Epilepsy |
Epilepsy and NeuroDevelopment- Neuro Disorders, Neuro Development and Health |
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| What is the difference between a seizure and epilepsy? - A seizure is a single event while epilepsy is chronic unavoidable seizures. |
| What is required to diagnose epilepsy or seizure? - EEG |
| How do you classify seizures? Based on what? - Origin on the seizure |
| What are the three different types of seizures and how are they different? - 1. Symptomatic -known lesion, tumor or bleed causing problem 2. Cryptogenic -Known area of activity but the specific cause and specific location not known 3. Idiopathic -unknown location due to genetic disorder or ion channel problem |
| What is the most important characteristic for physicians dealing with seizures to define? - Whether the seizure is focal or generalized. |
| What type of seizure is more easily treated? - Focal |
| Define a focal seizure. - Localized to a small area or only one hemisphere - Limited behavioral changes |
| Define a general seizure. - Bilateral, symmetric behavioral responses |
| Can an individual sense when a focal seizure is going to spread into a generalized seizure and warn you? - Yes |
| Do you have cortical function during a generalized seizure? - No cortical function |
| What type of onset do you have with a generalized seizure? - Sudden |
| Do you have conscious behavior with a generalized seizure? - No |
| What are six types of generalized seizures? - 1. Grand mal (tonic/clonic) 2. Absence 3. Febrile seizures 4. Myoclonic 5. Atonic 6. Tonic |
| Does a febrile seizure predispose you to epileptic seizures later in life? - No only atypical febrile seizures do. |
| What type of onset is seen with partial seizures? - A slower entry into the seizure. |
| What are the characteristics of a simple partial seizure? - Slow onset with some unusual motor movements. Remain conscious throughout the seizure. One can also respond to commands throughout the seizure. |
| What are the characteristics of a complex partial seizure? - the patient is conscious but unresponsive to commands. One also has some asymmetric senseless motor sx. |
| Which seizure is described as being "motor bizarre behaviors and beliefs, brief and nocturnal"? - Frontal lobe seizure |
| Which seizure is described as "fear, loss of consciousness, deja vu, amnesia and automatisms"? - Temporal lobe seizure |
| Which seizure is described as "somatosensory derrangements, diziness"? - Parietal lobe seizure |
| Which seizure is described as "visual changes"? - Occiptal lobe seizure |
| What can one use to determine where a seizure originates and then spreads to? - Ictal semiology |
| What property of the affected tissue allows one to determine if a seizure happened there? - the tissue is metabolically inactive. |
| What indicates a tendency or a history of seizures? - Interictal spikes |
| A seizure may be a warning for what? - Some other major underlying disorder. |
| In the ER, what two types of tests should be done on someone suspected of having a seizure? - MRI and EEG |
| What percentage of seizure patients that Dr. P sees do not have epilepsy? - 30% |
| Why would you want to be absolutely sure one has epilepsy before you subscribe epileptic drugs? - They are neurotoxic |
| Seizures are relatively common up until what age? - 5 |
| Why are seizures common in the elderly age group? - Falls, tumors, ect |
| Why are seizures common in ages up until 5? - Metabolic disorders and trauma |
| What determines treatment options? - Type of seizure |
| What is the ultimate goal of seizure treatment? - No seizures with no side-effects |
| How many drugs are used to begin with when treating seizures? - 1 |
| Can one develop drug resistance? - Yes |
| Of the four major seizure drugs, which has the best quantitative effect? - They all are the same -47% |
| What happens to effectiveness as you piggyback meds? - They only add a little bit more of a positive effect. |
| Name six alternative options when drug therapy is not working. - 1. Exp drug therapy 2. Ketogenic diet 3. Resective surgery 4. Vagal nerve stimulator 5. Implantable cortical stimulator 6. Disconnection procedure |
| How long (technically) until you consider a seizure status epilepticus? - 30 minutes |
| How long in a medical setting (not technically) before you consider a seizure status epilepticus? - 5 minutes |
| What is the first thing you treat SE with? - IV benzodiazepines or rectal valium |
| If unresponsive to the first SE reponse, what do you treat with? - IV anticonvulsants |
| If you cannot resolve SE by drugs (first two responses), what is the next step? - Induce comas for 24 hour intervals until the seizure subsides. |
| If one has an epileptic seizure, how long until they are allowed to drive again (AL)? - 6 months |
| What are the effects of seizure drugs on pregnancy? - Reduced fertility and they are teratogenic; also complicate pregnancy |
| Does progesterone promote or supress seizures? - Supress |
| Does estrogen promote or supress seizures? - Promote |
| What age group are generalized seizures more common in? - Children |
| What is the most common seizure type? - Partial seizure |
| Name five characteristics of absence seizures. - 1. Abrupt onset 2. Generalized 3Hz wave spike 3. Frontal lobe 4. Brief duration 5. Rapid return to baseline |
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