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30 Cards in this Set
- Front
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Recurrent unprovokaed seizures that result from abnormal electrical activity |
Epilepsy (important to estimate whether first unprovoked seizure is likely to lead to further attack*) |
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Seizures are mc in young children & elderly. What are some risk factors for epilepsy? |
Family hx cerebral injury neurologic dz Trauma Metabolic disorders Tumor Congenital abnormalities (infants) |
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_________seizures imply cerebral injury or lesion |
focal seizures |
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___________ seizures involve only a restricted part (focal area) of the brain |
Partial (focal) seizures: Simple partial Complex partial |
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In _________ seizures are limited to a focal circumscribed area of cortex & pts DO NOT lose consciousness*, often preceeded by AURAS *pts can still interact during seizure, except for loss of specific localized fxn* Tx? |
Simple partial seizures Tx: Carbamazepine, Phenytoin, Valproate |
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What is Todd's paralysis? |
postictal depression following a simple partial seizure--> transient REVERSIBLE neurologic deficit (focal weakness, numbness, paralysis) of specific area |
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In ___________ seizures are limited to a focal area of cortex & pts DO experience impaired consciousness, resulting in unresponsiveness, often preceeded by AURAS Tx? |
Complex partial seizures Tx: Carbamazepine, Phenytoin, Valproate |
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___________ is an olfactory aura (foul smell) that may precede a complex partial seizure. These auras have a high association w/ brain tumors* |
Uncinate fits (origin near the uncus of the medial temporal lobe) |
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__________seizures involve the ENTIRE cerebral cortex (both hemispheres simultaneously) *begin diffusely (no localized origin) |
Generalized seizures: Absence (petit mal) Myoclonic Tonic clonic (grand mal) Atonic Tonic (reflex) |
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__________ seizures begin w/ an abrupt LOSS of consciousness w/ bilateral tonic extension (tonic phase), often accompanied w, epileptic cry--> followed by bilaterally synchronous jerking (clonic phase)--> followed by flaccid coma *urinary incontinence is common Tx? |
Tonic clonic (grand mal) seizures Tx: Carbamazepine, Phenytoin, Valproate |
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What are some possible complications of generalized seizures? |
Oral trauma (tongue laceration) vertebral compression fracture (Posterior) shoulder dislocation Aspiration pneumonia |
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__________seizures are mc in children & involve a sudden momentary (< 10 sec) lapse in awareness (staring, rhythmic blinking)---> Behavior & awareness return to normal immediately (no postictal period) *Pt has NO recollection of seizure Tx? |
Absence (petit mal) seizures Tx: Ethosuximide |
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________seizures involve rapid, recurrent brief muscle jerks |
Myoclonic seizures |
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_______seizures mc occur in children w/ diffuse encephalopathies & involve sudden loss of musce tone--> results in fall (possible self injury) |
Atonic Seizures (Drop attacks) |
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________ seizures are the mc cause of convulsions in children *have no long-term sequelae BUT do inc risk of future epilepsy (do NOT cause mental retardation, behavioral problems, etc) Tx? |
Febrile seizures Tx: anti-pyretics (NSAIDs, etc) *anticonvulsants & prophylactic tx is NOT indicated |
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___________ is a common cause of pediatric epilepsy. Seizures usually begin btwn ages of 4-13 & primarily occur at night. *seizures often disappear during adolescence |
Rolandic Epilepsy |
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_______________ early childhood epileptic encephalopathy that results in; -Physical brain abnormality -Mental retardation -Uncontrolled seizures |
Lennox-Gastaut Syndrome |
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_________ is the mc epilepsy in adults & involves complex partial seizures: aura followed by--> staring, lip-smacking, repeated swallowing, making picking motions w/ fingers & loss of awareness of surroundings (30 sec- 2 min seizure)--> postictal period of confusion |
Temporal Lobe Epilepsy |
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Post-traumatic epilepsy may occur w/i 1 yr of .................. Tx? |
Head injury--> Prolonged LOC, dura injury (relate severity of injury) Tx: phenytoin *give prophylactically to all pts who suffer severe head injury |
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T/F New onset seizures in adults > 30 suggest possible new intracranial lesions |
TRUE |
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Focal features, reported as auras during or after seizures, suggest....... |
structural brain lesions |
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Epilepsy (type, cause, etc) diagnosis is via.... |
EEG (most important tool*) followed by--> MRI (detects lesions/ tumors, do in all pts > 18 & children w/ partial seizures) (sleep deprivation can help bring on a seizure) |
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How are ongoing seizures tx? |
1. IV lorazepam or diazepam to STOP seizure 2. Tx underlying cause 3. Oxygen 4. Cardiac monitoring |
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Anti-epileptics should be gradually increased until seizure is controlled. If medication not stopping seizure, what should you do? |
Select another medication if current one is not working, then add slowly until therapeutic level attained--> then discontinue first drug |
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__________ is when seizures occur back to back w/o full recovery. Why is this a medical EMERGENCY? What mc causes this? |
Status epilepticus can cause permanent brain damage mc caused by abrupt withdrawal of anticonvulsants |
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Status epilepticus: Tx |
1. maintain airway 2. oxygen 3. thiamine & glucose (if hx of alcoholism) 4. IV Lorazepam or Diazepam (if needed) 5. IV phenytoin 6. IV midazolam (refractory control) 7. Pentobarbital |
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What should be given to prevent/tx alcohol withdrawal seizures? |
Benzodiazepines (diazepam or lorazepam) (antiepileptics are NOT indicated*) *can also give thiamine & glucose |
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How can you differentiate Syncope from epilepsy? |
Caused by a positional change*, vasovagal dysfxn, stress |
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How do you differentiate Psychogenic nonepileptic seizures (PNES)? |
no abnormal brain activity (on EEG) |
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How do you differentiate Complex migraines (basilar artery migraine)? |
can have lethargy, mood changes, confusion, disorientation, vertigo, bilateral visual disturbances, & alteration or LOC |
