Epilepsy

Question 1

Seizure =

Answer 1

Occurs when there is temporary abnormal electrical activity in a group of brain cells that may spread to involve other parts of the brain.

Question 2

Seizure Clinical Features

Answer 2

• Duration of a few seconds or minutes; most are self-terminating
• involuntary changes in body movement or function, sensation, awareness or behaviour

Question 3

Seizure can be broadly divided into:

Answer 3

• Epilepsy (or epileptic seizures)

- Other seizures

Question 4

Epilepsy =

Answer 4

Group of disorders characterised by a tendency to have recurring unprovoked seizures.

Question 5

Types of Epilepsy:

Answer 5

Active Epilepsy

Refractory Epilepsy

Status Epilepticus

Question 6

Active Epilepsy =

Answer 6

Occurrence of an epileptic seizure in the last 2 years;

or

Where patient taking medication to prevent further epileptic seizures

Question 7

Refractory Epilepsy =

Answer 7

Inadequate control of seizures despite optimal treatment

Question 8

Status Epilepticus =

Answer 8

Rare but serious condition where epileptic seizures continue either constantly (>5mins) or repeatedly over a period of 30 minutes or more.

Question 9

Causes of Non-Epileptic Seizures

Answer 9

Fever (febrile convulsions)

Hypoglycaemia (low blood glucose)

Withdrawal of alcohol in alcohol dependency

Question 10

Classification of Epilepsy

Answer 10

Partial epileptic seizures

Generalised epileptic seizures

Question 11

Partial epileptic seizures =

Answer 11

Abnormal electrical activity restricted to a focal area in the brain

Question 12

Generalised epileptic seizures =

Answer 12

Abnormal electrical activity throughout the cerebral hemispheres

May develop from Partial epileptic seizures, or arise De novo

Question 13

Causes of Epilepsy

Answer 13

1. 66% of epilepsy has an unknown cause
2. Genetic Predisposition
3. Acquired Illness
   - Cerebrovascular disease
   - Cerebral neoplasms
   - Alcohol-related brain damage
   - Post-traumatic brain damage

Question 14

Diagnosis of Epilepsy

Answer 14

Made when a patient has 2 or more unprovoked seizures

Question 15

Impact of Epilepsy Diagnosis

Answer 15

Person who has suffered an epileptic attack whilst awake must refrain from driving for 1 year from the date of the attic before a driving license may be issued

To drive Large Goods Vehicles or Passenger Carrying Vehicles driver must be free from any epileptic attack and not required medication to treat epilepsy for a period of 10years preceding date when licence granted.

Decreased employment opportunities and earning potential

Can be associated with memory loss

Social Stigma

Question 16

Epilepsy Prognosis

Answer 16

Pt with refractory epilepsy are at risk of sudden death

Around 70% of patients with epilepsy will go into remission over a period of years.

Question 17

Partial epileptic seizures - Example

Answer 17

Temporal lobe epilepsy

• > abnormalities of taste or smell
• > psychic disturbances e.g. deja vu

Occipital lobe epilepsy
-> abnormal visual perceptions e.g. balls of lights or coloured patterns

Question 18

Generalised epileptic seizures - Example

Answer 18

Grand Mal Epilepsy