8: Epilepsy - seizures, syndromes and differentials Flashcards Preview

Neurology Week 3 2018/19 > 8: Epilepsy - seizures, syndromes and differentials > Flashcards

Flashcards in 8: Epilepsy - seizures, syndromes and differentials Deck (75)
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1

What are the differences between a faint (syncope) and a seizure?

Syncope:

Startled look, falls to the ground, unresponsive but little/no movement, awakens and is quickly back to normal

Seizure:

Abnormal vocalisations / sensations / movements +/- loss of consciousness, slow to recover

2

When taking a funny turn history, ask what happened ___, ___ and ___ the event.

before, during and after

3

___ accounts are helpful for determining the cause of a collapse.

Eyewitness

4

What should you ask about the onset of a funny turn?

What were you doing at the time?

How did you feel?

What did you look like?

5

If a patient is having recurring events, what could you ask them to give you?

Video

Eyewitness account

6

What are some risk factors for epilepsy?

Birth / developmental problems

Hx head injury, tumours

Hx seizure (including febrile!)

Fx epilepsy

7

Can people with a diagnosis of epilepsy drive?

No

A person with active epilepsy needs to stop driving and inform the DVLA

8

An epilepsy diagnosis has consequences for a patient's ___.

occupation

9

What should you examine in a patient presenting with syncope?

Full cardio exam

Blood pressure

10

What are some notable drugs which may precipitate seizures?

Analgesics e.g tramadol

Antibiotics

Anti-emetics

Opioids

if a patient has worsening seizures, check these before adjusting anticonvulsants

11

What investigation must you get for someone with new onset seizures?

ECG

12

Why is obtaining an ECG important in anyone with new onset seizures?

Arrhythmias (e.g long QT syndrome) cause cerebral hypoperfusion, precipitating seizures

13

In which case would a patient presenting with a seizure get an immediate CT scan?

Serious acute underlying pathology is suspected cause

e.g head trauma, haemorrhage, stroke, tumour

Persistently low GCS after admission

14

What is an EEG?

Electroencephalography 

like an ECG for your brain, "brain waves"

15

Are EEGs used to diagnose epilepsy?

No

16

What are EEGs used for?

Classification of epilepsy

Confirming non-epileptic attacks

Confirming non-convulsive status epilepticus

 

17

What are some epilepsy mimics?

Syncope

Non-epileptic attacks

Panic attacks

TIAs

Hypoglycaemia

 

18

What is epilepsy?

Tendency to have spontaneous, recurring epileptic seizures

19

What is an epileptic seizure?

UNPROVOKED abnormal discharges of electricity in the brain

20

Are the electrical discharges in an epileptic seizure excitatory or inhibitory?

Usually excitatory

21

What does focal epileptic seizure mean?

Discharge affects one area of the brain only

22

What does generalised epileptic seizure mean?

Discharge affects several areas of the brain

23

At what ages do patients typically develop

a) focal

b) generalised

epilepsy?

a) focal - older patients

b) generalised - children and teens

24

What is SUDEP?

Sudden death syndrome re: epilepsy

25

Patients with epilepsy are (more likely / less likely) to die than normal patients.

Why?

more likely

aspiration; nocturnal seizures; drink and drug problems, depression and suicide; learning difficulties

26

What is a focal seizure?

Discharge remains in one part of the brain

causing a focal epilepsy

27

What causes focal epilepsy?

Structural abnormality in one part of the brain

28

Focal epilepsy causes seizures with symptoms relating to the ___ of the brain the structural abnormally is in.

Area

e.g motor sensory visual memory

29

What is a generalised seizure?

Discharge propagating via pathways to multiple areas of the brain

30

Can focal epilepsy cause generalised seizures?

Yes, if discharge propagates via pathways