Epilepsy and Neurology Flashcards

1
Q

Whats the minimum no. of seizures you must have had to be diagnosed with epilepsy?

A

2

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2
Q

Status epilepticus: Def, Mx (APLS algorithm)

A

Sizure longer than 5m or when sizures occur one after the other with no recovery between.
PPx:
Highest in children and >60s
70% of children with epilepsy beginning in infancy with expererience at least 1 episode.

ABC
Vascular access?
If yes: IV Lorazepam 0.1 mg/kg
If no: Midazolam buccal [6-12m, 2.5mg, 1-5yrs 5mg, [ or rectal diazepam [dose]

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3
Q

SUDEP

A

Sudden unexpected death in epilepsy in which PM exam does not reveal a toxicological or anatomical reason

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4
Q

NEAD

A

Non-epileptic attack disorder. Episodes of change in behaviour or movement, not caused by primary change in electrical activity. Movements are varied and the attacks

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5
Q

DDx/Ix for seizures?

A

Hypoglycaemia (blood glucose)
CNS Infection e.g. meningitis, encephalitis, TB, malaria (raised temp/WCC)
Febrile convulsions
Trauma (signs of raised ICP, child abuse)
Drugs (hx of recreational drug use)

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6
Q

Juvenile myoclonic

A

15% of absence seizure epilepsy go on to this

Presents with 3 types: Tonic clonic, absence, myoclonic

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7
Q

Gen tonic clonic

A

Clonic seizures - should be symmetrical (if asymmetrical pattern query NEAD)
May get tongue biting, incontinence
Post ictal confusion (want to sleep after)

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8
Q

What is most common cause of neonatal seizures?

Other causes?

A

HIE (hypoxic-ischaemic encephalopathy)
Intracranial haemorrhage, metabolic disturbances (e.g. hypoglycaemia)
[FINISH]

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9
Q

Seizures: Ix?

A

Video, ECG, MRI or CT brain (for haemorrhage in resus), EEG has limitations is not first line and often not diagnostic

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10
Q

Epilepsy syndromes (the four syndromes that she said to learn)

A

Infancy
-West syndrome: infantile spasms, usually 3 to 18/12 MUST BE TREATED quickly OTHERWISE–> DISABILITY. Treated with steroids/IM ACTH.
Childhood period epilepsy syndromes:
-Childhood absence epilepsy
-Benign epilepsy with centrotemporal spikes
Adolescece/adult
-juvenile myoclonic (sodium valproate - TERATOGENIC 10x risk) - n.b although this is called JME this is just about the age of onset. You can be 70 years old with JME.

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11
Q

Can you drive with epilepsy?

A

Yes if you’ve been seizures free for 1 day

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12
Q

Cerebral palsy

Mr Cook - clinic

A

Neurological disorder caused by a non-progresive brain injury or malformation that occurs while the child’s brain is under development. Primarily affects movement and coordination.

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13
Q

Classic gait fo mild hemiplegia

A

Flexion of arm at elbow/wrist

Circumduction due to tight achilles

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