Duke PA Epilepsy
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| seizures result from abnormal __ | brain electrical activity
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| seizures are a common sign of __ | brain disfunction
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| not all seizures imply __ | epilepsy
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| seizures can result from a reaction of the brain to physiologic stress such as __ | sleep deprivation, fever, and withdrawal from alcohol or sedative drugs
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| in developed countries __% of all persons have recurrent seizures at some time during their lives | 2-4
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| the incidence of seizure is highest among __ | children, older adults, men, those in the inner city and in developing nations
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| a seizure that involves the cerebral cortex diffusely from the beginning | generalized seizure
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| a seizure with onset limited to part of the cerebral hemisphere | focal seizure
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| the two types of seizure | generalized, focal (partial)
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| rhythmic jerking movements | clonic
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| stiffening | tonic
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| simple partial seizures with motor signs begin with __ movements of a discrete body part | tonic or clonic
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| because of their large cortical representation, muscles of the __ are often involved in simple partial seizures | face and hand
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| __ may be followed by a transient neurologic abnormality reflecting postictal depression of the epileptogenic cortical area | simple partial seizures
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| the reversible neurologic deficits following a simple partial seizure are referred to as __ and rarely last for more than 48 hours | Todd's paralysis
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| __ impair consciousness and produce unresponsiveness | complex partial seizures
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| 70-80% of complex partial seizures arise from the __ | temporal lobe
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| many times simple focal seizures will progress to __ | complex partial seizures
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| complex partial seizures preceded by an olfactory aura are referred to as __ | uncinate fits
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| __ involve both cerebral hemispheres simultaneously from the outset | generalized seizures
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| __ are characterized by abrupt loss of consciouseness with bilateral tonic extension of the trunk and limbs, often accompanied by a loud vocalization, followed by bilaterally synchronous muscle jerking | generalized tonic-clonic seizures (grand mal convulsions)
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| following a generalized tonic-clonic seizure, a __ phase is marked by transient deep stupor, followed in 15-30 minutes by a lethargic, confused state with automatic behavior | postictal
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| __ occur mainly in children and are characterized by sudden, momentary lapses in awareness, staring, rhythmic blinking, and , often, a few small clonic jerks of the arms or hands | absence seizure (petit mal seizure)
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| most abscence seizures last less than __ seconds | 10
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| most generalized tonic-clonic seizures last less than __ seconds | 90
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| __ exhibit as rapid, recurrent, brief muscle jerks that can occur bilaterally, synchronously or asynchronously, or unilaterally without loss of consciousness | myoclonic seizures
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| myoclonic seizures tend to cluster shortly after __ | walking or while falling asleep
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| __ occur most often in children with diffuse encephalopathies and a re characterized by sudden loss of muscle tone that may result in falls with self injury. | atonic seizures (drop attacks)
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| __ are attacks precipitated by a specific stimulus such as touch, a musical tone, a particular movement, reading, stroboscopic light patterns, or complex visual images | reflex seizures
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| __ is the most common cause of convulsion in children | fever
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| most febrile seizures occur between the ages of 6 months and __ years | 4
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| most childre affected with __ have no long-term consequences, although they are more at risk of developing epilepsy later in life | febrile seizures
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| __ is the most common epileptic syndrome of adults | temporal lobe epilepsy
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| virtually all patients with __ have complex partial seizures, some of which secondarily generalize | temporal lobe epilepsy
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| post traumatic epilepsy usually occurs within __ years of injury, although new-onset seizures may occur later | 1-2
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| __ do not increase the risk of seizure | mild head injuries (no loss of consciousness, no skull fracture, absence of focal neurological signs, and not contusion ro hematoma)
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| __ is the most important diagnostic test for epilepsy | EEG
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| __ rarely offer diagnostic assistance in otherwise healthy patients with epilepsy | routine blood tests
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| __ should be ontained in all patients over the age of 18 who are suspected of having epilepsy | MRI
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| __ refers to the symptom complex that results when a transient, global reduction in cerebral perfusion occurs. Often mislabled as seizure. | syncope
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| the location of the original group of synchronously firing neurons | focus
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| definition of seizure | paroxysmal, excessive, synchronous discharge of a group of neurons
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| definition of epilepsy | documented history of two or more seizures that are not temporally related to an obvious metabolic or febrile cause
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| electrical discharge begins in a small region | partial seizure
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| focal seizure with no alteration of consciousness | simple partial seizure
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| focal seizure with altered consciousness | complex partial seizure
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| electrical discharge simultaneously at all EEG electrodes on the scalp | generalized seizure
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| partial seizures represent __ | focal brain disease
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| parial seizures may __ and are often confused with generalized seizures | secondarily generalize
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| Brief (5-10 seconds), recurrent episodes of staring sometimes associated with minor motor automatisms. Patients have no memory of the spells, but are normal immediately at completion | absence (petit mal)
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| EEG pattern for absence seizures, 3 second spike and wave, can be be induced by __ | hyperventilation
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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 __ is not epileptic in nature | myoclonus
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| almost exclusively in childhood. Begin with impaired consciousness, followed by asymmetric bilateral jerking. | clonic seizures
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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
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| the most common seizure type | complex partial seizures
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| people with __ bite the tips of their tongues | pseudoseizures (psychogenic seizures)
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| common causes of provoked seizures | sleep deprivation, excessive use of stimulants, withdrawal from sedatives or alcohol, substance abuse, high fever (childhood), hypoxia, hypoglycemia, electrolyte disturbance
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| first test to do just after a patient has a seizure | blood glucose
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| conditions that can be mistaken for a seizure | syncope, non-epileptic spells of psychogenic origin (pseudoseizures), breath holding spells, REM sleep behavior, panic attack
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| prolonged or recurrent seizures without regaining consciousness | status epilepticus
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| continuous simple seizures are also known as __ | epilepsia partialis continua
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| predictors of future epilepsy in the scenario of febrile seizures | multiple seizures during one illness, focal seizures, abnormal neurologic exam or delayed development
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| best treatment for febrile seizures is __ | prevention with antipyretics
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| alcohol withdrawal seizures usually occur __ hours after the last intake of alcohol | 6-48
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| long term treatment of alcohol withdrawal seizures | cessation of alcohol intake
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| who to treat after a single seizure | patients with a structural lesion, or recognized abnormal EEG pattern
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| who not to treat (probably) after a single seizure | Patients without structural or EEG abnormality; Alcohol withdrawal, Drug abuse; Provoked seizure; Single seizure after head injury without structural abnormality
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| risk of recurrence after a single unprovoked seizure is about __% in 5 years | 30
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