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Neuroscience Test 1 - Epilepsy


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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?
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?
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?
Do you have cortical function during a generalized seizure?
No cortical function
What type of onset do you have with a generalized seizure?
Do you have conscious behavior with a generalized seizure?
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?
What percentage of seizure patients that Dr. P sees do not have epilepsy?
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?
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?
Can one develop drug resistance?
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?
Does estrogen promote or supress seizures?
What age group are generalized seizures more common in?
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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