Epilepsy Flashcards
What are generalised tonic clonic seizures?
Involve tonic (muscle tensing) and clonic (muscle jerking) movements associated with a complete loss of consciousness.
Typically, the tonic phase comes before the clonic phase.
Patients might experience aura (occurs before seizure). There may be tongue biting, incontinence, groaning and irregular breathing.
What is the post-ictal period of a generalised tonic clonic seizure?
Occurs after the seizure where the person is confused, tired, and irritable or low.
Where do focal (partial) seizures occur?
Occur in an isolated brain area, often in the temporal lobes.
What are features of focal seizures?
Déjà vu
Strange smells, tastes, sight or sound sensations
Unusual emotions
Abnormal behaviours
What are myoclonic seizures?
Sudden, brief muscle contractions, like an abrupt jump or jolt.
They remain awake. Myoclonic seizures can occur as part of juvenile myoclonic epilepsy in children.
What are tonic seizures?
Involve a sudden onset of increased muscle tone, where the entire body stiffens.
This results in a fall if the patient is standing, usually backwards.
They last only a few seconds, or at most a few minutes.
What are atonic seizures?
They (causing “drop attacks”) involve a sudden loss of muscle tone, often resulting in a fall.
They last only briefly, and patients are usually aware during the episodes.
What are absence seizures?
Usually seen in children.
The patient becomes blank, stares into space, and then abruptly returns to normal.
During the episode, they are unaware of their surroundings and do not respond. These typically last 10 to 20 seconds.
What are infantile spasms?
A rare (1 in 4,000) disorder starting at around six months of age. It presents with clusters of full-body spasms.
What is the characteristic EEG for infantile spasms?
Hypsarrhythmia (disorganised and very chaotic brain activity) is the characteristic EEG finding.
What are febrile convulsions?
Occur in children during a high fever.
They are not caused by epilepsy or other pathology (e.g., meningitis or tumours).
Febrile convulsions occur in children aged between 6 months and 5 years.
What anti-convulsant is completely contraindicated in pregnant women or women of child bearing age?
Sodium valproate
Associated with significant risk of neurodevelopmental delay in children and potential neural tube defects.
Treatment of generalised tonic-clonic seizures?
males: sodium valproate
females: lamotrigine or levetiracetam
Treatment of focal seizures?
first line: lamotrigine or levetiracetam
second line: carbamazepine, oxcarbazepine or zonisamide
Treatment of absence seizures?
first line: ethosuximide
second line:
male: sodium valproate
female: lamotrigine or levetiracetam
