Deck 55: Epilepsy

Question 1

A seizure occurs when the cerebral cortex is hyperexcitable, caused by:

A) A decrease in excitatory neurotransmission, an increase in inhibitory neurotransmission, or a disturbance in brain circuitry
B) An increase in excitatory neurotransmission, a decrease in inhibitory neurotransmission, or a disturbance in brain circuitry
C) An increase in excitatory neurotransmission, an increase in inhibitory neurotransmission, or a disturbance in brain circuitry
D) A decrease in excitatory neurotransmission, a decrease in inhibitory neurotransmission, or a disturbance in brain circuitry

Answer 1

B

Question 2

A seizure may be provoked by:

A) Hyponatremia
B) Withdrawal from alcohol
C) Fever
D) All of the above

Answer 2

D

Question 3

Your patient's husband reports that during her 1-minute seizures, she wanders, smacks her lips, picks at her clothes, and loses awareness of her surroundings. What kind of seizure is she most likely having?

A) Focal seizure with loss of consciousness (complex partial)
B) Focal seizure without loss of consciousness (simple partial)
C) Generalized tonic-clonic
D) Absence

Answer 3

A

Question 4

A 29-year-old lawyer was recently diagnosed with focal seizures. Her provider prescribed lamotrigine and she has been tolerating it well at 150 mg BID. It has, so far, controlled her seizures; however, she is anxious that she may have another. She asks you what she can do to avoid seizures. Which is not a common seizure trigger?

A) Sleep deprivation
B) Missing medication
C) Exercising
D) Stress

Question 5

Ms. Smith tried phenytoin 300 mg daily, but stopped it because it made her dizzy and didn't stop her seizures. She was then asked to try levetiracetam, which she started at 500 mg BID; however, her insurance did not cover it; therefore it was discontinued. She is now taking zonisamide 200 mg at night (higher doses made her drowsy). As she is still having some seizures, she should be referred to an epilepsy center.

Question 6

Which are causes of epilepsy?

A) Brain tumors
B) Strokes
C) Congenital malformations
D) All of the above

Question 7

Which medication has a narrow therapeutic index:

A) Levetiracetam
B) Clobazam
C) Phenytoin
D) Lamotrigine

Question 8

A patient has a history of kidney stones. Which medication would you avoid prescribing?

A) Zonisamide
B) Lamotrigine
C) Levetiracetam
D) Clobazam

Question 9

A patient with epilepsy can have a normal EEG and normal MRI.

Question 10

A patient is on carbamazepine 600 mg BID and comes to you complaining of nausea, vomiting, headache, and fatigue. He is also having more seizures. What would you do?

A) Increase the carbamazepine dose.
B) Check carbamazepine levels.
C) Check sodium levels.
D) b and c

Question 11

Which of the following is a clinical management goal when titrating antiepileptic medications?

A) Titrate the patient to the maximum recommend dose even if they experience side effects.
B) Attempt to arrive at medication monotherapy, if possible
C) Combine two medications at low doses.
D) Achieve seizure-free status with the highest possible dosage of antiepileptic drug therapy.