Epilepsy Flashcards
What is the sensitivity of a single EEG
<50%
Choice of antiepileptics for partial seizures:
sodium channel antagonists
- carbamazepine
- oxcarbazepine
- lamotrigine
- phenytoin
Choice of antiepileptics for generalised seizures:
valproate, levetiracetam, topiramate, lamotrigine, phenobarbitol
Which antiepileptic has the highest rate of congenital malformations?
Sodium valproate 1-2% risk of neural tube defects (especially >1g per day), plus neurodevelopmental delay
Additionals:
Lamotrigine - cleft palate
Phenytoin - fetal hydantoin syndrome
Carbamazepine - seen in 1% of exposed pregnancies
What is Dravet’s syndrome?
Epilepsy syndrome
refractory epilepsy and neurodevelopmental problems from infancy
associated with SCN1A gene
What is Lennox-Gastaut syndrome?
Epilepsy syndrome
treatment resistant epilepsy and intellectual disability.
Multiple seizure types, many genetic causes
What is juvenile myoclonic epilepsy?
Myoclonic jerks, generalised tonic-clonic seizures, abesnce seizures
Occurs in adolescents, usually upon waking when sleep deprived
EEG shows bilateral polyspike and slow wave discharges
Treatment is with valproate (caution in females / pregnancy), other options: levetiracetam, lamotrigine, topiramate.
What is juvenile myoclonic epilepsy?
Myoclonic jerks, generalised tonic-clonic seizures, abesnce seizures
Occurs in adolescents, usually upon waking when sleep deprived
EEG shows bilateral polyspike and slow wave discharges
Treatment is with valproate (caution in females / pregnancy), other options: levetiracetam, lamotrigine, topiramate.W
What antiepileptic should be avoided in JME?
carbamazepine, phenytoin, oxcarbazepine - worsen partial seizures
HLA associated with Carbamazepine associated SJS/TEN
What ethnic group is this most commonly associated with?
HLA-B15:02
Asian / Han chinese
