sensation

Front 11

T or F: A seizure is a symptom

Back 11

TRUE

Front 12

Define epilepsy

Back 12

the chronic condition of recurrent unprovoked epileptic seizures

Front 13

Define status epilepticus

Back 13

rare emergency in which a person has continuous seizures for greater than 30 minutes, assoc w/ M & M.

Front 14

What is the most common epilepsy syndrome?

Back 14

febrile seizures

Front 15

What are the two types of seizures?

Back 15

focal onset and generalized onset

Front 16

If a seizure starts in one spot and spreads to the whole cortex, what type of seizure is this?

Back 16

still a focal onset seizure

Front 17

What are some examples of generalized onset seizures?

Back 17

abscence
tonic-clonic
infantile spasms
atonic, other rare

Front 18

What are some types of focal onset seizures?

Back 18

Simple partial (motor, sensory)
Complex partial

Front 19

Infantile spasms are associated with what disease?

Back 19

TSC

Front 20

Who gets febrile seizures?

Back 20

4% of population (all little kids)

Front 21

What are absence epilepsy?

Back 21

starting into space for a few seconds then coming back to totally normal

Front 22

When does Lennox-Gasteaux Syndrome onset?

Back 22

first decade

Front 23

When does Juvenile Myoclonic Epilepsy onset?

Back 23

adolescents

Front 24

What epilepsy syndrome is associated with developmental regression?

Back 24

Lennox-Gasteaux Syndrome and Infantile Spasms

Front 25

When do infantile spasms onset?

Back 25

infants (I know it's dopey)

Front 26

Which epilepsy syndrome consists of de-ja-vu or transient sense of fear or unpleasant olfactory sensations

Back 26

simple partial temporal lobe epilepsy

Front 27

Where do temporal lobe epileptic seizures arise?

Back 27

hippocampus or amygdala (medial temporal lobe)

Front 28

Which epilepsy syndrome consists of de-ja-vu or transient sense of fear or unpleasant olfactory sensations followed by confusion and speech problems lasting seconds to minutes, followed by amnesia of the event?

Back 28

Complex partial temporal lobe epilepsy

Front 29

What is the mainstay of evaluation of epilepsy?

Back 29

EEG

Front 30

___ is often performed to look for an underlying cause of a seizure such as a tumor when someone has a seizure disorder

Back 30

MRI

Front 31

What are the treatments for seizure syndromes?

Back 31

antiepileptic drugs and rarely, surgery

Front 32

How do you distinguish absence seizures from complex partial seizures?

Back 32

EEGs (and complex partials can have some subtle motor involvement)

Front 33

How can you tell wakefulness from REM sleep on EEG?

Back 33

You can't

Front 34

What is a polysomnogram?

Back 34

sleep study

Front 35

What are some sleep disorders?

Back 35

insomnia
sleep apnea
narcolepsy
restless leg syndrome
Parasomnias

Front 36

What are some examples of parasomnias?

Back 36

REM Sleep Behavior D/O
Non-REM Parasomnias (occur in stages 3 & 4) including night terrors, bruxism (teeth grinding), and sleep walking

Front 37

What are some non-REM parasomnias?

Back 37

Night terrors
Bruxism (teeth grinding)
Sleep walking

Front 38

Define insomnia

Back 38

difficulty getting to sleep or staying asleep or having non-refreshing sleep for at least 1 month

Front 39

What are some contributing factors of insomnia?

Back 39

Chronic pain
Stress
Mood d/o and anxiety
Caffeine misuse
Poor sleep hygiene (doing dumb things before bed)
Meds
Shift work

Front 40

What are some sx of obstructive sleep apnea?

Back 40

excessive daytime sleepiness, snoring, cessation of breathing in the middle of the night, morning HA, nonspecific cognitive complaints

Front 41

How do you treat OSA?

Back 41

CPAP and weight loss

Front 42

What are some risk factors for OSA?

Back 42

age, obesity and EtOH use

Front 43

What are the 4 cardinal features of narcolepsy?

Back 43

1. Excessive daytime sleepiness w/ "sleep attacks"
2. Cataplexy (sudden loss of tone)
3. Sleep paralysis
4. Hypnagogic hallucinations

Front 44

what is narcolepsy?

Back 44

sx of REM sleep occurring during wakefulness

Front 45

What does a polysomnogram show in a person w/ narcolepsy?

Back 45

awake --> REM instead of awake --> 1, 2, 3, 4, REM

Front 46

RLS is associated with what?

Back 46

Fe deficiency anemia

Front 47

How do you treat RLS?

Back 47

dopamine agonists

Front 48

__ is characterized by loss of normal muscle atonia during REM sleep, assoc w/ acting out of dreams

Back 48

REM behavior disorder

Front 49

What stage of sleep do night terrors, sleepwalking and bruxism occur?

Back 49

Stage 3 or 4. They are non-REM parasomnias