Gaznabi: Seizure Disorders
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| 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.
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| Define epilepsy. | A chronic brain d/o characterized by recurrent >2 unprovoked seizures. Mostly idiopathic but may be due to stroke,tumors.
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| Nonepileptic seizure | Provoked by a temporary d/o or any factors (metabolic, cardiovascular, CNS infection)
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| Symptomatic seizure | Are mostly symptomatic as in neonatal seizure/in elderly
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| Psychogenic seizure | Pts with psychiatric d/o simulate seizure with no abnormal electrical activity. Unresponsiveness is very common.
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| Your explanation of an 85 yr old patient's seizure is due to___ or ____ | stroke, tumor
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| Etiology of an adult seizure | Trauma, tumor, alcohol withdrawal
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| "I'm sorry but your <24 month old is having this seizure because......." | developmental defects, metabolic d/o, birth injuries
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| 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.
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| 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.
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| Complex partial seizure can arise from any location in the brain but most commonly (60%) arise in the________ lobe | temporal
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| Left temporal lobe seizures can cause...? | visual spatial memory abnormalities
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| 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
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| 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
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| What radiological test is diagnostic for focal seizures? | EEG
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| What is the 1 drug that CAN NOT be used to treat focal seizures? | ETHOSUXIMIDE
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| Why do you give your obese patient Topamax for her focal seizures? | Topamax side effect-weight loss
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| The elementary school teacher noticed that your 6 year old is "daydreaming" A LOT. What type of seizure is occurring? | Typical Absence Seizure
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| 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
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| 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.
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| 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.
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| 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.
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| The only diagnostic test for absence seizures is ? | EEG
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| The only two first line AEDs approved for treating absence seizures are___and ____ | ethosuximide and valproic acid
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