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50 Cards in this Set
- Front
- Back
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What is the difference between a seizure and epilepsy?
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A seizure is a single event while epilepsy is chronic unavoidable seizures.
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What is required to diagnose epilepsy or seizure?
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EEG
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How do you classify seizures? Based on what?
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Origin on the seizure
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What are the three different types of seizures and how are they different?
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1. Symptomatic - known lesion, tumor or bleed causing problem
2. Cryptogenic - Known area of activity but the specific cause and specific location not known 3. Idiopathic - unknown location due to genetic disorder or ion channel problem |
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What is the most important characteristic for physicians dealing with seizures to define?
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Whether the seizure is focal or generalized.
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What type of seizure is more easily treated?
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Focal
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Define a focal seizure.
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Localized to a small area or only one hemisphere - limited behavioral changes
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Define a general seizure.
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Bilateral, symmetric behavioral responses
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Can an individual sense when a focal seizure is going to spread into a generalized seizure and warn you?
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Yes
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Do you have cortical function during a generalized seizure?
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No cortical function
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What type of onset do you have with a generalized seizure?
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Sudden
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Do you have conscious behavior with a generalized seizure?
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No
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What are six types of generalized seizures?
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1. Grand mal (tonic/clonic)
2. Absence 3. Febrile seizures 4. Myoclonic 5. Atonic 6. Tonic |
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Does a febrile seizure predispose you to epileptic seizures later in life?
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No only atypical febrile seizures do.
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What type of onset is seen with partial seizures?
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A slower entry into the seizure.
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What are the characteristics of a simple partial seizure?
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Slow onset with some unusual motor movements. Remain conscious throughout the seizure. One can also respond to commands throughout the seizure.
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What are the characteristics of a complex partial seizure?
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The patient is conscious but unresponsive to commands. One also has some asymmetric senseless motor sx.
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Which seizure is described as being "motor bizarre behaviors and beliefs, brief and nocturnal"?
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Frontal lobe seizure
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Which seizure is described as "fear, loss of consciousness, deja vu, amnesia and automatisms"?
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Temporal lobe seizure
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Which seizure is described as "somatosensory derrangements, diziness"?
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Parietal lobe seizure
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Which seizure is described as "visual changes"?
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Occiptal lobe seizure
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What can one use to determine where a seizure originates and then spreads to?
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Ictal semiology
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What property of the affected tissue allows one to determine if a seizure happened there?
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The tissue is metabolically inactive.
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What indicates a tendency or a history of seizures?
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Interictal spikes
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A seizure may be a warning for what?
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Some other major underlying disorder.
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In the ER, what two types of tests should be done on someone suspected of having a seizure?
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MRI and EEG
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What percentage of seizure patients that Dr. P sees do not have epilepsy?
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30%
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Why would you want to be absolutely sure one has epilepsy before you subscribe epileptic drugs?
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They are neurotoxic
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Seizures are relatively common up until what age?
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5
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Why are seizures common in the elderly age group?
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Falls, tumors, ect
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Why are seizures common in ages up until 5?
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Metabolic disorders and trauma
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What determines treatment options?
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Type of seizure
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What is the ultimate goal of seizure treatment?
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No seizures with no side-effects
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How many drugs are used to begin with when treating seizures?
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1
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Can one develop drug resistance?
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Yes
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Of the four major seizure drugs, which has the best quantitative effect?
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They all are the same - 47%
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What happens to effectiveness as you piggyback meds?
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They only add a little bit more of a positive effect.
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Name six alternative options when drug therapy is not working.
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1. Exp drug therapy
2. Ketogenic diet 3. Resective surgery 4. Vagal nerve stimulator 5. Implantable cortical stimulator 6. Disconnection procedure |
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How long (technically) until you consider a seizure status epilepticus?
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30 minutes
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How long in a medical setting (not technically) before you consider a seizure status epilepticus?
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5 minutes
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What is the first thing you treat SE with?
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IV benzodiazepines or rectal valium
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If unresponsive to the first SE reponse, what do you treat with?
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IV anticonvulsants
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If you cannot resolve SE by drugs (first two responses), what is the next step?
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Induce comas for 24 hour intervals until the seizure subsides.
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If one has an epileptic seizure, how long until they are allowed to drive again (AL)?
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6 months
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What are the effects of seizure drugs on pregnancy?
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Reduced fertility and they are teratogenic; also complicate pregnancy
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Does progesterone promote or supress seizures?
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Supress
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Does estrogen promote or supress seizures?
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Promote
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What age group are generalized seizures more common in?
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Children
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What is the most common seizure type?
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Partial seizure
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Name five characteristics of absence seizures.
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1. Abrupt onset
2. Generalized 3Hz wave spike 3. Frontal lobe 4. Brief duration 5. Rapid return to baseline |
