epilepsy

Question 1

when can you drive if you have epilepsy ? for car and HGV

Answer 1

one year seizure free - car
HGV - 10 years seizure free and off meds

Question 2

when can you drive if youve had a single seizure

Answer 2

car - 6months
HGV - 5 years

Question 3

what are the broad categories of seizures

Answer 3

focal and generalised

Question 4

if a seizure starts on on eside of the brain and spreads bilaterally what is it called

Answer 4

focal to bilateral seizure

Question 5

if someone has a motor focal seizures where is it occuring in the brain

Answer 5

frontal libe

Question 6

if someone has a sensory seizure where is it occuring

Answer 6

parietal lobe- parastehsia

Question 7

if someone has a jamais vu seizure where is it occuring

Answer 7

temporal lobe

Question 8

what are automatism symptoms in temporal lobe seizures

Answer 8

lip smacking and plucking

Question 9

a focal seizure in what lobe has an aura and what would this typically be

Answer 9

temporal - rising feeling in stomach

Question 10

what would a frontal lobe focal seizure present as

Answer 10

motor - jacksonian march, post ictal weakness, posturing , hand and leg moveemnt

Question 11

what are the terms used to describe awareness in focal seizures

Answer 11

focal aware
focal impaired awareness

Question 12

what tends to cause focal seizures and who gets them

Answer 12

due to structural brain abnormality e.g post trauma or MS or Tumour

older adults

Question 13

when would anti-epileptics tend to be started

Answer 13

after second seizure

Question 14

for generalised tonic clonic seizures what is first line treatment

Answer 14

sodium valproate
women - lamotrigene or levetiracetam

Question 15

treatment of juvenile myoclonic epilepsy

Answer 15

sodium valpraote

Question 16

treatment of absent seizures

Answer 16

ethosuximide

Question 17

treatment of focal seizures

Answer 17

lamotirgene or levetiracetam

Question 18

mechanism of action for sodium valproate

Answer 18

enhances GABA synthesis

Question 19

what shoudl females with myoclonic seizured get

Answer 19

levetiracetam

Question 20

side effect of lamotrigene

Answer 20

stevens johnson syndrome

Question 21

is breastfeeding safe on anti-epileptics

Answer 21

yes but not barbituates

Question 22

what should pregnant women taking phenytoin be given and why

Answer 22

vit k in last month to prevent clotting disorders of the newborn

Question 23

what contracpetion can women on any anti-epileptic have

Answer 23

Depo IUd, IUs

Question 24

what contracetion can women on lamotigene have

Answer 24

depo, IUS, IUD , POP, IMPLANT

Question 25

what is status epilepticus defined as

Answer 25

a single seizure lasting >5 minutes, or >= 2 seizures within a 5-minute period without the person returning to normal between them

Question 26

management of status epilepticus - in community and hospital

Answer 26

ABC prehospital setting PR diazepam or buccal midazolam in hospital IV lorazepam is generally used

Question 27

how long after Iv lorazepam can more benzos be given in status

Answer 27

10-20 mins

Question 28

if benzos unsuccessgul at terminating status what may be given ? what is done if this is unsucessful adn after how long

Answer 28

phenytoin or phenobarbitol infusion 45mins then general ansthetsia

Question 29

how many rounds of benzos can be given in status

Answer 29

ONLY TWO

Question 30

what doese of benzos are given in status

Answer 30

4mg lorazepam IV 10mg buccal or rectal

Question 31

what are pseudoseizures or functional seizures called

Answer 31

psychogenic non epileptic seizures