Epilepsy Flashcards
(26 cards)
What is epilepsy?
A neurological condition characterised by recurrent seizures due to episodes of abnormal electrical activity in the brain.
Defined as 2 or more unprovoked epileptic seizures more than 24 hours apart.
What are the differentials for epilepsy?
- Non epileptic attack disorder
- Alcohol withdrawal
- Hypoglycaemia/metabolic
What are seizures?
Transient episodes of abnormal electrical activity in the brain.
What types of seizure are generally seen in adults?
- Generalised tonic-clonic seizures
- Focal seizures
- Myoclonic seizures
- Tonic seizures
- Atonic seizures
What types of seizure are more common in children?
- Absence seizures
- Infantile spasms
- Febrile convulsions
What are tonic-clonic seizures?
Involve** tonic (muscle tensing) and clonic (muscle jerking) movements** associated with complete loss of consciousness.
Patients may experience aura before, and there may be **tongue biting, incontinence, groaning & irregular breathing.
- Prolonged post-ictal period where person is confused, tired, irritable or low.
What are focal seizures?
Occur in an isolated brain area, often temporal lobes, affecting hearing, speech, memory & emotions. Patients remain awake.
How can focal seizures present?
- Hallucinations
- Memory flashbacks
- Deja vu
- Doing strange things on autopilot
What are myoclonic seizures?
Sudden, brief muscle contractions (jerk, twitch, like a sudden jump) but the patient remains awake.
What are tonic seizures?
Sudden onset of increased muscle tone where the entire body stiffens, causing a fall, but lasts only a few seconds.
What are atonic seizures?
Sudden loss of muscle tone, often resulting in a fall, also known as ‘drop attacks’. They don’t last more than 3 minutes.
What are absence seizures?
Usually seen in children where the patient becomes blank, stares into space, and then returns to normal.
They are unaware of surroundings and don’t respond, typically lasting 10-20 seconds.
What are infantile seizures?
West syndrome, which is rare, characterised by clusters of full body spasms.
Hypsarrhythmia is a characteristic EEG finding and is associated with developmental regression.
At what age do infantile spasms start?
In infancy at around 6 months.
What is the characteristic EEG finding for infantile spasms?
Hypsarrhythmia.
What are febrile convulsions?
Tonic-clonic seizures that occur in children during a high fever and are not caused by epilepsy or other pathology.
They typically occur between the ages of 6 months to 5 years.
What are the differentials for seizures?
- Vasovagal syncope
- Pseudoseizures
- Cardiac syncope
- Hypoglycaemia
- Hemiplegic migraine
- TIA
What investigations are done for seizures?
- EEG - electroencephalogram
- MRI brain
- ECG - to exclude heart problems
- Serum electrolytes
- Blood glucose
- Blood cultures, urine cultures & lumbar puncture if sepsis, encephalitis or meningitis is suspected.
What information does a patient need to know when diagnosed with epilepsy?
- DVLA remove license until seizure criteria are met.
- Showers > baths - drowning is a major risk factor.
- Caution with swimming, heights, traffic.
- Caution with heavy, hot or electrical equipment.
What is the treatment for epilepsy?
How does sodium valproate work?
Increases activity of GABA.
What are the side effects of sodium valproate?
- Teratogenic
- Liver damage
- Hair loss
- Tremor
- Reduced fertility
What is status epilepticus?
A medical emergency defined as either a **seizure lasting more than 5 minutes **or multiple seizures without regaining consciousness.
What is the management for status epilepticus?
- Secure airway
- High concentration O2
- Check blood glucose levels
- IV access
