Term
| What is a recurrent (more than one) unprovoked seizure resulting from an underlying neurologic condition (electrical variations in the brain) |
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Definition
| epilepsy (unprovoked-Na levels are normal, no wounds, etc) |
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Term
Determine if this is a positive or negative epileptic symptom:
depression of consciousness, or temporary paralysis or blindness
convulsive movement of body and limbs or the perception of flashing lights |
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Definition
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Term
How many americans have chronic seizure?
What does this prevalence increase with? |
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Definition
~3 million (1-2 % of population)
age |
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Term
| What is an abnormal excessive synchronized neuronal electrical discharges that escape normal inhibitory mechanisms (electrical storm) |
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Definition
| seizure (individual event) |
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Term
True or False:
A seizure may or may not have clinical manifestations depending on the part of the brain involved |
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Definition
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Term
| What is a seizure that is only seen on the electroencephalogram (EEG) only and no clinical manifestations called? |
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Definition
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Term
| What type of seizure begins in thalamus, spreads through thalamocortical relays diffusely to both hemispheres. Abnormal electrical activity recorded diffusely in both hemispheres from onset of seizure |
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Definition
| Generalized onset seizures (see it on the whole brain all at once) |
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Term
What type of seizure begins in one part of the brain and may stay localized to that cortex or may spread to surrounding cortex?
What clinical manifestation would you expect to see in this type of seizure? |
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Definition
Partial onset seizure
Clinically silent area-only see it on EEG |
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Term
What type of seizure begins in one part of the brain but spreads to involve most of both hemispheres (“whole brain”)?
What clinical manifestation would you expect to see in this type of seizure? |
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Definition
Complex partial with secondary generalization
Typically manifests with generalized tonic-clonic activity (whole body convulsion) |
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Term
| Are Partial or Generalized onset seizures more common? |
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Definition
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Term
| What is a clinical description of seizure? |
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Definition
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Term
| What is a positive or negative affecting motor, sensory, psychic, or autonomic systems depending on what part of the brain is involved? |
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Definition
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Term
What is pertaining to seizure?
in between seizures?
time following a seizure? |
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Definition
Ictal – pertaining to seizure
Interictal – in between seizures
Postictal – time following a seizure |
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Term
| If looking at a graph comparing incidences of convulsive disorders compared to age, what age group(s) would you expect to see a lot of incidents? |
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Definition
| very young ages (premature birth, hemorrhage of the brain, CNS infections, genetic causes) and older population |
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Term
| What are the 2 main types of seizure classification? |
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Definition
Generalized onset
Partial (or localization-related) onset |
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Term
| What type of seizure is characterized by a phase of whole-body stiffening or tonic posturing and then a series of relaxations and then tonic posturing again (grand mal, convulsion)? |
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Definition
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Term
What type of seizure are also known as staring seizures/petit mal, they are very brief, and common in childhood age?
Is this generalized or partial? |
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Definition
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Term
What seizure type is characterized by a lot of tonic stiffening?
Is this generalized or partial? |
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Definition
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Term
What seizure type is characterized by a loss of tone, kind of crumbling to the ground, drop seizures.
Is this generalized or partial? |
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Definition
atonic seizure
generalized |
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Term
What type of seizure is due to to rapid change in the temperature. Very high fever that you reach very rapidly in little children.
Is this generalized or partial onset? |
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Definition
febrile seizure
generalized |
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Term
| What type of partial (or localization-related) onset seizure has no altered awareness (ex: deja vu) |
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Definition
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Term
| What type of partial onset seizure has altered awareness (ranges from totally unconscious to missing something that was said)? |
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Definition
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Term
What type of seizure is characterized by "jerks" of the hand and foot?
Is this generalized or partial onset? |
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Definition
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Term
| What are simple localization-related seizures (partial onset) involving the limbic system that may cause unusual sensations such as a sense of fear, a rising sensation in the abdomen, or a specific odor (patient may call his/her "warning"? |
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Definition
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Term
True or false:
In a generalized seizure, motor activity is asymmetric and more common in children. |
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Definition
False to 1st statement, true to 2nd
Motor activity is symmetric |
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Term
| If an EEG had abrupt onset, *generalized 3 Hz Spike and Wave discharge, frontal predominance, brief duration, and a rapid return to baseline, what type of seizure would you expect this to be? |
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Definition
| Absence (generalized) seizure |
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Term
| What is called when there are automatic behaviors most commonly associated with complex partial seizures (Blinking, chewing, lip smacking, hands picking at clothes/sheets, stirring, rocking, humming)? |
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Definition
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Term
What part of the brain are these types of symptoms associated with?
Motor, bizarre, Often brief and nocturnal
Fear, LOC, Amnesia, Automatisms
Somatosensory, dizziness
Visual, often propagate with false localization |
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Definition
Frontal – Motor, bizarre, Often brief and nocturnal
Temporal – Fear, LOC, Amnesia, Automatisms
Parietal – Somatosensory, dizziness
Occipital – Visual, often propagate with false localization |
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Term
What is a continuous clinical/electrographic seizure OR recurrent seizures without full recovery lasting 5 minutes or more?
How long do most seizures last? |
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Definition
status epilepticus
<2-3 minutes |
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Term
| Seizures ongoing for > ___ minutes is more unlikely to resolve spontaneously. |
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Definition
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Term
| What happens if you have a generalized tonic-clonic status epilepticus that is occurring for more than an hour? |
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Definition
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Term
What would you NOT want to do in an emergency department to a patient experience a first time seizure?
History and physical, good neurological exam
Electrolytes, glucose, Ca2+, Mg2+, CBC, O2 sat or arterial blood gas
Toxicology screen
EEG
Neuroimaging (usually CT) |
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Definition
| EEG (would do as outpatient and also do MRI to get a better picture) |
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Term
| Sudden Unexplained Death in Epilepsy Patients (SUDEP) are more common in what types of patients? |
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Definition
Generalized tonic-clonic convulsions (primary or secondarily generalized)
Uncontrolled seizures
Nonadherence with anti epileptic medications
Having seizures since you were a child |
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Term
| How do we try to diagnose people with psychogenic non-epileptic spells (non epileptic seizures, pseudo seizures) |
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Definition
Video-EEG Epilepsy Monitoring
lower seizure meds, sleep deprive them, flashlights at them, and hyperventilate them to try to induce the speclss |
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Term
| What type of seizure is of psychogenic etiology, more common in females, and the EEG is normal? |
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Definition
| Non-epileptic seizures (NES) |
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Term
| What is the key difference clinically between an epileptic seizure and non-epileptic? |
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Definition
variable movements in non-epileptic
(in epilepsy the same movements every time) |
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Term
| What type of seizure has no risk of brain damage, typically no injuries, and there is an increased prevalence of sexual & physical abuse |
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Definition
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Term
| After failure of 2 anti epileptic drugs, what should be the next approach to treatment? |
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Definition
| consider the possibility of Epilepsy Surgery (1st drug= seizure free ~50%, 2nd ~13%) |
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Term
| Are generalized or partial seizure easier to control? |
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Definition
| generalized (partial is most common and hardest to control) |
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Term
| What is used to map out the brain so you can record where the seizure is occurring? |
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Definition
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Term
| What lobe of the brain is the most effective epilepsy surgery and is the most common lobe where seizures come from? |
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Definition
| temporal lobe (77% 1 year remission) |
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Term
True or false:
Focal onset or partial onset seizures are the most common, most refractory to the antiepileptic drugs and the most amenable to the epileptic surgery? |
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Definition
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Term
True or false:
Likelihood of seizure freedom after failing first 2 medications dramatically decreases |
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Definition
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Term
| Do you treat non-epileptic seizures with anti epileptic drugs? |
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Definition
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