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NBME 15 Answers

nbme15/Block 2/Question#21 (reveal difficulty score)
A 43-year-old woman comes to the physician ...
Complex partial ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: neuro

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 +6  upvote downvote
submitted by โˆ—ergogenic22(401)
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She has motor and sensory symptoms. This r/o both kinds of simple. Her seizures are not described as tonic/clonic movements, and include periods of impaired consciousness. This rules out generalized tonic/clonic. There is a post-ictal state, that rules out absence.

Also the lip smacking is characteristic of automatism, which is found in complex partial seiuzres

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bbr  Isn't is just motor symptoms, thats why its Partial? Maybe Im conflating things here. But complex partial decoded would be: Complex (lose consciousness) and partial (just 1 area of the brain, just motor). +9
euchromatin69  simple seizure wont have altered cociousness....alt. concious = complex or generaliised +
i_hate_it_here  What's the difference between a complex partial and an absence seizure? +
kaf  Absence - they just gaze off as if they're daydreaming. +2



 +3  upvote downvote
submitted by โˆ—cheesetouch(249)
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FA18 p 501

Partial = single area of brain. Simple = consciousness intact, vs complex = impaired consciousness (IE when patient does not respond during event). Complex also presents with automatisms (lip smacking). Absence is blank stare, commonly in kids, no post-ictal confusion. Tonic-clonic has alternating stiffening and movement.

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 +1  upvote downvote
submitted by โˆ—pakimd(31)
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partial seizures are focal seizures that are limited to one lobe of the brain and symptoms are according to what lobe of the brain is affected. since only motor symptoms are seen in one part of the body frontal motor cortex of that area of the body is the probable area of hyperactivity. now since there is a post ictal state (pt takes a few min to return to normal) and during the episode of seizure the pt. does not respond to questions (impaired awareness) followed by automatisms you know its complex and not simple partial. you know its not absence because even though pt's awareness is impaired during the seizure there is no post ictal state.

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pakimd  there is no post ictal state in absence +



 +1  upvote downvote
submitted by โˆ—whoopthereitis(5)
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  • Simple Seizures: no impaired consciousness
  • Complex Seizures: impaired consciousness
  • Partial Seizures: "part" of body
  • Generalized Seizures: whole body
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