Neurology
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| EEG 3/sec spike and wave = | Absence
🗑
|
||||
| Most common cause of tonic-clonic in pts (onset < 30 yo) is: | idiopathic epilepsy
🗑
|
||||
| Clonic seizures: | usually in childhood; impaired consciousness, followed by asymmetric bilateral jerking
🗑
|
||||
| Most common seizure type: | complex partial
🗑
|
||||
| complex partial: etiology may be: | 10-30 yo; common post-head trauma; 50% abnml CT/MRI; 50% mesial temporal sclerosis; 20% hamartoma
🗑
|
||||
| complex partial: 30-60 yo: etiology may be: | brain tumor?
🗑
|
||||
| complex partial: >60 yo: etiology may be: | stroke?
🗑
|
||||
| Seizure: labs | EEG most important. Glucose; lytes; AED levels; LP if suspect meningitis; EtOH/tox screen; ABG if suspect hypoxia; poss CXR, CT; MRI study of choice for epileptogenic lesions
🗑
|
||||
| Status epilepticus: does not apply to: | continuous simple partial seizures
🗑
|
||||
| EtOH withdrawal seizure: | onset 6-48 hr after last drink; often primary generalized, often have Todd’s
🗑
|
||||
| Tx after single seizure if: | there is a structural lesion or recognized abnormal EEG
🗑
|
||||
| Remission: | usu within 3 yrs of first seizure; prolonged remission in 60% of such pts
🗑
|
||||
| Factors against remission | FH; psych comorbid; febrile seizure hx; more seizures; age
🗑
|
||||
| Seizure etiology | CNS dysfn, metabolic/lytes, febrile (peds), trauma, CVA, AVM, SAH, mass, infxn, hepatic enceph, drugs, EtOH WD, hyperthermia, idopathic (most common)
🗑
|
||||
| Motor (type of simple partial) = | focal rhythmic extremity twitching; involved area may enlarge due to increased neuron recruitment -> "Jacksonian march" (increased motor deficit)
🗑
|
||||
| Todd paralysis = | postictal hemiparalysis, may persist up to 36 hrs
🗑
|
||||
| Continuous seizure activity w/o interictal return to baseline for >15-20 minutes = | status epilepticus (medical emergency)
🗑
|
||||
| status epilepticus mgmt | O2/tele. Labs & neuro assessment. Thiamnin and D50. Ativan 0.02-0.03mg/kg (or Valium 0.3 vs Versed 0.1). Dilantin load up to 50mg/min
🗑
|
||||
| If status epilepticus persists despite Dilantin: | increase by 5-10mg/kg; consider phenobarbital 50-100/min (max 25 mg/kg). If >60 min, pentobarbital 5-15mg/kg or propofol
🗑
|
||||
| complex partial sz | may have aura, then impaired consciousness
🗑
|
||||
| simple partial sz has no: | impairment of consciousness
🗑
|
||||
| Most common cause of tonic-clonic in pts (onset < 30 yo): | idiopathic epilepsy
🗑
|
||||
| Clonic seizures: | usu in childhood; impaired consciousness, followed by asymmetric bilateral jerking
🗑
|
||||
| Most common seizure type: | complex partial
🗑
|
||||
| complex partial sz: | 10-30 yo; common post-head trauma; 50% abnml CT/MRI; 50% mesial temporal sclerosis; 20% hamartoma
🗑
|
||||
| complex partial sz: etio by age | 30-60 yo: poss brain tumor; >60 yo: more likely stroke
🗑
|
||||
| Status epilepticus dx does not apply to: | continuous simple partial seizures
🗑
|
||||
| EtOH withdrawal seizure: | onset 6-48 hr after last drink; often primary generalized, often have Todd paralysis
🗑
|
||||
| Sz remission: | usu within 3 yrs of first seizure; prolonged remission in 60% of such pts
🗑
|
||||
| Factors against sz remission | FH; psych comorbid; febrile seizure hx; more seizures; age
🗑
|
||||
| Todd paralysis = | post-ictal focal weakness in part of body, confined to L or R, usu arms/legs
🗑
|
||||
| Anti Epileptic Drugs: titration | Start low & gradually increase; initiate with 1/3-1/4 of anticipated maintenance dose & increase over 3-4 weeks
🗑
|
||||
| when Anti Epileptic Drugs may be dc'd: | If onset btw age 2-35 & normal EEG; seizure-free period 2-4 yrs; complete ctrl within 1 yr; very gradual taper over 6 mos; relapse usu within first few mos after withdrawal; f/u in 5 yrs if no problems
🗑
|
||||
| Concomitant dysphasia, hemianopia, or focal epilepsy suggests a lesion located: | supratentorial
🗑
|
||||
| epilepsy that has failed two medications is | medically intractable epilepsy
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Abarnard
Popular Medical sets