Seizure And Epilepsy

Front 1

what causes the highest risk of seizure recurrence

Back 1

symptomatic seizure and abnormal eeg

Front 2

what kind of seizure causes a higher risk of a second one

Back 2

partial

Front 3

what two things are required for seizure generation

Back 3

hypersynchrony and hyperexcitabilty

Front 4

___ seizure is focal onset involving particular area of cortex). Signs and symptoms depend on what area of the brain is involved

Back 4

partial

Front 5

__seizure begin simultaneously in widespread brain regions in both hemispheres

Back 5

generalized

Front 6

what is char of simple partial seizure

Back 6

no alteration of consciosuness, motor signs-jacksonian march, somato or special sensory symp, autonomic (vom), psychotic

Front 7

what is char of complex partial seizure

Back 7

altered consciouness is present

Front 8

can partial evolve to general seizures

Back 8

yes. simple to complex to secondary general...or just complex to secondary general

Front 9

any other type of seizure is considered___

Back 9

generalized

Front 10

what are the phases of seizure

Back 10

prodrome, aura, ictal, postictal

Front 11

what are the ictal features of a seizure

Back 11

Dyscognitive ( alteration in the level of consciousness)
Sensory symptoms (elementary such as somatosensory, visual, olfactory; experiential such as hallucinatory, illusory)
Motor symptoms (elementary such as clonic and/or tonic; automatisms such as lip smacking, hand picking)

Front 12

what are postictal features

Back 12

aphasia, todds paresis, confusion

Front 13

what imaging should you do for seizure

Back 13

MRI of the brain: with and without contrast – look for structural abnormality
PET scan of the brain – look for functional abnormality
CT of the brain – look for intracranial hemorrhage

Front 14

do you have to have an abnormal eeg to have a seizure

Back 14

nope fifty percent have normal eeg
better results if done within 24 hours

Front 15

what is epilepsy

Back 15

Epilepsy is the condition of recurrent (two or more) spontaneous (unprovoked) epileptic seizures
persist abnorm brain fxn that allows abnormal neuron firing

Front 16

who does epilepsy occur most in

Back 16

young kids and elderly

Front 17

how do u get epilepsy

Back 17

inherited or aquired through trauma, stroke, birth defect, infxn

Front 18

what is the most comon generalized seizure disorder in adults!!
when is its onset

Back 18

juvenile myoclonic epilepsy
12-18 years of age
assoc with mutations in several genes

Front 19

what dz is this: frequent myoclonic seizures typically after awakening,mostly in arm, no impair consciousness may progress to generalized tonic clonic

Back 19

Juvenile myoclonic ep

Front 20

what does eeg of interictal JME look lik

Back 20

Fast (3.5- to 6-Hz) and irregular spike-and-wave and polyspike-and-wave complexes
possible photoparoxysmal

Front 21

what is the most common form of focal epilepsy

Back 21

Mesial Temporal Lobe Epilepsy with Hyppocampal Sclerosis

Front 22

Mesial Temporal Lobe Epilepsy with Hyppocampal Sclerosis--what structures are involved

Back 22

hippo gyrus, amygdala, hippo
--these type of seizure are likely to recurr and are more resistant to AED

Front 23

when do Mesial Temporal Lobe Epilepsy with Hyppocampal Sclerosis typically occur

Back 23

childhood and adolesence

Front 24

what causes and increase chance of getting mesial temporal lobe ep

Back 24

a neuro hx of febrile seizures, meningitis, head injury, fmaily hx of seizures

Front 25

how do mesial temporal seizures start

Back 25

simple partial with rising epigastric sensation, dejavu, olfact symp

Front 26

what are symp of mesial temp that have spread to both hem

Back 26

Behavioral arrest with unresponsiveness
Quiet staring with widened palpebral fissures
Oroalimentary automatisms

Front 27

what do longer mt seizures progress to

Back 27

Limb automatisms

Front 28

what happens if MT seizures spread outside the temp lobe

Back 28

motor symptoms of the contralateral hand, arm, or leg occur
Dystonic posturing if coming from Basal ganglia, and Clonus if coming from primary motor complex

Front 29

what can occur if MT seizure happens during sleep

Back 29

secondary generalization

Front 30

what happens postictally after MT seizure

Back 30

The patient is often confused and amnestic for the ictal event
post ictal localization: aphasia, hemiparesis, nose wiping with hand ipsilat to ictal side

Front 31

how long do mt seizures last

Back 31

1-3 mins

Front 32

what does interictal MT seizure eeg show

Back 32

May be normal
May show focal slowing over the temporal region
May show focal spike-and-wave or sharp-and-slow-wave discharges

Front 33

what does ictal MT seizure eeg show

Back 33

5-7Hz rhythmic sharp activity over anterior and inferior temporal regions

Front 34

what does neuro imaging of MT seizure show

Back 34

MT sclerosis (MTS)
Focal lesion in MT region (ex. tumor)

Front 35

what is carbamazapine used for
who needs low dose

Back 35

works well for partial seizures but can make primary generalized seizures worse
low dose for elderly

Front 36

what is valproic acid used for
who needs low dose

Back 36

drug of choice for primary generalized seizures/ epilepsy
-low dose for elderly

Front 37

what is lamotrigine used for

Back 37

can be used for both partial and primary generalized seizures ( but may not control associated GTCS), and requires long titration time

Front 38

which two AEDs are assoc with teratogenic effect

Back 38

carbamazapine and valproic acid

Front 39

what AED should be avoided in patients taking warfarin

Back 39

phenytoin- if you have to give it monitor serum levels of both meds closely

Front 40

avoid___ in patients with mood disorders

Back 40

levetiracetam

Front 41

what drugs should be considered in pt with seizure,migraine, and or mood disorder

Back 41

valporic acid and topiramate

Front 42

___ is a good drug for pt with epilepsy and mood disorder

Back 42

lamotrigine

Front 43

------- is one continuous unremitting seizure lasting 30 minutes or longer, or recurrent seizures without regaining consciousness between seizures for 30 minutes or longer

Back 43

status epilepticus

Front 44

who much time for seizure is sufficient to damage a neuron

Back 44

5 mins

Front 45

what is char of generalized convulsive seizure

Back 45

Associated with multiple cerebral and systemic complications
If remains untreated, motor manifestations subside

Front 46

what is the ideal timing to stop a seizure and prevent damage

Back 46

within a half hour

Front 47

what are the 4 main drugs to treat Seizure

Back 47

lorazepam, diazepam, phenytoin, phenobarbital