4. Epilepsy Flashcards
(21 cards)
What is
Epilepsy
A sudden surge of electrical activity of Neurons in the brain
What are
Non-epileptic seizures?
Unrelated to abnormal electrical activity in the brain.
(nothing to do with epilepsy)
2 types
Organic = hypoglycaemia, fever
psychogenic (mental/emotional) =
Distressing thoughts
Define
Seizure
“Sudden attack of disease” usually caused by a sudden surge of electrical activity
Define
Epilepsy syndrome
a group of features usually occuring together.
The features in a syndrome may include types of seizures commonly seen, age when seizures commonly begin, part of the brain involved, usual course, genetic information, and much more
If epilepsy syndrome is not clear
How do we determine what to prescribe?
The type of seizure
How do we consider what to prescribe in epilepsy
- Epilepsy syndrome
If that is not clear then
- Type of seizures
Epileptic seizures
Types 2
Name them
Partial/forcal seizures
Generalised seizures
Epileptic seizure
Partial/ forcal
Define:
The seizure activity is centralised in 1 part of the brain.
Sometimes the seizure activity spreads to other parts of the brain (secondary generalised seizures)
The person remains conscious.
What is
secondary generalised seizure
In partial/ forcal seizures (where the seizure is centralised in 1 part of the brain)
Sometimes the seizure activity spreads to other parts of the brain this is secondary generalised seizure
Define
Generalised seizure
The seizure affects the whole brain 🧠
The person loses consciousness
Types of seizures
5
List them
1 forcal / partial seizures (with/without secondary generalisation) 1 part of the brain 🧠 person conscious.
- Tonic-clonic seizures (generalised, unconscious)
- Absence seizures (generalised, unconscious)
- Myoclonic seizures (generalised, unconscious)
- Atonic/tonic seizures (generalised, unconscious)
What is
Tonic-clonic seizure?
1st line meds
(generalised, unconscious)
When muscles go stiff & starts jerking
1st line:
Valproate (if not suitable give: lamotrigine)
Also 1st line: carbamazepine
What is
Partial/ forcal seizures?
First line meds?
Seizure in 1 part of the brain, sometimes it spreads to other parts ( secondary generalised seizure)
Patient conscious
1st line: lamotrigine/ carbamazepine
Alternatively
Valproate
Oxcarbazepine
Levetiracetam
What is
Absence seizure ?
First line?
Pt looks blank, staring into space (daydreaming)
(unresponsive)
1st line:
Ethosuximide
valproate (especially if high risk of tonic-clonic seizures)
Alternatively: lamotrigine
What is
Myoclonic seizure ?
First line?
Muscle jerking
1st line: valproate
Alternatively:
Topiramate
Or
Levetiracetam
What is
Atonic/ tonic seizure?
1st line?
Atonic : Muscles go floppy
Tonic seizures : stiff muscles
Mainly seen in childhood
1st line: valproate
Most teratogenic anti-epileptic
Valproate
Therefore avoid In premenopausal females
When prescribing in epilepsy
remember 3 factors:
Age
Gender
Concomitant medication
What is a
Febrile seizure
A febrile seizure is a convulsion in a child that’s caused by a fever. The fever is often from an infection. Febrile seizures occur in young, healthy children who have normal development and haven’t had any neurological symptoms before
they are harmless to the child. Febrile seizures do not cause brain damage, nervous system problems, paralysis, intellectual disability, or death
Symptoms of febrile convulsions loss of consciousness (black out) twitching or jerking of arms and legs. breathing difficulty. foaming at the mouth. going pale or bluish in skin colour. eye rolling, so only the whites of their eyes are visible. your child may take 10 to 15 minutes to wake up properly afterwards.
Most anti-epileptic medicine is given
BD
LIST 4 that are given OD
- Lamotrigine
- Phenytoin
- Phenobarbital
- Perampanel
ON (due to long half-life)
What is the aim of treating epilepsy
Prevent seizures by maintaining an effective dose of 1 or more anti-epileptic drugs
