Epilepsy

Question 1

Which 6 anti-epileptic drugs are not enzyme-inducing?

Answer 1

1. Sodium valproate
2. Levetiracetam
3. Gabapentin
4. Pregabalin
5. Vigabatrin
6. Tiagabine

Question 2

What are 7 differentials for seizures in pregnancy?

Answer 2

1. Epilepsy
2. Cerebral venous sinus thrombosis
3. PRES: posterior reversible encephalopathy syndrome
4. Space-occupying lesions
5. Reversible cerebral vasoconstriction syndrome
6. Syncope
7. Metabolic (hypoG, hypoNa, Addisonian crisis)

Question 3

Which 8 obstetric complications are more common in epilepsy?

Answer 3

1. Spontaneous miscarriage
2. APH
3. Hypertensive disorders
4. IOL
5. CS
6. preterm delivery
7. FGR
8. PPH

Question 4

Which 4 obstetric complications are higher in women on AEDs than with unmedicated epilepsy?

Answer 4

1. IOL
2. FGR
3. PPH
4. NICU admission

Question 5

How is a seizure lasting over 5 mins managed? (6)

Answer 5

1. Maintenance of airway & oxygen
2. Left lateral tilt
3. Benzodiazepines:
   IV loraz 4mg, again after 10-20m
   PR diaz 10-20mg, again after 15m
   bucc midaz 10mg
4. Phenytoin IV 10-15mg/kg (1g)
5. Tocolytics if hypertonus
6. CS if NVB not imminent

Question 6

What 5 side effects of AEDs can be seen in neonates?

Answer 6

1. Lethargy
2. Difficulty feeding
3. Excessive sedation
4. Withdrawal Sx
5. Inconsolable crying

Question 7

Which 3 AEDs transfer most readily into breast milk?

Answer 7

1. Lamotrigine
2. Levetiracetam
3. Topiramate