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Neuro Day 3/5

Gaznabi: Seizure Disorders

Define seizure. A seizure is an abnormal, unregulated paroxysmal electrical discharge in the brain that occurs within cortical grey matter and transiently interrupts normal brain function.
Define epilepsy. A chronic brain d/o characterized by recurrent >2 unprovoked seizures. Mostly idiopathic but may be due to stroke,tumors.
Nonepileptic seizure Provoked by a temporary d/o or any factors (metabolic, cardiovascular, CNS infection)
Symptomatic seizure Are mostly symptomatic as in neonatal seizure/in elderly
Psychogenic seizure Pts with psychiatric d/o simulate seizure with no abnormal electrical activity. Unresponsiveness is very common.
Your explanation of an 85 yr old patient's seizure is due to___ or ____ stroke, tumor
Etiology of an adult seizure Trauma, tumor, alcohol withdrawal
"I'm sorry but your <24 month old is having this seizure because......." developmental defects, metabolic d/o, birth injuries
Focal seizure vs Generalized seizure Focal-limited to one cerebral hemisphere/usually associated with structural abnormalities of the brain. Gen-across both cerebral hemispheres/may result from cellular, biochemical, or structural abnormalities that have a more widespread distribution.
Clinical features of complex partial seizure Preceded by an aura, impaired consciousness, but aware of surroundings so pt withdraws from noxious agents, limb automatism, utterance of unintelligible sounds w/o understanding what they say, head/eye deviation contralateral to the seizure foci,etc.
Complex partial seizure can arise from any location in the brain but most commonly (60%) arise in the________ lobe temporal
Left temporal lobe seizures can cause...? visual spatial memory abnormalities
What are some causes of CPS? Most often: Idiopathic Causes include:hippocampal sclerosis, neoplasm, cortical or vascular malformations, stroke Others:CNS infection, hypoxia to brain, head trauma
Clinical manifestations of a focal seizure w/o LOC Focal seizures can cause motor, sensory, autonomic, or psychic symptoms without impairment of cognition. Motor:Convulsive jerking somatosensory:paresthesia Sensory:light flashes or buzzing Autonomic:sweating, flushing, pupillary dilation
What radiological test is diagnostic for focal seizures? EEG
What is the 1 drug that CAN NOT be used to treat focal seizures? ETHOSUXIMIDE
Why do you give your obese patient Topamax for her focal seizures? Topamax side effect-weight loss
The elementary school teacher noticed that your 6 year old is "daydreaming" A LOT. What type of seizure is occurring? Typical Absence Seizure
What is Lennox-Gastaut Syndrome? severe form of epilepsy. Seizures begin before 4 years of age.children experience some degree of impaired intellectual functioning along with developmental delays, and behavioral disturbances.Causes:brain malformations, perinatal asphyxia,head injury
What technique can you do in the clinic to diagnose and absence seizure? in typical absence seizure, the physical and neurological findings are normal. having the child hyperventilate for 3-5 mins. often provoke absence seizures. this procedure can easily be performed in the clinic or office and the result is diagnostic.
What is the most useful clinical feature differentiating absence from cps? the most useful clinical feature distinguishing absence seizure from cps is the abrupt ending of typical absence seizures w/o postictal phase.
What do you see on EEG for typical and atypical absence seizure? in typical absence seizures, the EEG is usually regular and symmetrical, about 2-4Hz spike and slow wave complexes. In atypical absence seizure the EEG is more heterogenous and may include irregular spike and slow wave complexes, fast activity etc.
The only diagnostic test for absence seizures is ? EEG
The only two first line AEDs approved for treating absence seizures are___and ____ ethosuximide and valproic acid
Created by: pastudygroup