7. Epilepsy Flashcards
What is epilepsy?
Recurrent unprovoked seizures caused by excessive electrical discharge from the cerebral cortex
Classify epilepsy by mode of onset
Generalised vs focal
What are the types of generalised seizure?
Absence
Tonic clonic
Myoclonic
Atonic
Classify epilepsy by aetiology
Genetic Structural Metabolic Immune Infectious Unknown
What are the risk factors for developing epilepsy?
Febrile seizures as an infant CNS infection Trauma Family history Perinatal injury
What gene is associated with AD nocturnal frontal lobe epilepsy?
CHRNA2
What gene is associated with AD epilepsy with auditory features?
LGI 1
What factors can trigger epilepsy?
Sleep deprivation Illness Psychological distress Loud noise or music Light Hyperventilation Not adhering to anti-epileptic medication
What investigations can be done into epilepsy?
Clinical: 2+ seizures without a cause CT and MRI EEG LP if infection or inflammatory disease present Genetic studies
What is the acute treatment of epilepsy?
IV/IM/ buccal/rectal benzodiazepine and supportive
2nd line: phenytoin, levetiracetam, valprolate
What is a seizure lasting more than 5 mins known as?
Status epilepticus: medical emergency
When should long term epilepsy treatment be considered?
Not necessary if just one seizure unless abnormal EEG, remote symptomatic cause (tumour), first seizure nocturnal or abnormal neuro exam
What non-medication therapies can be considered in epilepsy?
Surgery if structural abnormality
Vagal nerve stimulator
Responsive neurostimulation device
Ketogenic diet
What is the MOA of benzodiazepines and phenobarbital?
Bind to GABA receptor
What are the adverse effects of benzodiazepines?
Sedation
Respiratory depression
Irritability
Ataxia
