Convulsiones 2

Postictal blindness is typically: A sign of reactive seizures only. Transient and resolving within hours. Unrelated to seizures. Permanent in all cases.

The postictal phase may last: Less than 5 seconds. Indefinitely. Several weeks in all cases. Minutes to hours.

Which finding most strongly supports structural epilepsy?. Onset between 6 months and 6 years. Normal neurological exam. Normal laboratory database. Persistent interictal neurological deficits.

Long-term epilepsy management requires: Ongoing reassessment of seizures and therapy. Stopping treatment after improvement. No follow-up once controlled. Emergency therapy only.

According to the IVETF outcome proposal, recurrent epileptic seizures may contribute to: Permanent cure of epilepsy. Neuronal cell loss and progressive disease severity. Improved drug responsiveness. Exclusive peripheral nerve damage.

Reactive seizures differ from epilepsy because they: Require lifelong AED therapy. Resolve once the underlying disturbance is corrected. Occur only in older dogs. Are caused by intracranial tumors.

Status epilepticus can lead to: Only peripheral nerve damage. Neuronal injury and systemic complications. No systemic effects. Immediate seizure remission.

According to the IVETF outcome proposal, partial therapeutic success may include: Reduction in seizure frequency or prevention of cluster seizures without full seizure freedom. Only complete elimination of seizures. Development of structural epilepsy. Stopping treatment due to mild sedation.

According to the ACVIM consensus, why is a seizure diary recommended?. To objectively monitor seizure frequency and treatment response. To avoid drug monitoring. To replace veterinary rechecks. To determine drug doses without consultation.

Diagnosis of idiopathic epilepsy (IE) is described as: A diagnosis based only on breed predisposition. A diagnosis of exclusion after ruling out metabolic, toxic, and structural causes. A diagnosis confirmed solely by EEG in all dogs. A diagnosis requiring visible structural lesions on MRI.

During generalized epileptic seizures, consciousness is typically: Lost or markedly impaired. Unaffected in all cases. Enhanced. Fully preserved.

Seizure severity assessment includes evaluation of: Only serum drug levels. Duration, intensity, and postictal effects. Only seizure frequency. Only MRI findings.

According to consensus documents, long-term management of canine epilepsy requires: Stopping medication once seizures decrease. Avoiding follow-up visits. Regular reassessment of seizure control and adverse effects. Using emergency drugs only.

In acute seizure management, benzodiazepines are primarily used because they: Act rapidly to terminate ongoing seizures. Provide long-term seizure prevention only. Replace maintenance therapy. Induce hepatic enzyme inhibition.

According to consensus documents, many phenobarbital adverse effects are: Dose-related and may improve with dose adjustment. Unrelated to serum drug concentration. Only seen in cats. Irreversible in all cases.

An epileptic seizure is defined as: A transient occurrence of signs due to abnormal excessive or synchronous neuronal brain activity. A cardiovascular syncope episode. A behavioral disorder without brain involvement. A permanent neurological deficit.

Which set of adverse effects is listed as most commonly reported in dogs treated with phenobarbital (PB) in the IVETF (Europe) consensus proposal?. Permanent blindness and deafness as common effects. Alopecia, pruritus, and otitis externa. Severe bradycardia and collapse in most dogs. Sedation, ataxia, polyphagia, and polydipsia/polyuria.

In the IVETF (Europe) consensus proposal, why should dogs receiving potassium bromide be maintained on a constant diet (chloride intake)?. Because chloride intake alters renal excretion of bromide and can cause therapeutic failure or toxicity if diet changes. Because bromide monitoring is only reliable during fasting. Because bromide is metabolised in the liver and requires a high-protein diet. Because dietary chloride has no effect on bromide elimination.

When adverse effects of antiepileptic drugs are dose-related, appropriate management may include: Immediate permanent discontinuation. Adding multiple drugs without monitoring. Ignoring adverse effects. Dose adjustment while monitoring seizure control.

According to the ACVIM statement, after a first unprovoked seizure, the risk of recurrence in dogs is approximately: More than 95%. Less than 5%. Exactly 10%. Approximately 50% or higher.

A key distinction between reactive seizures and idiopathic epilepsy is that reactive seizures: Occur only in adult dogs. Are caused by structural lesions. Always require lifelong AED therapy. Resolve after correction of systemic disturbance.

The diagnostic approach to seizures should first aim to: Exclude metabolic and toxic causes. Perform surgery. Start lifelong AED therapy immediately. Avoid laboratory testing.

According to the ACVIM Small Animal Consensus Statement, cluster seizures are defined as: A single seizure lasting more than 5 minutes. One seizure per week for two weeks. Two or more seizures within 24 hours with recovery between seizures. Continuous seizure activity without recovery.

According to the review on refractory epilepsy, approximately what proportion of dogs with epilepsy are considered refractory to conventional therapy?. Less than 1%. More than 80%. Approximately one-third (around 30%). Exactly 50% of all epileptic dogs.

Long-term epilepsy management requires: No follow-up once therapy begins. Ongoing reassessment of seizures and treatment response. Emergency drugs only. Dietary therapy exclusively.

After a first unprovoked seizure, the risk of recurrence is approximately: Around 50% or higher. Exactly 10%. Nearly 100%. Less than 5%.

Owners of epileptic dogs should understand that epilepsy is typically: Exclusively diet-controlled. A surgical condition in all cases. A chronic condition requiring long-term therapy. A short-term disorder resolving spontaneously.

According to emergency seizure management guidelines, the immediate priority in status epilepticus is: Stabilization of airway, breathing, and circulation. Dietary modification. Immediate MRI of the brain. Withdrawal of all antiepileptic drugs.

The primary objective of the minimum database in seizure evaluation is to: Confirm tumor presence. Replace neurological examination. Determine seizure type. Exclude metabolic and toxic causes.

According to the ACVIM consensus statement, immediate long-term antiepileptic treatment after a single unprovoked seizure is generally: Required before performing any diagnostics. Not automatically recommended unless additional risk factors are present. Recommended only in dogs under 1 year. Mandatory in all dogs.

What is the estimated prevalence of epilepsy in dogs according to the epidemiology slide?. Less than 0.01% of dogs. More than 20% of male dogs. Approximately 0.60–0.75% (about 1 in 130 dogs). Approximately 10% of the canine population.

According to IVETF Tier I recommendations, the minimum database typically includes: CBC, serum biochemistry, and urinalysis. Thoracic radiographs exclusively. MRI and EEG only. Muscle biopsy.

According to the IVETF outcome proposal, sudden unexpected death in epilepsy (SUDEP): Has never been described in veterinary medicine. Occurs only in reactive seizures. Is a rare but possible risk associated with seizures. Is unrelated to seizure activity.

According to the IVETF outcome proposal, why are owner-related QoL factors important?. Because owners replace neurological examinations. Because owners diagnose structural epilepsy. Because owners determine serum drug concentrations. Because owner perception influences management decisions.

What therapeutic serum phenobarbital (PB) range is given in the IVETF (Europe) consensus proposal for dogs?. 100–300 mg/L. 15–40 mg/L. 1–5 mg/L. 50–80 mg/L.

Idiopathic epilepsy is most accurately described as: A primary brain disorder without identifiable structural cause. A toxin-induced condition. A metabolic disturbance. A cardiovascular disorder.

According to the seizure phase descriptions, the prodrome is characterized by: Subtle behavioral changes hours to days before the seizure. Continuous tonic-clonic movements. Permanent neurological deficits. Immediate recovery after seizure.

Seizure onset after 6 years of age increases suspicion for: Reactive seizures only. Benign epilepsy. Structural epilepsy. Idiopathic epilepsy exclusively.

According to the Clinician’s Brief description, the postictal phase: Is absent in generalized seizures. Always includes permanent neurological deficits. Lasts minutes to hours and is associated with abnormal behaviour. Lasts several weeks in most cases.

A seizure diary should include which essential information?. Only owner emotions. Date, duration, characteristics, and possible triggers. Only drug doses. Only laboratory values.

Which of the following etiologies is consistent with structural epilepsy?. Inflammatory intracranial disease. Electrolyte imbalance. Stress-induced syncope. Transient hypoglycaemia.

Partial therapeutic success may include: Permanent discontinuation of therapy. Diagnosis of structural epilepsy. Complete elimination of seizures only. Reduction in seizure frequency or severity.

According to the consensus documents, when should a second antiepileptic drug be considered?. Only in dogs younger than 6 months. Before starting any monitoring. When seizures remain inadequately controlled despite appropriate dosing of the first AED. After the first single seizure.

According to IVETF definitions, reactive seizures are expected to: Resolve once the underlying cause is corrected. Persist lifelong regardless of treatment. Occur only in young dogs. Always progress to structural epilepsy.

Serum bromide concentrations should be monitored because: Eliminates need for diet control. Replaces seizure diary. Diagnoses seizure type. Ensures therapeutic levels and minimizes toxicity.

Higher phenobarbital serum concentrations are associated with increased risk of: Permanent blindness. Hepatotoxicity. Renal failure in all cases. Hyperthyroidism.

According to the Clinician’s Brief article on emergent epilepsy and status epilepticus, what is the first priority in emergency management of a seizuring patient?. Wait until the seizure stops spontaneously before intervention. Treat airway, breathing, and circulatory disturbances first. Administer phenobarbital before assessing vital parameters. Immediately perform MRI before stabilisation.

According to consensus documents, cluster seizures are clinically significant because they: Confirm idiopathic epilepsy. Increase risk of progression to status epilepticus. Always resolve without intervention. Indicate reactive seizures exclusively.

In the IVETF (Europe) consensus proposal, a second phenobarbital serum concentration may be measured at what time point to evaluate the effect of metabolic tolerance?. 6 months after initiation of therapy. 6 days after initiation of therapy. Only at the time of the next seizure. 6 weeks after initiation of therapy.

Generalized tonic-clonic seizures are typically characterized by: Bilateral tonic and/or clonic limb movements with loss of consciousness. Normal awareness throughout. Exclusive autonomic signs without motor activity. Single limb twitching only.

Epilepsy in dogs is best described as: A chronic neurological disorder. A self-limiting condition. A transient metabolic imbalance. A short-term toxic exposure.

Based on the Vet Clin N Am definition, status epilepticus is defined as: Three focal seizures within 24 hours with full recovery. A single seizure lasting 5 minutes or two or more seizures without recovery between them. Any seizure lasting more than 30 seconds. Two seizures occurring within one month.

According to the IVETF outcome consensus, drug-resistant epilepsy is diagnosed when: One AED fails to reduce seizures by 25%. A dog has focal seizures only. Seizures occur during sleep. Two adequate and tolerated AED trials fail to achieve sustained seizure freedom.

According to IVETF terminology, an epileptic seizure is defined as: A permanent neurological deficit. Any collapse due to cardiac disease. A behavioral disorder without brain involvement. A transient occurrence of signs due to abnormal excessive or synchronous neuronal brain activity.

According to the consensus slides, why is owner education essential in managing epileptic dogs?. To eliminate the need for veterinary supervision. To avoid all follow-up examinations. To ensure regular AED administration and appropriate monitoring. To allow abrupt discontinuation of drugs when seizures stop.

According to the IVETF consensus, focal epileptic seizures are characterized by: Lateralized and/or regional motor, autonomic, or behavioural signs with consistent ictal onset. Always bilateral tonic-clonic movements. Exclusive occurrence during exercise. Immediate loss of consciousness in all cases.

What key finding about placebo response is highlighted in the refractory epilepsy review?. Placebo effects are only seen in cats, not dogs. Placebo responses do not occur in canine epilepsy studies. Placebo always causes seizures to worsen. A large proportion of dogs may show a ≥50% seizure reduction with placebo alone.

Generalized seizures typically involve: No motor signs. Localized twitching only. Preserved awareness in all cases. Bilateral motor activity with impaired consciousness.

Long-term monitoring in epileptic dogs should include: Emergency drugs only. Dietary therapy exclusively. Stopping follow-up after improvement. Regular reassessment of seizures and adverse effects.

Dietary chloride affects potassium bromide therapy because: Chloride competes with bromide for renal reabsorption. Chloride increases hepatic metabolism of bromide. Chloride eliminates need for monitoring. Chloride prevents seizures directly.

Which condition may cause structural epilepsy?. Stress-induced collapse. Hypoglycaemia. Intracranial neoplasia. Transient electrolyte imbalance.

Seizure frequency is an important outcome measure because it: Eliminates need for follow-up. Replaces drug monitoring. Confirms structural epilepsy. Allows objective assessment of treatment response.

According to the IVETF consensus report, what is a reactive seizure?. A seizure caused by a confirmed intracranial tumor. A seizure with a confirmed genetic mutation. A seizure resulting from a transient metabolic or toxic disturbance in an otherwise normal brain. A seizure occurring only in dogs under 6 months of age.

A second antiepileptic drug should be considered when: Only in dogs under 1 year. Seizures remain inadequately controlled. Before monitoring serum levels. After a single seizure.

Reactive seizures are caused by: Genetic mutations exclusively. Permanent structural lesions only. Chronic idiopathic epilepsy. Transient metabolic or toxic disturbances.

Seizure onset outside 6 months to 6 years increases suspicion of: Guaranteed idiopathic epilepsy. Reactive seizures only. Benign epilepsy. Structural epilepsy.

In refractory status epilepticus, phenobarbital may be administered as a loading strategy in order to: Prevent future structural epilepsy. Avoid monitoring serum levels. Eliminate need for airway support. Rapidly achieve therapeutic serum concentrations.

According to IVETF criteria, EEG contributes to which diagnostic confidence level?. Tier I only. Tier III confidence level. Reactive seizure confirmation. Structural epilepsy confirmation without imaging.

According to the IVETF classification, structural epilepsy refers to: Epilepsy occurring only during sleep. Epilepsy without any brain abnormality. Epilepsy caused by an identifiable intracranial structural lesion. Epilepsy triggered by transient hypoglycaemia.

In dogs with idiopathic epilepsy, the interictal neurological examination is typically: Persistently abnormal. Normal. Showing progressive paresis. Showing cranial nerve deficits.

Brain MRI is primarily used to: Measure serum drug levels. Detect or exclude structural intracranial lesions. Replace neurological exam. Confirm reactive seizures.

According to the IVETF document, imepitoin acts primarily as: A direct NMDA receptor antagonist. A potassium channel opener. A partial agonist at the benzodiazepine site of the GABA-A receptor. A sodium channel blocker.

For Tier I confidence diagnosis of idiopathic epilepsy, the age at seizure onset should typically be: Less than 1 month. Older than 10 years only. Between 6 months and 6 years. Exclusively between 8 and 12 years.

Which metabolic disturbance is commonly associated with reactive seizures?. Osteopenia. Hypertension. Hypoglycaemia. Hypercalcaemia only.

According to the epidemiology slide on reactive seizures, which metabolic disorder is most commonly associated with reactive seizures?. Hypoglycaemia. Chronic renal fibrosis. Hyperthyroidism. Osteoarthritis.

According to IVETF terminology, Tier III confidence level for idiopathic epilepsy includes: EEG findings consistent with epileptic seizure activity in addition to Tier I and II criteria. Radiographic confirmation of vertebral lesions. Only owner description of seizures. Presence of metabolic disease.

According to IVETF information, potassium bromide reaches steady state: Within 24 hours. Only after liver metabolism. Immediately after first dose. After a prolonged period because of its long half-life.

Serum phenobarbital measurement is primarily used to: Identify structural lesions. Ensure therapeutic levels and adjust dosage. Diagnose seizure type. Replace seizure diary.

The primary management strategy for reactive seizures is to: Correct the underlying metabolic or toxic disturbance. Start lifelong phenobarbital therapy. Perform immediate brain surgery. Avoid diagnostic testing.

In focal epileptic seizures, consciousness: Cannot be evaluated. Is always completely lost. Is always fully normal. May be preserved or impaired.

The purpose of the minimum database in seizure evaluation is to: Replace MRI. Determine seizure classification. Exclude metabolic and toxic causes. Diagnose intracranial tumors.

Which of the following is listed as a differential diagnosis for episodic paroxysmal disorders?. Osteoarthritis. Syncope. Diabetes mellitus. Chronic hepatitis.

According to the IVETF outcome proposal, outcome assessment in epilepsy should be based on: Standardized definitions such as seizure freedom and partial success. Single postictal examination. Subjective impression only. MRI findings alone.

Why is accurate seizure frequency documentation essential in epileptic dogs?. To eliminate need for follow-up. To confirm structural lesions. To objectively assess treatment efficacy. To avoid drug monitoring.

Adjustment of antiepileptic drug dosage should be based on: Seizure control, adverse effects, and serum concentrations. Coat color. Owner preference alone. Breed size.

According to clinical descriptions, transient postictal blindness is: Only seen in reactive seizures. Unrelated to epileptic events. A permanent consequence of all seizures. A temporary deficit that may occur after generalized seizures.

Which of the following is part of the Tier I confidence level for diagnosis of idiopathic epilepsy (IE)?. Onset exclusively before 3 months of age. MRI confirmation of a structural brain lesion. At least two unprovoked seizures >24 hours apart with normal interictal exam and minimum database results. Positive PCR for infectious encephalitis.

According to IVETF recommendations, Tier II confidence level for idiopathic epilepsy includes: Absence of minimum database testing. Normal MRI and CSF analysis in addition to Tier I criteria. Abnormal CSF confirming inflammation. Positive MRI confirming tumor.

Cluster seizures are defined as: Three seizures in one year. One seizure lasting more than 10 minutes. Continuous seizure activity without recovery. Two or more seizures within 24 hours with recovery between them.

Seizure freedom as a treatment outcome requires: No seizures for ≥3× longest pre-treatment interval and ≥3 months. 50% reduction in seizure frequency. No cluster seizures only. No seizures for 1 month.

Drug-resistant epilepsy implies: Late onset seizures only. Presence of focal seizures. Failure of two adequate and tolerated AED trials. Failure of a single emergency treatment.

In the refractory epilepsy review, the drug target hypothesis suggests resistance is due to: Increased dietary chloride intake. Exclusive liver metabolism of all antiepileptic drugs. Changes in drug targets in epileptogenic brain tissue that reduce sensitivity to antiepileptic drugs. Owner placebo bias as the sole cause.

According to the IVETF terminology, a seizure that begins focally and subsequently involves both hemispheres is termed: A focal seizure evolving into a generalized seizure. A reactive seizure. A cluster seizure. A pseudoseizure.

According to IVETF Tier I criteria, idiopathic epilepsy most commonly presents between: 6 months and 6 years. Over 12 years only. Birth and 3 months. 8 and 12 years.

In the refractory epilepsy review, human clinical trials of VNS suggest that approximately: One-third have ≥50% reduction, one-third have 30–50% reduction, and one-third have little or no change. No patients show any improvement. All patients become seizure-free. Exactly 90% have ≥50% reduction.

A second AED may be added when: Only in puppies. Before monitoring drug levels. Seizures persist despite adequate first-line therapy. After one isolated seizure.

According to the ACVIM consensus, the primary goal of antiepileptic therapy is: Induce permanent sedation. Treat only postictal signs. Eliminate seizures while minimizing adverse effects. Avoid all blood testing.

According to consensus recommendations, worsening seizure frequency over time suggests: Exclusive metabolic disturbance. Automatic remission. Inadequate seizure control or disease progression. Normal therapeutic response.

How is the preictal phase described in companion animals?. Severe hyperthermia lasting several hours. Continuous tonic-clonic movements. Subtle behavioural changes occurring before the seizure. Permanent blindness.

According to emergency management guidelines, cluster seizures require: Prompt intervention to prevent progression to status epilepticus. Immediate discontinuation of all AEDs. Dietary modification only. Observation only without treatment.

Accurate seizure classification is important because it: Guides diagnostic and therapeutic decisions. Confirms reactive seizures automatically. Determines serum potassium levels. Eliminates need for diagnostics.

Status epilepticus is clinically dangerous primarily because it: Guarantees remission of epilepsy. Only affects peripheral nerves. Increases risk of neuronal injury and systemic complications. Has no systemic consequences.

Which of the following is described as a possible manifestation of a focal epileptic seizure?. Contraction of a single limb or fly-biting behaviour. Bilateral tonic-clonic movements in all limbs. Chronic renal failure. Persistent coughing.

In the IVETF (Europe) consensus proposal, phenobarbital (PB) therapy in dogs is started and then tailored primarily based on which approach?. Start PB at a recommended oral dose, then tailor to the individual using seizure control, adverse effects, and serum PB concentrations. Start PB only after MRI and CSF analysis in every patient. Avoid any drug monitoring and adjust dose only by body weight. Use PB only as an emergency drug and never for maintenance therapy.

Potassium bromide is eliminated primarily through: Hepatic metabolism. Gastrointestinal degradation. Renal excretion. Pulmonary exhalation.

According to the emergency management article, propofol may be used when: The owner prefers an oral medication. The seizure lasted less than 10 seconds. The patient fails to respond to benzodiazepines or requires rapid control of status epilepticus. The dog has a history of mild focal seizures only.

Serum phenobarbital monitoring is recommended to: Diagnose seizure type. Ensure therapeutic levels and minimize toxicity. Identify metabolic causes. Replace seizure diary.

According to the IVETF classification, epileptic seizures are categorized by seizure type into: Acute and chronic seizures. Primary and secondary seizures. Focal epileptic seizures and generalized epileptic seizures. Reactive and metabolic seizures.

The interictal period refers to: The prodromal phase only. The time between seizures. The active seizure phase. Status epilepticus.

A normal interictal neurological examination most strongly supports: Structural epilepsy. Status epilepticus diagnosis. Reactive seizures. Idiopathic epilepsy (if other causes excluded).

According to the IVETF outcome proposal, quality of life (QoL) assessment in epileptic dogs should consider: Both patient-related and owner-related factors. Only seizure frequency. Only presence of structural lesions. Only serum drug concentrations.