Year 3. Texas Tech: Ch 37- Seizures

Front 1

most common cause of seizure in adults over 60?

Back 1

Stroke

2nd: malignancy

Front 2

Difference btw Primary and 2ndary seizure?

Back 2

1: seizures recurring without consistent provocation or cause

2: response to certain toxic, metabolic, or environmental events

Front 3

Difference btw generalized and partial seizures?

Back 3

Gen: both cerebral hemispheres and is accompanied by LOSS OF CONSCIOUSNESS (grand mal or absence)

Partial: one cerebral hemisphere; consciousness either maintained (simple partial) or abnormal consciousness (complex partial)

Front 4

difference btw simple and complex seizures

Back 4

consciousness either maintained (simple)

abnormal consciousness (complex)

Front 5

define status epilepticus

Back 5

abnormal electrical activity for more than 5 minutes

can be any kind of seizure

unlikely to terminate spontaneously

Front 6

Metabolic causes of seizure

Back 6

Hypoglycemia
Hypo/hypernatermia
hypocalcemia
hypomagnesemia
renal failure
high anion gap acidosis
thyroid dz

Front 7

given the following history or exam finding give the potential seizure red flag:

fever, HA, neck stifness

Back 7

meningitis
abscess
febrile seizure

Front 8

given the following history or exam finding give the potential seizure red flag:

alcohol, benzo or drug abuse

Back 8

withdrawal seizure

Front 9

given the following history or exam finding give the potential seizure red flag:

new onset

Back 9

epiliepsy

brain mass

Front 10

given the following history or exam finding give the potential seizure red flag:

vesicular rash

Back 10

herpes encephalitits

Front 11

given the following history or exam finding give the potential seizure red flag:

hypertension, tachycardia, piloerection

Back 11

alcohol, benzo, or drug withdrawal

Front 12

recurrent seizures without a return to consciousness is another definition for...

Back 12

status epilepticus

Front 13

leading cause of adult onset epilepsy in areas such as Latin America, Asia, Africa

Back 13

Neurocysticercosis

arasitic disease of the nervous system

Neurocysticercosis can be acquired via fecal-oral contact with carriers of the adult tapeworm Taenia solium

Front 14

prolonged tonic clonic seizures can lead to what MSK problem

Back 14

posterior should dislocation

Front 15

anisocoria suggests what?

Back 15

impending herniation through the foramen magnum

(unequal pupils)

Front 16

automatisms (repetitive actions such as lip smacking, swallowing, or chewing) are frequent in what kind of seizure?

Back 16

complex partial

Front 17

what is Todd's paralysis

if present what might it suggest

Back 17

postictal paralysis

following seizure

weakenss of one extremity or complete hemiparesis

can last up to 24 hours

higher likelihood of underlying structural cause for seizure (look for a cause)

Front 18

given the following signs/sx give the diagnosis:

usually brought on by anger, fear, frustation. Pallor or cyanotic spells, apnea or bradycardia

normal neuro exam

Back 18

Breath-holding spells in infants

EEG during spells

Front 19

given the following signs/sx give the diagnosis:

tongue deviation, torticollis, jerking random limb movements, lvl of consciousness usually maintained

Back 19

Extrapyramidal reactions

look for specific meds

Front 20

given the following signs/sx give the diagnosis:

shortness of breath followed by paresthesias, carpopedal spasm and LOC

increased respiratory rate, normal neuro exam

Back 20

Hyperventillation syndrome

Front 21

given the following signs/sx give the diagnosis:

may closely mimic sx of true seizure, often in the setting of emotional distress

usually quick return to normal mental status post event

Back 21

Psychogenic seizures

continuous EEG monitoring during events

Front 22

given the following signs/sx give the diagnosis:

sudden onset of weakness, difficulty speaking, or walking

abnormal neuro findings

Back 22

TIA/CVA

head CT, ECG, labs

Front 23

given the following signs/sx give the diagnosis:

brief twitching movements; classic prodrome includes lightheadedness, tunnel vision

no post ictal state, no tongue biting

Back 23

Vasovagal syncope

ECG, glucose testing

Front 24

key electrolytes to look at in seizure pts?

Back 24

Na
Ca
Mg

Front 25

this procedure is indicated when a pt has a seizure and fails to reutrn to normal mental status

Back 25

LP

look for SAH or Meningitis

Front 26

given the following association with seizure, give the appropriate labs to order:

Neonatal seizure

Back 26

Serum Glucose
Electrolytes
BUN
Cr
Mg
CT if age>1

Front 27

given the following association with seizure, give the appropriate labs to order:

First-time seizure; mental status returning to baseline

Back 27

glucose
Na
Ca
CT

Front 28

given the following association with seizure, give the appropriate labs to order:

first-time seizure: mental status NOT returning to baseline

Back 28

glucose
Na
Ca
CT

Consider: CBC, EtOH/tox screen, ABG/CarboxyHg, BUN/Cr, Mg, preg test, anticonvulsant lvls

Front 29

given the following association with seizure, give the appropriate labs to order:

hx of alcoholism

Back 29

glucose
Na
Ca
CT

Consider: CBC, EtOH/tox screen, ABG/CarboxyHg, BUN/Cr, Mg, preg test, anticonvulsant lvls

Front 30

given the following association with seizure, give the appropriate labs to order:

known seizure disorder: MS not returning to normal or abnormal seizure pattern

Back 30

glucose
Na
Ca
CT

Consider: CBC, EtOH/tox screen, ABG/CarboxyHg, BUN/Cr, Mg, preg test, anticonvulsant lvls

Front 31

given the following association with seizure, give the appropriate labs to order:

known seizure disorder: MS status retuning to normal and normal seizure pattern

Back 31

Anticonvulsant lvls

glucose

Front 32

given the following association with seizure, give the appropriate labs to order:

Febrile Seizure

Back 32

Glucose

Consider: fever work-up and LP

Front 33

what imaging should be done in any first time seizure pt or person whos MS doesnt return to normal?

Back 33

CT

Front 34

what study should be ordered if a seizure is believed to be due to drug or toxin exposure (such as tricyclic antidepressant)

Back 34

ECG

Front 35

what must always be assumed in a pt who is in status epilepticus?

Back 35

compromised airway

INTUBATE

Front 36

3 easy to correct things that should be done immediately in a pt with seizure

Back 36

hypoglycemia
hyponatremia
hypoxia

Front 37

first line medication for terminating seizure activity?

Back 37

IV or IM benzos

Front 38

what can happen if you give phenytoin (2nd line anti-seizure in ED) too quickly

Back 38

hypotension and cardiac dysrhythmias

Front 39

hypoglycemia or ketonuria can cause what in kids

Back 39

seizure

Front 40

what can be used to help control seizures in pregnant ladys who arent ready to give birth (pre mature)

Back 40

Mg Sulfate

Front 41

abrupt loss of consciousness with the onset of seizures upon surfacing from SCUBA=

Back 41

Cerebral arterial gas embolism (CAGE)

person holds breath, then pulmonary overinflation, tear of bronchoalveolar sheath, air enters the pulmonary venous system, return of air to left side of heart, systemic embolization of air bubbles

tx with hyperbaric O2

Front 42

most common cause of recurrent primary seizures?

Back 42

subtherapeutic anticonvulsant levels

often due to noncompliance

Front 43

most common cause of secondary seiuzre?

Back 43

hypoglycemia

Front 44

when should an LP be given to a child with febrile seizure

Back 44

clinical suspicion of CNS infection

history of recent abx use

Front 45

pts who are intubated often stop actively seizing. What should be performed on them?

Back 45

EEG

they may still be seizing at neuronal level