Chapter 4 - Epilepsy Flashcards Preview

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Flashcards in Chapter 4 - Epilepsy Deck (119)
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1

What does the ILAE define epilepsy as?

>2 unprovoked seizures >24h apart

Or

One unprovoked seizure and a 60% probability of having another within 10 years

2

What is seizure freedom?

12 months without a seizure

3

What is a good therapeutic effect of an AED?

3 times the longest previous interval between seizures

4

Does glutamate cause an excitatory or inhibitory response?

Excitatory

5

Does GABA cause an excitatory or inhibitory response?

Inhibitory

6

What are the two types of focal seizures?

Simple - remain aware
Complex - lose consciousness

7

What are the five main types of motor generalised seizures?

Tonic-clonic
Tonic
Clonic
Myoclonic
Atonic

8

What are some signs and symptoms that may be seen in a focal seizure?

Kicking
Rocking
Altered vision
Numbness or tingling
Muscles stiffening in one area
Smelling, tasting, hearing or seeing things
Behavioural changes

There may be an aura

9

What is an example of a non-motor generalised seizure?

Absence

10

What happens during a tonic-clonic seizure?

Muscles contract and the body becomes rigid

Loss of consciousness and falling to the floor

Violent muscle contractions

11

How long to tonic-clonic seizures last for?

Usually 1-3 mins
>5 mins is a medical emergency

12

Do people always recover straight away after a tonic-clonic seizure?

No, it can take a while to recover

The person may feel confused, tired, agitated etc

13

If a person has bitten their tongue/cheek during a seizure, what type of seizure does this usually indicate?

Generalised tonic-clonic

14

What is a myoclonic seizure?

Brief jerks of a muscle/group of muscles

15

Does a person usually lose consciousness during a myoclonic seizure?

No, they are usually too short to affect consciousness

16

What age group do absence seizures usually occur in?

Children

17

How long do absence seizures usually last?

A few seconds

18

What is an absence seizure?

A brief seizure that causes a lapse in awareness, e.g. the child may stare at something

19

What groups of people are atonic and tonic seizures seen in?

Children
Epilepsy syndromes

20

What are tonic and atonic seizures?

Tonic - rigidity/stiffness, usually happens I’m in sleep

Atonic - the body goes limp e.g. head may drop, eyelids mag drop, the person may drop items that they are holding

21

What is a febrile seizure?

A seizure in a child caused by a high fever

22

How are febrile seizures managed?

Usually with antipyretics e.g. paracetamol

>5 mins is a medical emergency (status epilepticus)

23

What is reflex epilepsy?

Seizures triggered by the environment

E.g. due to noises, chewing, flashing lights, sleep deprivation

24

How is epilepsy diagnosed?

Speak to the patient and any witnesses (especially if they were unconscious)

ECG - but don’t use this alone to diagnose epilepsy

25

Why isn’t an ECG used alone to diagnose epilepsy?

It can sometimes give false positive or false negative results

26

What is status epilepticus?

A seizure lasting >5 mins

Or

Multiple seizures where the person doesn’t regain consciousness in between

27

In a person with status epilepticus, what should also be given if alcohol abuse is suspected?

Thiamine

28

What would you give for status epilepticus in the community?

Rectal diazepam
Buccal midazolam

29

What is the first treatment for status epilepticus in hospital?

When should this be repeated if it fails or if seizures reoccur?

IV lorazepam
IV diazepam (carries a high risk of thromboplebitis)

Repeat after 10mins if necessary

30

In status epilepticus, if seizures are still occur 25mins after giving IV lorazepam/diazepam, what would you do?

Either:
IV phenytoin
IV fosphenytoin
IV phenobarbital