Flashcards in Chapter 4 - Epilepsy Deck (119)
What does the ILAE define epilepsy as?
>2 unprovoked seizures >24h apart
One unprovoked seizure and a 60% probability of having another within 10 years
What is seizure freedom?
12 months without a seizure
What is a good therapeutic effect of an AED?
3 times the longest previous interval between seizures
Does glutamate cause an excitatory or inhibitory response?
Does GABA cause an excitatory or inhibitory response?
What are the two types of focal seizures?
Simple - remain aware
Complex - lose consciousness
What are the five main types of motor generalised seizures?
What are some signs and symptoms that may be seen in a focal seizure?
Numbness or tingling
Muscles stiffening in one area
Smelling, tasting, hearing or seeing things
There may be an aura
What is an example of a non-motor generalised seizure?
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
How long to tonic-clonic seizures last for?
Usually 1-3 mins
>5 mins is a medical emergency
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
If a person has bitten their tongue/cheek during a seizure, what type of seizure does this usually indicate?
What is a myoclonic seizure?
Brief jerks of a muscle/group of muscles
Does a person usually lose consciousness during a myoclonic seizure?
No, they are usually too short to affect consciousness
What age group do absence seizures usually occur in?
How long do absence seizures usually last?
A few seconds
What is an absence seizure?
A brief seizure that causes a lapse in awareness, e.g. the child may stare at something
What groups of people are atonic and tonic seizures seen in?
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
What is a febrile seizure?
A seizure in a child caused by a high fever
How are febrile seizures managed?
Usually with antipyretics e.g. paracetamol
>5 mins is a medical emergency (status epilepticus)
What is reflex epilepsy?
Seizures triggered by the environment
E.g. due to noises, chewing, flashing lights, sleep deprivation
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
Why isn’t an ECG used alone to diagnose epilepsy?
It can sometimes give false positive or false negative results
What is status epilepticus?
A seizure lasting >5 mins
Multiple seizures where the person doesn’t regain consciousness in between
In a person with status epilepticus, what should also be given if alcohol abuse is suspected?
What would you give for status epilepticus in the community?
What is the first treatment for status epilepticus in hospital?
When should this be repeated if it fails or if seizures reoccur?
IV diazepam (carries a high risk of thromboplebitis)
Repeat after 10mins if necessary