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3 Neurology > Epilepsy 1 > Flashcards

Epilepsy 1 Flashcards

(58 cards)

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1
Q

best way to take a seizure history

A

find out what happened before, during and after the event

take a collateral history

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2
Q

feel woozy and slump to the ground and get back up suggests…

A

syncope

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3
Q

stiff, rigid, spasming on the ground suggests a….

A

seizure

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4
Q

what should you ask in the O section of SOCRATES in a seizure history?

A

what were they doing?

what did they look like when it happened

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5
Q

what movements should you ask about in a seizure history

A

stiff/rigid movements
head turning right to the left
rigors

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6
Q

a tonic clonic seizure looks like…

A

rigid, stiff body with rigors and jerking

eyes open

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7
Q

risk factors for epilepsy

A 
birth problems
development
seizures in the past eg febrile fits
head injury
FH
drugs
alcohol
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8
Q

what should be covered in the social history

A

driving

occupation

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9
Q

what would you examine in a suspected epileptic patient

A

neurological exam

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10
Q

what drugs can precipitate epileptic seizures?

A 
penicillins, cephalosporins, quinolones
anti-emetics
opioids
tramadol
theophylline
the pill
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11
Q

main Ix of someone with a seizure

A

ECG

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12
Q

what cardiac syndrome can cause seizures

A

long QT syndrome

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13
Q

when would you image someone with a seizure acutely?

A

skull fracture
GCS going down
head injury
suggested pathology intracerebrally

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14
Q

an EEG is an essential investigation for someone with a seizure T or F

A

F, very ineffective

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15
Q

when would you do an EEG on a patient?

A

classify epilepsy (NOT TO DIAGNOSE IT)
confirm non-epileptic attack
confirm non-convulsive status

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16
Q

differentials for epilepsy

A

syncope
non-epileptic attack
panic attack
sleep phenomena

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17
Q

define epilepsy

A

a condition in which you have recurrent epileptic seizures

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18
Q

what are the driving regulations for someone with a seizure (not epilepsy)

A

dont drive for 6 months

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19
Q

what are the driving regulations for someone with epilepsy who has seizures while awake

A

cant drive for 6 months

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20
Q

what are the driving regulations for someone with eplepsy while asleep

A

can maybe still drive if its been more than a year since the last attack

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21
Q

pathophysiology of epileptic seizures

A

abnormal discharge of electricity in the brain from excitatory neurons with high freq APs

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22
Q

what is a focal seizure

A

abnormal electrical discharge only affecting 1 part of the brain

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23
Q

what is a generalised seizure

A

abnormal electrical discharge affecting more than 1 part of the brain

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24
Q

a fit lasting more than _ mins is pathological

25
how long do epileptic seizures last
secs-mins
26
main incidence of epilepsy
infancy and 50-80yrs old
27
name the only jobs you cant do if youve got stable epilepsy
pilot a plane | carry a firearm for the military
28
causes of death for epileptics
aspiration cardiac event slowed brain function which eventually stops
29
there are _ types of epilepsy, what are they?
2 focal generalised
30
what is the problem in focal epilepsy
one part of the brain is structurally abnormal which causes focal seizures and if the seizure hits a pathway/cortical network you can also get generalised seizures
31
what is the problem in generalised epilepsy
abnormality in the brain pathways, NOT structural problem so you get generalised seizures
32
those with a genetic disposition of epilepsy are more likely to get ___ epilepsy
generalised
33
name the types of generalised seizures
``` absence myoclonic atonic tonic tonic clonic ```
34
if both arms are tonic, what is happening to the brain?
must be an abnormal electric discharge in the motor cortices of the brain on both sides
35
what is clonus?
uncoordinated, shaking movement that becomes worse; happens because the abnormal electrical activity becomes less active after a while so it a form of abnormal relaxation
36
in a tonic clonic fit, does tonicity or clonus happen first
tonicity
37
sensory focal seizures described as..
a sensory problem that cannot be described well by the patient because it is abnormal i.e not stabbing, not warm sensation
38
what epilepsy is more common over the age of 50? why?
focal | the older you get the more likely you are to have a structural abnormality
39
what are the 3 types of focal epilepsy?
motor sensory psychic eg memories
40
generalised epilepsies tend to manifest under the age of __
30
41
Tx for primary generalised epilepsy
sodium valproate
42
main contraindication to sodium valproate?
teratogenicity
43
what drug can be given as a substitute for sodium valproate?
lamotrigine
44
contraindications to carbamazepine?
on the pill
45
presentation of juvenile myoclonic epilepsy
early morning jerks generalised seizures triggered by sleep deprivation, flashing lights
46
Tx of focal onset epilepsy
carbamazepine
47
__ of patients will have drug resistant epilepsy
1/3
48
Tx for absence seizures
sodium valproate
49
Tx for myoclonic seizures
sodium valproate levetiracetam clonazepam
50
Tx for atonic, tonic, generalised tonic clonic seizures
sodium valproate
51
what drug should never be given for a generalised seizures
carbamazepine
52
side effects of sodium valproate
weight gain teratogenic hair loss fatigue
53
what epileptic drug can cause mood swings?
levetiracetam
54
when should you treat an epileptic seizure
only if theyve had recurrent seizures ie epilepsy | increased risk if theres only been 1
55
what epileptic drugs can affect womens contraception? what should be done
carbamazepine topiramate AVOID PROG-PILL, give higher dose of contraception
56
the morning after pill doesnt work for epileptics T or F
T
57
what should be given to epileptic women preconceptually ?
high dose folic acid
58
hippocampal sclerosis is a type of __ epilepsy
focal

3 Neurology (41 decks)

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