Convulsiones

The primary goal of epilepsy treatment is to: ERR Avoid all diagnostic procedures. ERR Achieve seizure freedom with minimal adverse effects. ERR Induce sedation. ERR Eliminate need for monitoring.

Which of the following is an example of a toxic cause of reactive seizures?. ERR Mild dehydration. ERR Chronic arthritis. ERR Organophosphate intoxication. ERR Hyperkeratosis.

Standardized outcome classifications (e.g., seizure freedom, partial success) are important because they: ERR Confirm etiology without diagnostics. ERR Eliminate need for seizure diaries. ERR Replace clinical monitoring. ERR Allow consistent comparison of therapeutic interventions.

According to outcome consensus recommendations, seizure severity assessment should consider: ERR Only seizure frequency. ERR Only MRI findings. ERR Only serum drug concentration. ERR Duration, intensity, postictal abnormalities, and quality of life impact.

Prolonged tonic-clonic seizure activity may lead to hyperthermia, which can result in: ERR Reduced metabolic demand. ERR Improved neurological status. ERR Permanent seizure cure. ERR Multi-organ dysfunction.

According to the IVETF recommendations, MRI and CSF analysis should be performed in dogs with seizures when: ERR Only when focal seizures are observed. ERR Age at onset <6 months or >6 years, interictal neurological deficits, status epilepticus/cluster seizures, or drug resistance. ERR Only when seizures occur during sleep. ERR All dogs after their first single seizure.

According to IVETF guidelines, MRI is primarily used to: ERR Measure serum phenobarbital levels. ERR Confirm reactive seizures. ERR Identify or exclude structural intracranial lesions. ERR Replace neurological examination.

According to the IVETF classification, idiopathic epilepsy is defined as: ERR Epilepsy occurring only in geriatric dogs. ERR Epilepsy caused by metabolic disturbances. ERR Epilepsy secondary to confirmed intracranial tumor. ERR A disease entity often presumed genetic with no identifiable structural cause.

The main therapeutic goal in canine epilepsy management is to: ERR Avoid all diagnostic procedures. ERR Achieve seizure freedom while minimizing adverse effects. ERR Stop treatment after first improvement. ERR Induce permanent sedation.

In the review article on management of refractory epilepsy, refractory epilepsy in veterinary medicine generally refers to: ERR Seizures that stop without treatment within 24 hours. ERR Only seizures caused by transient metabolic disturbances. ERR Frequent/severe seizures or intolerable side effects despite appropriate antiepileptic drug therapy. ERR Any dog that has ever had a single seizure.

In focal epileptic seizures, consciousness may be: Always completely lost. Impossible to assess. Preserved or impaired depending on brain regions involved. Always fully normal.

Which of the following is an example of a structural cause of epilepsy?. Transient toxin exposure. Intracranial neoplasia. Electrolyte imbalance. Hypoglycaemia.

Focal motor seizures may present with: Localized motor activity such as facial twitching. Only gastrointestinal signs. No motor involvement. Always bilateral tonic-clonic activity.

According to consensus recommendations, long-term antiepileptic therapy should be considered when: Only postictal signs are observed once. The dog is younger than 3 months without diagnostics. A single brief seizure occurs with no recurrence. Seizure frequency increases or cluster seizures/status epilepticus occur.

Cluster seizures are best defined as: Two or more seizures within 24 hours with recovery between seizures. Three seizures in one month. One seizure lasting more than 5 minutes. Continuous seizure activity without recovery.

According to the ACVIM consensus, serum antiepileptic drug monitoring is primarily used to: Replace seizure diary documentation. Ensure therapeutic concentrations and guide dose adjustments. Diagnose structural epilepsy. Determine seizure type.

In the ACVIM Small Animal Consensus Statement on Seizure Management in Dogs, which monitoring schedule is recommended for phenobarbital drug levels?. Every 24 hours during the first week of therapy. Only once yearly regardless of clinical status. At 2 and 6 weeks, every 6 months, or 2 weeks after a dose change. Only if pancreatitis is suspected.

According to the emergency management article, which drug class is typically used as first-line therapy for acute seizure control?. Imepitoin. Benzodiazepines such as diazepam or midazolam. Potassium bromide. Topiramate.

According to the ACVIM consensus, status epilepticus is defined as: Only focal motor seizures. Any seizure lasting more than 30 seconds. A seizure lasting ≥5 minutes or recurrent seizures without full recovery between them. Three seizures in one month.

A seizure diary primarily assists clinicians by: Providing objective seizure frequency and pattern data. Determining drug dose automatically. Replacing clinical exams. Confirming structural lesions.

According to IVETF terminology, the interictal period refers to: The prodromal phase immediately before a seizure. The time between two epileptic seizures. The time during status epilepticus. The period during active seizure activity.

According to the refractory epilepsy review, refractory epilepsy occurs in approximately what proportion of dogs with epilepsy?. Less than 1%. Approximately one-third (up to about 30%). More than 95%. About 75%.

According to the IVETF European consensus, imepitoin is indicated primarily for: Dogs with syncope. Dogs with idiopathic epilepsy experiencing generalized seizures. Dogs with structural brain tumors only. Cats with reactive seizures.

Which test is included in the minimum database (MDB) for Tier I diagnosis of idiopathic epilepsy?. MRI of the brain. Complete blood count (CBC). Genetic testing in all cases. Muscle biopsy.

Typical generalized seizures usually last: More than 30 minutes. Less than 5 minutes. Exactly 15 minutes. Several hours.

Brain MRI in epileptic dogs is primarily performed to: Determine serum drug levels. Detect or exclude structural intracranial abnormalities. Measure seizure frequency. Replace neurological examination.

Which finding increases suspicion of structural epilepsy?. Normal neurological exam. Seizures between 6 months and 6 years only. Persistent interictal neurological abnormalities. Normal minimum database.

According to the notes, generalized epileptic seizures typically last: Less than 5 minutes. Exactly 15 minutes. Several hours without interruption. More than 30 minutes in most cases.

Reactive seizures occur because: Transient systemic disturbances affect a normal brain. Unknown intracranial tumors. Permanent structural brain lesions. Inherited channelopathies only.

How are cluster seizures defined in the Vet Clin N Am reference?. A single prolonged seizure lasting more than 5 minutes. More than one seizure in 24 hours with recovery of consciousness between events. Continuous seizure activity without recovery. Two seizures occurring more than 24 hours apart.

Drug-resistant epilepsy is diagnosed after failure of how many adequate AED trials?. Three emergency treatments. Two adequate and tolerated AED trials. One AED trial. Five different drugs.

Idiopathic epilepsy is primarily a: Metabolic disease. Diagnosis based solely on MRI. Diagnosis of exclusion. Toxic disorder.

Why is strict compliance with antiepileptic drug administration essential?. Because seizures are unrelated to drug levels. Because inconsistent dosing can lead to loss of seizure control. Because AEDs work even if given irregularly. Because compliance does not affect outcome.

According to the IVETF consensus, phenobarbital is known to: Completely inhibit hepatic metabolism. Have no interaction with other drugs. Be eliminated unchanged exclusively in feces. Induce hepatic microsomal enzymes.

According to the Clinician’s Brief article, which are the three seizure phases described in dogs?. Preictal, ictal, and postictal phases. Aura, coma, and relapse phases. Prodromal, chronic, and recovery phases. Acute, subacute, and chronic phases.

According to the IVETF (Europe) consensus proposal, when should the serum phenobarbital concentration be measured after starting therapy (baseline for future adjustments)?. 14 days after starting therapy (or after a dose change). 24 hours after the first dose. Only if seizures worsen. Only after 6 months of treatment.

EEG contributes most strongly to which diagnostic tier?. Tier III confidence. Metabolic seizure confirmation. Tier I only. Reactive seizure diagnosis.

Monitoring serum antiepileptic drug concentrations helps to: Diagnose seizure type. Replace neurological examination. Assess therapeutic range and compliance. Identify structural lesions.

According to consensus information, prognosis in canine epilepsy depends on: Season of onset. Breed size exclusively. Coat color only. Seizure frequency, treatment response, cluster/status presence, and etiology.

Cluster seizures require urgent management because they: Confirm reactive etiology. Guarantee remission. Increase risk of progression to status epilepticus. Always resolve without intervention.

Reactive seizures are expected to resolve when: MRI confirms normal brain. The dog reaches 6 years of age. Phenobarbital is given lifelong. The underlying cause is corrected.

According to the provided notes, generalized epileptic seizures typically: Occur at rest or during sleep, last less than 5 minutes, and are followed by postictal abnormalities. Occur only during physical exercise. Never show postictal behavioural changes. Always last more than 10 minutes.

Decision to modify AED therapy should be based on: Breed size only. Seasonal variation. Seizure control, adverse effects, and monitoring results. Owner preference alone.

According to IVETF Tier I criteria, the interictal neurological examination in idiopathic epilepsy should be: Showing cranial nerve deficits. Unremarkable (normal). Consistently abnormal. Showing persistent ataxia.

According to IVETF guidelines, the purpose of the minimum database (MDB) in seizure work-up is to: Determine seizure type directly. Replace neurological examination. Confirm structural brain tumors. Exclude metabolic and toxic causes of reactive seizures.

According to the International Veterinary Epilepsy Task Force consensus proposal (Europe), in dogs with idiopathic epilepsy, long-term antiepileptic drug (AED) treatment is recommended when which of the following criteria is present?. Only seizures occurring during sleep. Two or more epileptic seizures within a 6-month period (interictal period ≤ 6 months). Only focal seizures with no postictal abnormalities. One isolated epileptic seizure with no recurrence.

Dogs with cluster seizures are at increased risk of: Progression to status epilepticus. Reactive seizures only. Immediate cure. Permanent seizure remission.

Epilepsy is generally considered: A chronic disease requiring long-term management. A metabolic disturbance only. An acute self-limiting condition. A surgical emergency in all cases.

According to the IVETF outcome document, pseudoresistance refers to: Structural brain lesions on MRI. Lack of response due to inadequate dosing, compliance issues, or inappropriate regimen. Presence of reactive seizures. True pharmacoresistance after multiple drug failures.

According to European consensus, two or more seizures within what timeframe support initiating AED therapy?. Within six months. Within two years. Within 24 hours only. Within one week only.

Persistent interictal neurological deficits most strongly suggest: Structural brain disease. Normal variant. Guaranteed benign prognosis. Reactive seizures.

The prodromal phase may include: Immediate full recovery. Subtle behavioral changes before the seizure. Permanent neurological deficits. Continuous tonic-clonic movements.

According to the International Veterinary Epilepsy Task Force (IVETF), how is epilepsy defined?. A transient metabolic disturbance without brain involvement. A disease of the brain characterized by an enduring predisposition to generate epileptic seizures. Any single seizure caused by hypoglycaemia. Only seizures associated with structural brain lesions.

Autonomic signs during seizures may include: Chronic coughing. Hair loss. Polyuria unrelated to seizures. Hypersalivation and urination.

According to IVETF recommendations, seizure onset at which ages raises suspicion for structural epilepsy?. Exactly at 3 years only. Only between 8 and 10 years. Before 6 months or after 6 years of age. Between 6 months and 6 years.

In status epilepticus, phenobarbital is commonly used because: It has no effect on seizure propagation. It allows rapid loading to reach therapeutic blood levels. It acts only as a short-acting sedative. It replaces the need for airway management.

According to the refractory epilepsy review, most dogs with epilepsy are successfully treated with which conventional antiepileptic drugs?. Phenobarbital and potassium bromide. Vagal nerve stimulation and ketogenic diet. Topiramate and rufinamide. Gabapentin and pregabalin.

According to the IVETF (Europe) consensus proposal, why can serum chloride appear falsely elevated on biochemistry profiles in dogs treated with potassium bromide?. Because bromide causes true life-threatening hyperchloraemia in all dogs. Because bromide interferes only with serum sodium measurement, not chloride. Because chloride decreases as bromide increases, leading to pseudohypochloraemia. Because laboratory assays cannot distinguish between chloride and bromide ions (pseudohyperchloraemia).

According to IVETF recommendations, which interictal finding increases suspicion for structural epilepsy?. Normal neurological examination. Seizures occurring only during sleep. Persistent interictal neurological deficits. Normal minimum database.

Common phenobarbital adverse effects include: Permanent blindness. Chronic cough. Hypoglycaemia. Sedation and ataxia.

Correct classification of seizure type is essential because it: Determines serum electrolyte levels. Eliminates need for diagnostics. Confirms structural etiology automatically. Guides diagnostic investigation and treatment planning.

According to the IVETF outcome proposal, an adequate AED trial requires: Avoiding serum drug measurements. Using multiple drugs simultaneously without monitoring. Stopping treatment after first recurrence. Appropriate drug selection, adequate dosing, duration, compliance, and monitoring.

Postictal behavioral changes may include: Only muscle atrophy. Immediate full alertness. Permanent coma. Disorientation or temporary blindness.

Status epilepticus is diagnosed when a seizure lasts: Exactly 2 minutes. More than 1 hour only. More than 30 seconds. 5 minutes or longer.

In dogs treated with potassium bromide, diet changes should be: Restricted to protein only. Unnecessary to consider. Gradual, with monitoring of bromide levels. Abrupt and without monitoring.

According to IVETF Tier III criteria, EEG is used to: Replace MRI in detecting tumors. Provide additional diagnostic confidence in idiopathic epilepsy. Measure serum AED concentrations. Diagnose metabolic disorders.

According to the IVETF outcome consensus, seizure freedom is defined as: A 50% reduction in seizure frequency. Absence of cluster seizures only. No seizures for exactly 30 days. No seizures for at least three times the longest pre-treatment interseizure interval and at least three months.

According to the Clinician’s Brief article, prolonged or severe seizure activity may lead to: Immediate normalization of neurological status. Exclusive damage to peripheral nerves only. Permanent resolution of epilepsy. Severe hyperthermia and potentially multiple organ failure.

According to the refractory epilepsy review, the drug transporter hypothesis proposes that drug resistance occurs due to: Failure of the kidneys to excrete antiepileptic drugs. Lack of dietary fat intake. Exclusive degeneration of peripheral nerves. Overexpression of multidrug transporters that limit antiepileptic drug entry into the brain.

Canine epilepsy is generally considered: A chronic neurological disease. A transient metabolic imbalance. A surgical emergency in all cases. An acute self-limiting disorder.

During the ictal phase of generalized seizures, autonomic signs may include: Hair loss. Chronic weight gain. Persistent coughing. Urination, defecation, hypersalivation, or pupillary dilation.

The postictal phase is characterized by: Permanent paralysis. Immediate complete recovery. No neurological changes. Disorientation, ataxia, or lethargy.

According to the IVETF classification, epilepsy can be classified by etiology into which two main categories?. Genetic epilepsy and metabolic epilepsy. Focal epilepsy and generalized epilepsy. Idiopathic epilepsy and structural epilepsy. Primary epilepsy and reactive epilepsy.

According to the ACVIM statement, which factor supports initiation of long-term AED therapy?. Normal neurological exam and long interictal interval. Single brief seizure with complete recovery. Presence of cluster seizures or status epilepticus. Owner preference to avoid medication despite frequent seizures.

According to IVETF recommendations, why is a detailed seizure description from the owner important?. To replace all diagnostic testing. To determine serum phenobarbital levels. To classify seizure type and guide diagnosis and treatment. To confirm structural epilepsy without imaging.

In the refractory epilepsy review, a “positive response” to therapy in many studies is defined as: No adverse effects regardless of seizure frequency. A ≥50% reduction in seizures. A ≥10% reduction in seizures. Complete seizure freedom in all patients.

The prognosis for reactive seizures is generally good when: MRI is normal. The underlying cause is corrected. Phenobarbital is given indefinitely. The dog ages beyond 6 years.

Tier I confidence for idiopathic epilepsy requires: Positive EEG only. Typical age range, normal exam, and normal minimum database. Abnormal MRI findings. Confirmed metabolic disorder.

Successful long-term epilepsy management requires: Dietary therapy alone. Stopping treatment after first improvement. Continuous reassessment of seizure control and adverse effects. Emergency treatment only.

During a generalized tonic-clonic seizure, consciousness is typically: Lost or markedly impaired. Enhanced. Fully preserved. Unaffected in all cases.

Therapeutic drug monitoring primarily aims to: Replace seizure diary use. Maintain concentrations within therapeutic range while minimizing adverse effects. Diagnose structural epilepsy. Eliminate need for clinical evaluation.

Serum antiepileptic drug measurement helps assess: Presence of reactive seizures. Structural brain lesions. Compliance and adequacy of dosing. Seizure classification.

Cluster seizures are clinically important because they: Indicate guaranteed remission. Confirm reactive seizures. Increase risk of progression to status epilepticus. Eliminate need for treatment.

During the ictal phase of a generalized (grand mal) seizure, the patient may: Show tonic or clonic limb movement and altered consciousness. Demonstrate exclusively dermatological signs. Be completely normal and responsive. Exhibit only chronic weight loss.

Therapeutic drug monitoring is essential because it: Confirms structural disease. Eliminates need for follow-up. Replaces clinical assessment. Ensures adequate serum concentrations and guides safe adjustment.

Detailed seizure semiology is important because it: Replaces MRI findings. Helps differentiate focal from generalized seizures. Determines serum bromide levels. Eliminates need for neurological examination.

According to consensus principles, long-term follow-up of epileptic dogs should be: Regular and ongoing with periodic reassessment. Performed only if seizures recur monthly. Only once at diagnosis. Stopped after first improvement.

According to the consensus recommendations, why is periodic liver monitoring recommended in dogs receiving phenobarbital?. Only to diagnose reactive seizures. Because liver enzymes always decrease. Due to risk of hepatotoxicity associated with phenobarbital. Because phenobarbital causes universal liver failure.

Which abnormality is commonly observed during the postictal phase?. Lethargy and ataxia. Chronic cardiac arrhythmia. Immediate full recovery with no behavioural change. Permanent spinal cord paralysis.

Status epilepticus is defined as: Postictal disorientation only. Seizure ≥5 minutes or repeated without recovery. Two seizures in one year. A seizure during sleep.

According to the refractory epilepsy review, a randomized study of a high-fat, low-carbohydrate diet in epileptic dogs: Showed seizures always worsened with the control diet. Proved all dogs became seizure-free. Demonstrated that ketosis was consistently achieved in all dogs. Failed to identify a difference in seizure frequency compared with a control diet.

Which statement about potassium bromide (KBr) pharmacokinetics in dogs is stated in the IVETF (Europe) consensus proposal?. KBr undergoes extensive hepatic metabolism, so it should be avoided in liver disease. KBr is eliminated rapidly, reaching steady state within 48 hours. KBr is highly protein-bound and cannot cross cellular membranes. KBr is not metabolised in the liver and can be a good alternative in dogs with hepatic dysfunction.

Prolonged seizure activity in status epilepticus may lead to: Neuronal injury and systemic complications. Immediate cure of epilepsy. Exclusive peripheral nerve damage. Improved neurological prognosis.

According to the IVETF (Europe) consensus proposal, serum phenobarbital concentrations above what level are associated with an increased risk of hepatotoxicity and should be avoided?. More than 15 mg/L. More than 25 mg/L. More than 5 mg/L. More than 35 mg/L.

Focal seizures may present with: Only systemic metabolic signs. Localized motor, autonomic, or behavioral signs. Permanent neurological deficits. Always bilateral tonic-clonic activity.

According to the refractory epilepsy review, vagal nerve stimulation (VNS) involves: Daily ocular drops that stimulate the vagus nerve. A single injection given only during status epilepticus. A diet designed to induce ketosis in all dogs. Surgical implantation of a device that delivers repetitive stimulation to the left cervical vagus nerve.

After a generalized seizure, dogs commonly experience: Postictal disorientation or lethargy. Permanent coma. Immediate full alertness in all cases. No behavioral changes ever.

According to IVETF outcome recommendations, standardized outcome definitions are important because they: Confirm structural etiology. Allow consistent evaluation and comparison of therapeutic interventions. Eliminate need for monitoring. Replace clinical examination.

Which of the following intoxications is listed in the notes as a possible cause of reactive seizures?. Mild dehydration. Organophosphate intoxication. Vitamin C overdose. Hyperlipidaemia.

Status epilepticus can lead to systemic complications such as: Guaranteed spontaneous remission. Only mild sedation. Hyperthermia and systemic complications. Exclusive peripheral nerve damage.