Epilepsy Flashcards
(25 cards)
What are seizures?
transient episodes of abnormal electrical activity in the brain
What are the 5 key types of seizures in adults?
tonic clonic
partial/ focal
myoclonic
tonic
atonic
absence
Describe the key features of generalised tonic clonic seizures.
muscle tensing and jerking
complete loss of consciousness
aura pre seizure = tongue biting, incontinence, groaning, irregular breathing
post ictal phase = confusion, tired, irritable, low
Which region of the brain do partial seizures most commonly affect?
temporal lobes
How are tonic clonic seizures treated?
sodium valproate
in women of child baring age = lamotrigine or levetiracetam
How are partial seizures treated?
lamotrigine or levetiracetam
Describe a partial seizure.
affects hearing, speech, memory, emotion
remain awake
loose awareness
symptoms depend on location:
de ja vu
strange smells, taste, sight or sound
unusual emotions
abnormal behaviours
Describe a myoclonic seizure
typically occurs in the morning after sleep deprivation
sudden brief muscle contractions
remain awake
What drugs are used to treat myoclonic seizures?
sodium valproate
in women of child baring age = levetiracetam
Describe a tonic seizure
sudden onset of increased muscle tone where the entire body stiffens
fall backwards
lasts few secs to mins
What drugs are used to treat tonic seizures?
sodium valproate
women of child baring age - lamotrigine
Describe atonic seizures
awake
brief
fall
sudden loss of muscle tone
often begin in childhood
What drugs are used to treat atonic seizures?
sodium valproate
women of child baring age = lamotrigine
Give a summary of the drugs used to treat the different type of seizures.
sodium valproate = atonic, tonic, myoclonic, generalised tonic clonic
women of child baring age= lamotrigine in tonic and atonic, levetiracetam in myoclonic, and either in generalised tonic clonic and partial seizures
Describe an absence seizure
blank, stares into space, abruptly returns to normal
unaware of surroundings and don’t respond
lasts for 10-20 seconds
usually stop having these as you get older
What drug can be used to treat absence seizures?
ethosuximide
What investigations should be carried out after a seizure?
electroencephalogram
MRI
What are the DVLA rules for epilepsy?
remove drivers licence until seizure free for 1 year
What is the danger with sodium valproate? And when should it be prescribed?
increased risk of neurodevelopment disorders in children fathered by men taking sodium valporate
shouldn’t be prescribed to males or females under 55 unless there is no suitable alternative
Give examples of less commonly used anti epileptic drugs.
carbamazepine
phenytoin
topiramate
How does sodium valporate work? And what are the side effects?
increases the activity of GABA - has a calming effect
harmful in pregnancy
liver damage and hepatitis
hair loss
tremor
reduce fertility
What effects does sodium valporate during pregnancy cause?
neural tube defects
developmental delay
What defines status epilepticus?
a seizure lasting more than 5 mins
or multiple seizures without regaining consciousness in between
how do you manage status epilepticsu?
give high flow oxygen
check blood glucose
gain IV access
give benzodiazepine
repeat after 5-10 minutes if seizure continues
