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Exam 1
Seizure Patient
30
Veterinary Medicine
Professional
02/06/2017

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Cards

Term
What are the components of seizure activity?
Definition
-Aura: pre-seizure changes
-Ictus: primary seizure activity
-Post-ictus: changes after sz
Term
Definition: Epilepsy
Definition
-repeating seizure (NOT an etiology)
Term
What are common components of the post-ictal period?
Definition
-confusion
-disorientation
-restless
-aggressive
-blinness
-salivation
-PD followed by vomiting
-wandering
0obtunded
pacing
Term
What are the two major classifications of seizures?
Definition
-partial
-generalized
Term
how long does a grand mal seizure usually last?
Definition
-2 mins or less
Term
What is the typical history of a seizure patient?
Definition
-description of sz
-age
-duration of sz
-interictal activity
-hx of febrile illness
-frequency of sz
-current drugs
-related to eating
Term
What does syncope look like?
Definition
-look perfectly normal, suddenly fall completely limp w/ arrhythmia, then back to normal
Term
HOw does syncope differ from episodic weakness?
Definition
-muscle faccidity/collapse w/out loss of consciousness
Term
What are some signs we see on opatho exam that might hint at etiology behind seizure?
Definition
-optic neuritis
-chorioretinitis
-ant uveitis
Term
Why do we bother with a neuro exam for seizure cases?
Definition
-to make sure that one does not miss sibtle abnormalities that could point to a thalamic or cortical lesion as the focus for the seizure activity
Term
What is puppy epilepsy?
Definition
-cannot find etiology behind epilepsy in a dog less than 6m of age
Term
What is idiopathic epilepsy? AGe range?
Definition
-sz occur at rest or sleeping
-starts w/ one sz episode
-NORMAL NEURO EXAM
Term
What are some common metabolic causes of sz in dogs from 6m to 5y?
Definition
-hypocalcemia
-hypothyroidism
-hyperlipidemia
Term
Which etiologies become more likely to be causing seizures if the dog is >5y?
Definition
-brain neoplasia
-insulinoma
-ASSUMING THAT THIS IS THE TRUE AGE OF ONSET
Term
True or FAlse: There is a similar timing of treatment for every seizure patient.
Definition
-FALSE, seizure tx is individualized for each patient!!!
Term
Which breeds are especially responsive to sz tx?
Definition
-small breeds
Term
Which breeds are especially known for epilepsy?
Definition
-Shelties
-Border Collies
Term
What are the general guidelines for initiation of seizure therapy?
Definition
-more than one seizure every 4-6w
-more than 1 sz in same day
-animal initially rpesents in status epilepticus
-cluster sz are the trend
-larger breeds treated earlier than smaller breeds
Term
WHat are the major drugs used for canine sz patients?
Definition
-phenobarbital
-K bromide
Term
What are the major drugs used for feline sz patients?
Definition
-diazepam
-lorazepam
-phenobarbital
Term
What are the pros of Phenobarb? Cons?
Definition
-Pros: inexpensive, short half life, easy to alter, pill/elixer, available
-COns: hepatotoxicity, enzyem induction
Term
What are the pros of K Bromide? Cons?
Definition
-Pros: not expensive, capsule/liquid, few interactions, available, NO HEPATOTOXICITY
-Cons: long half life, difficult to alter, bitter taste, vomiting
Term
How is phenobarb metabolized? halflife? steady state?
Definition
-liver & induces microsomal enzyme actibity
-half life 50-60hr
-steady state 11-14d
Term
How is bromide metabolized? half life? steady state?
Definition
-excreted by kidney & absorbed quickly bi GI tract
-half life 24d
-steady state 8-12 WEEKS
-high salt diet will lower blood levels
Term
What are the major side effects of phenobarb?
Definition
-PU/PD
-polyphagia
-sedation
-mild ataxia
-liver enzyme elevations
Term
What are the major side effects of Bromide?
Definition
-PU/PD
-polyphagia
-vomiting
-unique hindlimb ataxia
-behavioral changes
Term
When is drug monitoring necessary in sz patients?
Definition
-when steady state is reached
-every 6m during maintenance
-after sz activity
-after change in dosage
-when there are signs of toxicity
-after a loading dose regime
Term
How does estrus relate to sz acitivity?
Definition
-dec sz trheshold
Term
Is idiopathic epilepsy more common in cats or dogs?
Definition
-dogs
Term
Compare & contrast idiopathic and symptomatic/organic sz in cats.
Definition
-Idiopathic: one sz at time, 6-36m, sz during rest/sleep
-Symptomatic/organic: multiple sz, 2y or older, sz while awake
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