Term
|
Definition
*NO loss of consciousness*
Motor, sensory, autonomic, cognitive features
No impairment of awareness
Less than 1 minute |
|
|
Term
|
Definition
*NO loss of consciousness*
Impaired awareness and blank stare
May begin with an aura
1-2 minutes |
|
|
Term
| Absence "petit mal" Seizures |
|
Definition
- Primarily generalized
- last 10-15 seconds
- recur daily, sometimes>100/day
- no warning signs
- childhood onset |
|
|
Term
| Partial seizures (both complex and simple) have this in common |
|
Definition
NO affect on consciousness
Difference between the two:
Simple has no aura, Complex may. Complex has impaired awareness and blank stare |
|
|
Term
| Tonic-Clonic Seizures "Grand mal" |
|
Definition
- Impaired consciousness
- 1-2 minutes
- confusion
- headache
- Partial seizures can progress to these |
|
|
Term
|
Definition
- loss of consciousness & muscle tone
- no other motor features
- Return to awareness within seconds
- occur in significant intellectual disability
- usually child onset |
|
|
Term
|
Definition
Myoclonic seizures
- Very brief "shock-like" jerks |
|
|
Term
| Non-Pharm choices vs. Seizures |
|
Definition
Avoid Sleep deprivation
Minimize alcohol
Avoid cocaine or amphetamines
Maybe Yoga or meditation |
|
|
Term
| First choice therapies for Tonic-Clonic Seizures |
|
Definition
CVLP!
Carbamazepine
Lamotrigine
Phenytoin
Valproic AcidDivalproex |
|
|
Term
| Managing AED's dosing in patients who are unresponsive to therapy. General principles in AED management |
|
Definition
1) Start with an AED, and titrate up the dose until seizure control is adequate
2) If Max dose is reached and inadequate control is established initiate a new AED at a low dose and titrate up, as you titrate down the dose of the previous AED
3) Use of multiple drugs is reserved for failure of 2-3 AEDs monotherapy |
|
|
Term
|
Definition
|
|
Term
| Myoclonic Seizure or Atonic Seizure therapy |
|
Definition
|
|
Term
| Any Partial Seizure (with or without progression to generalized) |
|
Definition
CLLP
Phenytoin
Lamotrigine
Levetiracetam
Carbamazepine |
|
|
Term
| What factors increase risk for recurrence following the first seizure? |
|
Definition
1) Unclear, remote cause
2) Focally originating seizure
3) Abnormal neurological exam
4) Abnormal EEG |
|
|
Term
What AEDs can reduce the effectiveness of oral contraceptions?
Recommendations concerning contraception when taking AEDs? |
|
Definition
CPPPOT
Carbamazepine, Phenytoin, Primidone, and Phenobarbital, Oxcarbazepine, topiramate
Recommend other contraceptives such as IUD, progestin depots, injection formulations. Also recommend combining with barrier methods |
|
|
Term
| AED's during pregnancy - important points |
|
Definition
1) monitor AED levels as in pregnancy they might drop due to increased clearance
2) Do NOT switch AED therapy during pregnancy as congenital malformations are highest in the first trimester. Switching will only subject the fetus to multiple AEDs
3) Always take folic acid to reduce risk of congenital malformations |
|
|
Term
Define Convulsive Status Epilipticus
How long does a tonic clonic seizure usually last? At what point should it be treated aggressively as it is likely to progress to SE? |
|
Definition
SE - Seizure involving loss of consciousness lasting longer than 30 minutes
A tonic-clonic seizure usually lasts 1-2 minutes. A tonic-clonic seizure lasting longer than 5 minutes will likely progress to SE. |
|
|
Term
| General Safety measure for Seizure/Epilepsy patients |
|
Definition
- Discourage smoking to avoid burns
- Place pots/pans on back burners to avoid burns
- Shower, not bathe to avoid drowning
- Assess driving status |
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