epilepsy Flashcards

(33 cards)

1
Q

what are the types of seizures?

A

myoclonic seizures
tonic clonic
atonic
generlaised tonic -clonic
partial or focal seizures

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2
Q

what seizures are most common in children?

A

febrile
absence
infantile spasms

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3
Q

what are tonic clonic seizures?

A

tonic - muslce tensing
clonic - muscle jerking
associated with complete loss of consciousness

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4
Q

what is involved within tonic clonic seizures?

A

aura - warning pre seizure
during; tongue bititng, incontinence, groaning and irregular breathing
post ictal: confused, tired, irritable and low

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5
Q

where do partial seizures occur?

A

one area in the brain - usual temporal

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6
Q

what does partial seizures affect?

A

hearing, speech, memory, emotions

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7
Q

what occurs during partial seizures?

A

remain awake
can remain aware in simple but lose awareness in complex partial seizures

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8
Q

what symptoms occur during partial seizures?

A

deja vu
strange smells, taste, sights or sound sensation
unusual emotions
abnormal behaviours

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9
Q

what are myoclonic seizures?

A

sudden, brief msucle contractions like abrupt, jump or jolt
remain awake

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10
Q

what are tonic seizure’s?

A

sudden onset of increased muscle - often results in fall
last briefly
begin in childhood

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11
Q

what are atonic seizures?

A

drop attacks - sudden loss in muscle tone - results in a fall

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12
Q

what are absence seizures?

A

usually in children
Patient becomes blank, stares in space
then abruptly returns to normal
do not respond and unaware of surroundings

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13
Q

what are infantile spasms?

A

also known as west syndrome
presents at 6mths
clusters of full body symptoms

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14
Q

how do you detect infantile spasms?

A

hypsarrhthymias - on EEG

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15
Q

how is infantile spasms managed?

A

associated with developmental regression and has poor prognosis
treat with ACTH and vigabatrin

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16
Q

what are febrile convulsions?

A

tonic clonic seizures occurring in children with high fevers

17
Q

are febrile convulsions linked to epilepsy?

A

do not cause lasting damage
have a slight risk of developing epilepsy

18
Q

how do you investigate epilepsy and why?

A

EEG: typical patterns show different forms of epilepsy
MRI brain: diagnose structural pathology
ECG
serum electrolytes- sodium, potassium , calcium and magnesium
blood glucose: hypoglycaemia and diabetes
blood cultures, urine cultures and LP

19
Q

what general management need to be taken with seizures?

A

DVLA remove their driving licence - until seizure free for one year
taking showers rather than baths
caution with swimming, heights, traffic and dangerous equipment

20
Q

for men, what is 1st line management for generalised tonic -clonic?

A

sodium valproate

21
Q

for women of childbearing age, what management should they have for generalised tonic clonic seizures?

A

lamotrigine
levetiracetam

22
Q

what management is given for partial or focal seizures?

A

lamotrigine
levetiracam

23
Q

what medication is given in myoclonic seizures?

A

sodium valproate - men
levetiracim - women of childbearing age

24
Q

what medication is given to tonic atonic seizures?

A

men- sodium valproate
women of childbearing age - lamotrigine

25
what medication should be given to absence seizures?
ethosuximide
26
how does sodium valproate work?
increasing activity of GABA - calming effect on the brain
27
what are the side effects are sodium valproate?
teratogenic - harmful in pregnancy liver damage and hepatitis hair loss tremor reduce fertility
28
why is sodium valproate tetrogenic?
neural tube defects and developmental delay
29
what is valproate pregnancy prevention?
ensure effective contraception fill out annual acknowledgement form
30
how do you define status epilepticus?
seizure lasting more than 5mmins mulitple seizures without regaining consciousness between
31
how do you manage status epilepticus?
ABCDE secure airway high flow oxygen check BMs gaining IV cannula
32
what are medical management for status epilepticus?
benzopdiazepines - repeat after 5-10 mins after seizures second line - after benzo = IV levetiracetam, phenytoin, sodium valproate third line - phenobarbita or GA
33