12.2 Antiepileptics

Question 1

glutamate receptor

Answer 1

NMDA

Question 2

GABA receptor

Answer 2

GABA a or b

Question 3

define seizure

Answer 3

clinical manifestation of abnormal excessive exception and synchronisation of group of neurones in brain, sudden and temporary

Question 4

underlying conditions which can cause non epileptic provoked seizures

Answer 4

drugs
CNS infection
alcohol
hypoglycaemia/DKA
pyrexia

Question 5

differential diagnoses for seizures

Answer 5

vasovagal syncope
cardiac arrhytmias
TIA
migraine
delirium
meds, alcohol
panic attack

Question 6

differential diagnoses for seizures in children

Answer 6

febrile convulsion
night terrors
breath holding attacks

Question 7

epilepsy risk factors

Answer 7

premature
complicated febrile seizure
head trauma, infection tumour
dementia

Question 8

reflex stimuli examples

Answer 8

photogenic (strobe lights)
musicogenic
eating
hot water immersion
movement

Question 9

how far apart must unprovoked seizures be to class as epilepsy?

Answer 9

> 24 hours
or 1 seizure with probability of recurrence risk same as after 2

Question 10

how to diagnose epilepsy

Answer 10

assess risk of second seizure
patient history
eyewitness account/video
EEG
MRI

Question 11

petit mal

Answer 11

absence seizure

Question 12

grand mal

Answer 12

generalised seizure

Question 13

prodrome

Answer 13

early signs seizure may be coming hours/days before

Question 14

aura

Answer 14

focal aware seizure leading to secondary generalised

Question 15

interictal

Answer 15

between seizures

Question 16

post ictal symptoms

Answer 16

confusion
fatigue
headache
frustration
anxiety
injury

Question 17

CYP affecting carbamazepine

Answer 17

3A4

Question 18

phenytoin exhibits zero order elimination kinetics, why is this important?

Answer 18

small dose chnage = big plasma change

Question 19

pregnancy prevention programme when on AEDs

Answer 19

at least one highly effective contraceptive method or 2 forms including barrier

Question 20

lamotrigine

Answer 20

sodium and calcium channel blocker selective for neurones

Question 21

how should AEDs be changed?

Answer 21

slowly, titration
by epilepsy specialist

Question 22

benzodiazepine effect on chloride ions

WRONG ON LUSUMA

Answer 22

efflux, = hyperpolarisiton

Question 23

ADRs for benzodiazepines

Answer 23

ataxia
depression
drowsiness
hypotension

Question 24

status epilepticus

Answer 24

seizure lasting 5 minutes or more, or multiple without recovery between