Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
66 Cards in this Set
- Front
- Back
|
Seizure: definition
|
Single provoked or unprovoked episode. Lifetime risk is 1 in 10!
|
|
|
Epilepsy: definition
|
Two or more unprovoked seizures [recurrent unprovoked seizures]. 8th leading cause of morbidity, 50 million people worldwide, 2 million in the US!
|
|
|
Age adjusted incidence of seizures
|
There is a bimodal distribution - the young and the old
|
|
|
Types of Partial Seizures
|
(1) Simple partial; (2) Complex partial; (3) Secondarily GTC
|
|
|
Complex Partial Seizure
|
Impaired consciousness! Clinical manifestations vary with site of origin and degree of spread; Usually last 15sec-3min
|
|
|
Generalized Tonic Clonic Seizure
|
Variable symmetry, intensity, and duration of tonic (stiffening) an clonic (jerking) phases; generally last 30-120secs; produce postical confusion, somnolence, w/ or w/o transient focal deficits
|
|
|
Absence seizure
|
Occurs in school-age children; "staring spells" - brief, last 10-30 secs; 80% outgrow by 10-11yrs; Rx: ETHOSUXIMIDE
|
|
|
Absence seizure: EEG
|
Can provoke with hyperventilation; can have automatisms, clonic activity (eye blinking), and changes in tone. End abruptly without post-ictal changes. 3Hz spike-and-wave activity
|
|
|
Types of Generalized Seizures
|
(1) Tonic; (2) Clonic; (3) Tonic-Clonic; (4) Myoclonic; (5) Atonic; (6) Absence
|
|
|
Atonic Seizure
|
Sudden loss of muscle tone and brief - occurs mainly in setting of Lennox-Gestault Syndrome; most patients require helmets or use wheelchairs
|
|
|
Frequency of seizure types
|
MC is complex partial (36%), but generalized TC is 2nd with 23%. GENERALIZED SEIZURES PREDOMINATE in 1st YEAR OF LIFE
|
|
|
Causes of seizure
|
2/3 are idiopathic/cryptogenic
|
|
|
Consequences of epilepsy
|
Morbidity, mortality, and socioeconomic outcomes - only 56% finish high school and 15% finish college
|
|
|
IV AEDs
|
Phenobarbital, Phenytoin, Valproate, Keppra
|
|
|
Phenobarbital SE
|
Sedation, Hyperactivity
|
|
|
Phenytoin SE
|
Gingival hyperplasia, bone marrow suppression
|
|
|
Primidone SE
|
Sedation, Hyperactivity
|
|
|
Ethosuximide SE
|
GI upset, Headache
|
|
|
Carbamazepine SE
|
Hyponatremia, Leukopenia, Hepatitis
|
|
|
Valproate SE
|
Thrombocytopenia, Hepatitis, Pancreatitis
|
|
|
Felbamate SE
|
Aplastic Anemia
|
|
|
Gabapentin SE
|
Sleepiness
|
|
|
Lamotrigine SE
|
Rash (increased risk with VPA)
|
|
|
Topiramate SE
|
Cognitive slowing, renal stones
|
|
|
Tiagibine SE
|
Dizziness, Somnolence
|
|
|
Levetiracetam SE
|
Sleepiness
|
|
|
Oxcarbazepine SE
|
Hyponatremia (No leukopenia like carbamazepine)
|
|
|
Zonisamide SE
|
Renal stones
|
|
|
What two AEDs can cause renal stones?
|
Zonisamide and Topiramate
|
|
|
Driving after seizure
|
Doctors NOT required to report patients; seizure-free period of 6 months with doctors recommendation. Still allowed to drive if (1) Change in medication or (2) Nocturnal seizure only
|
|
|
Common malformation with AEDs
|
Cleft lip, palate, digit, and crease abnormalities; NT defects (esp VPA)
|
|
|
Pregnancy recs
|
(1) Folate 400mcg/day; (2) Level 2 U/S at 16-18wks; (3) Vitamin K 10mg/day during last week to prevent Hemorrhagic Disease
|
|
|
Seizure: definition
|
Single provoked or unprovoked episode. Lifetime risk is 1 in 10!
|
|
|
Outcome of Medical Management
|
60% of patients respond to first two medications
|
|
|
Epilepsy: definition
|
Two or more unprovoked seizures [recurrent unprovoked seizures]. 8th leading cause of morbidity, 50 million people worldwide, 2 million in the US!
|
|
|
Age adjusted incidence of seizures
|
There is a bimodal distribution - the young and the old
|
|
|
Types of Partial Seizures
|
(1) Simple partial; (2) Complex partial; (3) Secondarily GTC
|
|
|
Complex Partial Seizure
|
Impaired consciousness! Clinical manifestations vary with site of origin and degree of spread; Usually last 15sec-3min
|
|
|
Generalized Tonic Clonic Seizure
|
Variable symmetry, intensity, and duration of tonic (stiffening) an clonic (jerking) phases; generally last 30-120secs; produce postical confusion, somnolence, w/ or w/o transient focal deficits
|
|
|
Absence seizure
|
Occurs in school-age children; 'staring spells' - brief, last 10-30 secs; 80% outgrow by 10-11yrs; Rx: ETHOSUXIMIDE
|
|
|
Absence seizure: EEG
|
Can provoke with hyperventilation; can have automatisms, clonic activity (eye blinking), and changes in tone. End abruptly without post-ictal changes. 3Hz spike-and-wave activity
|
|
|
Types of Generalized Seizures
|
(1) Tonic; (2) Clonic; (3) Tonic-Clonic; (4) Myoclonic; (5) Atonic; (6) Absence
|
|
|
Atonic Seizure
|
Sudden loss of muscle tone and brief - occurs mainly in setting of Lennox-Gestault Syndrome; most patients require helmets or use wheelchairs
|
|
|
Frequency of seizure types
|
MC is complex partial (36%), but generalized TC is 2nd with 23%. GENERALIZED SEIZURES PREDOMINATE in 1st YEAR OF LIFE
|
|
|
Causes of seizure
|
2/3 are idiopathic/cryptogenic
|
|
|
Consequences of epilepsy
|
Morbidity, mortality, and socioeconomic outcomes - only 56% finish high school and 15% finish college
|
|
|
IV AEDs
|
Phenobarbital, Phenytoin, Valproate, Keppra
|
|
|
Phenobarbital SE
|
Sedation, Hyperactivity
|
|
|
Phenytoin SE
|
Gingival hyperplasia, bone marrow suppression
|
|
|
Primidone SE
|
Sedation, Hyperactivity
|
|
|
Ethosuximide SE
|
GI upset, Headache
|
|
|
Carbamazepine SE
|
Hyponatremia, Leukopenia, Hepatitis
|
|
|
Valproate SE
|
Thrombocytopenia, Hepatitis, Pancreatitis
|
|
|
Felbamate SE
|
Aplastic Anemia
|
|
|
Gabapentin SE
|
Sleepiness
|
|
|
Lamotrigine SE
|
Rash (increased risk with VPA)
|
|
|
Topiramate SE
|
Cognitive slowing, renal stones
|
|
|
Tiagibine SE
|
Dizziness, Somnolence
|
|
|
Levetiracetam SE
|
Sleepiness
|
|
|
Oxcarbazepine SE
|
Hyponatremia (No leukopenia like carbamazepine)
|
|
|
Zonisamide SE
|
Renal stones
|
|
|
What two AEDs can cause renal stones?
|
Zonisamide and Topiramate
|
|
|
Driving after seizure
|
Doctors NOT required to report patients; seizure-free period of 6 months with doctors recommendation. Still allowed to drive if (1) Change in medication or (2) Nocturnal seizure only
|
|
|
Common malformation with AEDs
|
Cleft lip, palate, digit, and crease abnormalities; NT defects (esp VPA)
|
|
|
Pregnancy recs
|
(1) Folate 400mcg/day; (2) Level 2 U/S at 16-18wks; (3) Vitamin K 10mg/day during last week to prevent Hemorrhagic Disease
|
|
|
Outcome of Medical Management
|
60% of patients respond to first two medications
|
