Epilepsy Flashcards

1
Q

What is epilepsy?

A

Neurological disorder

Characterised by seizures

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2
Q

What is a seizure?

A

Signs or symptoms due to abnormal excessive electrical activity in the brain

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3
Q

What are the signs and symptoms of a seizure?

A

Sensory disturbance

Convulsions

Loss of consciousness

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4
Q

What is an aura?

A

Sensory disturbance

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5
Q

When do auras occur?

A

Before a seizure begins, for some patients only

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6
Q

What are some examples of an aura?

A

Strange light
Unpleasant smell
Confusing thoughts

Depending on which part of the brain is affected

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7
Q

What are the types of seizures?

A

Partial

Generalised

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8
Q

What is a partial seizure?

A

Source of seizure is localised in the brain

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9
Q

What is a generalised seizure?

A

Source of seizure is distributed throughout the brain

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10
Q

What are the types of partial seizures?

A

Simple

Complex

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11
Q

What is a simple partial seizure?

A

Consciousness is maintained throughout the seizure

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12
Q

What is a complex partial seizure?

A

Consciousness is impaired throughout the seizure

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13
Q

What are some examples of partial seizures?

A

Temporal lobe epilepsy

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14
Q

What is temporal lobe epilepsy?

A

Focal seizures that originate in the temporal lobe

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15
Q

What age group does temporal lobe epilepsy occur in?

A

Young age e.g. children, adolescents

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16
Q

What are the causes of temporal lobe epilepsy?

A

Head injury

Brain infections

17
Q

What are the signs and symptoms of temporal lobe epilepsy?

A

Auditory or olfactory hallucinations

Rush of memories

18
Q

How is consciousness affected in generalised seizures?

A

Loss of consciousness

19
Q

What are the types of generalised seizures?

A

Tonic-clinic

Absence

Myoclonic

Atonic

Tonic

20
Q

What is a tonic-clonic seizure?

A

Increased muscle tone followed by convulsions

21
Q

What is an absence seizure?

A

Patient stops what they’re doing for a short while and then carries on as normal

22
Q

What is a myoclonic seizure?

A

Muscle spasms with breaks in between

23
Q

What is an atonic seizure?

A

Lack of muscle tone

24
Q

What do atonic seizures look like?

A

Drop attacks e.g. if standing up then fall down, if sitting down then neck drops backwards

25
Q

What is a tonic seizure?

A

Increased muscle tone

26
Q

What is status epilepticus?

A

Epileptic seizures occurring continuously without recovery of consciousness in between

27
Q

How is status epilepticus managed?

A

As a medical emergency

28
Q

What is a convulsion?

A

Uncontrolled shaking movement due to rapid repeated contraction and relaxation of muscles

29
Q

How is epilepsy diagnosed?

A

History

EEG

MRI head

ECG

30
Q

What are the parts of a history for a patient who’s had a seizure?

A

Before the seizure e.g. past medical history, family history, triggers, aura, first sign or symptom

During the seizure e.g. description of seizure, duration, abrupt or gradual end, maybe by a collateral history

After the seizure e.g. post-ictal state, tongue biting, incontinence, neurological deficit

31
Q

Why is an MRI head done for a patient who’s had a seizure?

A

To look for structural changes in the brain to rule out other causes

32
Q

Why is an EEG done for a patient who’s had a seizure?

A

To support the diagnosis

The assess the risk of seizure recurrence

33
Q

How is an EEG done for a patient who’s had a seizure?

A

Use photic stimulation e.g. flashing lights, hyperventilation to induce a seizure

34
Q

If an EEG of a patient who’s had a seizure gives unclear results, what is done?

A

Repeat standard EEGs

Do sleep EEGs or when the patient is sleep-deprived

Ambulatory EEG, done when patient is at home

35
Q

What are some other conditions that may also cause seizures?

A

Vascular - stroke, transient ischaemic attack

Infection - abscess, meningitis, febrile seizure

Trauma - intracerebral haemorrhage

Metabolic - hypoxia, hypoglycaemia, electrolyte imbalance

Iatrogenic - drugs

Neoplastic - intracerebral tumour

36
Q

Why is an ECG done for a patient who’s had a seizure?

A

To look for any cardiac abnormalities causing syncope to rule it out

37
Q

How are seizures managed?

A

ABCDE approach for emergencies

Benzodiazepines

38
Q

What are some examples of benzodiazepines given to patients with seizures?

A

Lorazepam

Midazolam

39
Q

How are benzodiazepines given to patients with seizures?

A

If pre-hospital, give through cheek or rectally

If in hospital, give intravenously