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47 Cards in this Set
- Front
- Back
what causes the highest risk of seizure recurrence
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symptomatic seizure and abnormal eeg
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what kind of seizure causes a higher risk of a second one
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partial
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what two things are required for seizure generation
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hypersynchrony and hyperexcitabilty
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___ seizure is focal onset involving particular area of cortex). Signs and symptoms depend on what area of the brain is involved
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partial
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__seizure begin simultaneously in widespread brain regions in both hemispheres
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generalized
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what is char of simple partial seizure
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no alteration of consciosuness, motor signs-jacksonian march, somato or special sensory symp, autonomic (vom), psychotic
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what is char of complex partial seizure
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altered consciouness is present
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can partial evolve to general seizures
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yes. simple to complex to secondary general...or just complex to secondary general
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any other type of seizure is considered___
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generalized
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what are the phases of seizure
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prodrome, aura, ictal, postictal
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what are the ictal features of a seizure
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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) |
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what are postictal features
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aphasia, todds paresis, confusion
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what imaging should you do for seizure
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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 |
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do you have to have an abnormal eeg to have a seizure
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nope fifty percent have normal eeg
better results if done within 24 hours |
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what is epilepsy
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Epilepsy is the condition of recurrent (two or more) spontaneous (unprovoked) epileptic seizures
persist abnorm brain fxn that allows abnormal neuron firing |
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who does epilepsy occur most in
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young kids and elderly
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how do u get epilepsy
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inherited or aquired through trauma, stroke, birth defect, infxn
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what is the most comon generalized seizure disorder in adults!!
when is its onset |
juvenile myoclonic epilepsy
12-18 years of age assoc with mutations in several genes |
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what dz is this: frequent myoclonic seizures typically after awakening,mostly in arm, no impair consciousness may progress to generalized tonic clonic
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Juvenile myoclonic ep
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what does eeg of interictal JME look lik
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Fast (3.5- to 6-Hz) and irregular spike-and-wave and polyspike-and-wave complexes
possible photoparoxysmal |
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what is the most common form of focal epilepsy
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Mesial Temporal Lobe Epilepsy with Hyppocampal Sclerosis
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Mesial Temporal Lobe Epilepsy with Hyppocampal Sclerosis--what structures are involved
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hippo gyrus, amygdala, hippo
--these type of seizure are likely to recurr and are more resistant to AED |
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when do Mesial Temporal Lobe Epilepsy with Hyppocampal Sclerosis typically occur
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childhood and adolesence
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what causes and increase chance of getting mesial temporal lobe ep
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a neuro hx of febrile seizures, meningitis, head injury, fmaily hx of seizures
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how do mesial temporal seizures start
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simple partial with rising epigastric sensation, dejavu, olfact symp
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what are symp of mesial temp that have spread to both hem
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Behavioral arrest with unresponsiveness
Quiet staring with widened palpebral fissures Oroalimentary automatisms |
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what do longer mt seizures progress to
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Limb automatisms
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what happens if MT seizures spread outside the temp lobe
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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 |
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what can occur if MT seizure happens during sleep
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secondary generalization
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what happens postictally after MT seizure
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The patient is often confused and amnestic for the ictal event
post ictal localization: aphasia, hemiparesis, nose wiping with hand ipsilat to ictal side |
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how long do mt seizures last
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1-3 mins
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what does interictal MT seizure eeg show
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May be normal
May show focal slowing over the temporal region May show focal spike-and-wave or sharp-and-slow-wave discharges |
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what does ictal MT seizure eeg show
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5-7Hz rhythmic sharp activity over anterior and inferior temporal regions
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what does neuro imaging of MT seizure show
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MT sclerosis (MTS)
Focal lesion in MT region (ex. tumor) |
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what is carbamazapine used for
who needs low dose |
works well for partial seizures but can make primary generalized seizures worse
low dose for elderly |
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what is valproic acid used for
who needs low dose |
drug of choice for primary generalized seizures/ epilepsy
-low dose for elderly |
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what is lamotrigine used for
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can be used for both partial and primary generalized seizures ( but may not control associated GTCS), and requires long titration time
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which two AEDs are assoc with teratogenic effect
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carbamazapine and valproic acid
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what AED should be avoided in patients taking warfarin
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phenytoin- if you have to give it monitor serum levels of both meds closely
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avoid___ in patients with mood disorders
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levetiracetam
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what drugs should be considered in pt with seizure,migraine, and or mood disorder
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valporic acid and topiramate
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___ is a good drug for pt with epilepsy and mood disorder
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lamotrigine
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------- is one continuous unremitting seizure lasting 30 minutes or longer, or recurrent seizures without regaining consciousness between seizures for 30 minutes or longer
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status epilepticus
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who much time for seizure is sufficient to damage a neuron
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5 mins
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what is char of generalized convulsive seizure
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Associated with multiple cerebral and systemic complications
If remains untreated, motor manifestations subside |
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what is the ideal timing to stop a seizure and prevent damage
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within a half hour
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what are the 4 main drugs to treat Seizure
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lorazepam, diazepam, phenytoin, phenobarbital
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