Tuesday, February 9, 2016

The average duration of a tonic–clonic seizure is-DrSudeepKC

The average duration of a tonic–clonic seizure is

a. 15 seconds.
b. 28 seconds.
c. 60 seconds.
d. 120 seconds.
e. 148 seconds.

The answer is c. In a typical tonic–clonic seizure, electroencephalogram changes last an average of 59.9 seconds, and behavioral changes last only a few second longer. Thus, a seizure lasting 5 minutes is more than 17 standard deviations beyond the “typical” seizure.

A 40-year-old man complains of a unilateral periorbital headache accompanied by rhinorrhea and
lacrimation. The most effective abortive therapy to treat this headache seems to be:

a. Transnasal sumatriptan.
b. High-flow oxygen using a nonrebreather mask.
c. Intravenous ketorolac.
d. Valsalva maneuver while squatting.
e. Papaya juice.

The answer is b. Cluster headaches share with migraine headaches of a vascular origin and recurrent nature. Men are afflicted far more often than women. The age of onset, unlike that of migraine, is usually the mid-thirties to mid-forties. There is no aura, nausea, or vomiting. A cluster headache has recurrent characteristics of time, location, and duration. The pain has a boring quality and localizes to the frontal region. Unlike a migraine headache, it does not become bilateral or extend posteriorly to the scalp. A nocturnal onset is a characteristic but not invariable finding. Accompanying autonomic signs include ipsilateral lacrimation, rhinorrhea, and flushing. Intranasal drugs are usually not well absorbed because of the mucosal swelling. High-flow oxygen therapy using a nonrebreather
mask can abort the attack in less than 1 minute.


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