CM Neurology Seizure
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| The location of the original group of synchronously firing neurons | Focus
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| Epilepsy Definition | Documented history of two or more seizures that are not temporally related to an obvious metabolic or febrile cause.
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| Children often have what kind of seizures? | Febrile. Less than 6 years old. Treatment is supportive and anticonvulsants are not routinely given (don't want to give kids something that affects their brain development). Liberal use of antipyretics in future febrile illnesses is suggested
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| Most common time to begin having seizures in your lifetime? | Highest in first year of life, then drops to a minimum; at 30 to 40 years before beginning to increase again.
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| Electrical discharge simultaneously at all EEG electrodes on the scalp. | Generalized Seizure
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| Seizures placed in this category usually result from incomplete data | Unclassified Seizure
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| If a an electrical discharge begins in a small region | Partial Seizure
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| A partial seizure in which consciousness is altered | Complex partial seizure. If no consciousness is lost, then it is called a simple partial seizure
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| Which type of seizure (partial or generalized) represents focal brain disease? | partial
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| Synchronous jerking of all 4 extremities | does not rule out onset as a partial seizure
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| Brief (5-10seconds) generalized seizures (staring spells or minor motor automatisms) | Absence (petit mal). Happens most commonly in kids. EEG pattern: 3/sec spike and wave.
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| What technique can be used to bring out a petit mal? | Hyperventilation.
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| Favorable prognotic factors associated with absence seizures. | Onset between the ages of 4 and 8 years,Not associated with any other seizure type,Normal intelligence, EEG consistent with typical absence, No other EEG abnormalities.
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| When is the typical onset of tonic/clonic seizures (generalized?) | after age 3, before age 30
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| Name the most common cause of generalized tonic clonic seizures with onset before age 30 | idiopathic epilepsy
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| brief, lightning-like jerking movements of the extremities or trunk associated with a paroxysmal EEG abnormality. | Myoclonic Seizures
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| Nocturnal myoclonus is/is not epileptic in nature | is not
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| almost exclusively in childhood. Begin with impaired consciousness, followed by asymmetric bilateral jerking. | Clonic Seizures
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| Clonic | Jerking
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| Tonic | Stiffness
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| Seizure with only stiffness | Tonic seizure. Relatively rare
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| sudden loss of muscle tone that may cause a standing pt to fall. This may be as mild as nodding of the head or sagging at the knees, or as severe as total loss of body tone. Last 1 to 4 seconds and there is no detectable loss of consciousness. | Atonic Seizures. Lose muscle tone and drop to the ground
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| The most common seizure type | Partial complex; some can walk around but are 'out of it'.
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| What not to do if witnessing a seizure | don't put anything in their mouth: spoons, fingers.
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| What is a common sequala of head trauma? | Partial complex seizure
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| Post Partial complex seizure MRI | >50% of patients will have an abnormal CT or MRI scan
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| 50% Of patients with complex partial seizures will have | mesial temporal sclerosis (oftentimes herpes is found here)
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| 80% of patients with temporal lobe Complex partial seizures have | abnormal tissue
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| Psychogenic signs/pseudoseizures signs | bite the tip of their tongue,
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| Predisposing conditions to Seizures | DM, uremia, lupus, arrhythmia, hyponatremia, hypocalcemia, substance abuse, alcohol, prescription drugs
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| Common causes of provoked seizures | sleep deprivation, excessive use of stimulants, withdrawals from sedatives or alcohol, substance abuse, high fever (in kids), hypoxia, hypoglycemia, eletrolyte disturbance
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| Electrolytes to check | sodium, calciu, magnesium and phosphorus
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| What is one thing you must check in seizure patients? | GLUCOSE. Can save their life and their brain. If hypo, give D50.
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| Prolonged, or recurrent seizures without regaining consciousness | Status epilepticus. This does not apply to continuous simple partial seizures.
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| Continuous simple seizures are also known as | epilepsia partialis continua (EPC)
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| When do alcohol withdrawal seizures occur? | Usually occur 6 to 48 hours after the last intake of alcohol. They are often primary generalized seizures
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| Todd's postictal phenomenon | post seizure, temporary focal deficit. associated with alcohol withdrawl seizures
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| Risk of recurrence after a single unprovoked seizure is approximately | 30% in 5 years. So if you treated 100 people, only 30 of them will have a seizure in the future. 70 treated people would never have had a 2nd seizure anyhow
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| Who to treat after a single seizure | structural lesion or abnormality
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| >90 of patients with epilepsy who will go into remission do so within how many years of the first seizure? | 3 years
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| Which age of onset has the lowest remission rate? | adults (53% remission rate)
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| Which drug is not used in pregnant patients with epilepsy b/c it causes spina bifida? | valproate
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| How long after you have a seizure should you not drive? | 6-12 months (document this in the pt chart that you talked with them about this). Take care about operative machinery and taking baths (can drown)
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| automatisms are most likely found in which type of seizures? | partial
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