Epilepsy Flashcards Preview

Neurology > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (29):
1

What causes seizures?

Imbalance in inhibitory/excitatory currents/neurotransmission in the brain

2

Precipitants (5)

Flashing lights
drugs
sleep deprivation
metabolic
cryptogenic

3

Key features from history

Before- what was happening? Prodrome?
During- aura, onset, duration, loss, of consciousness, tongue biting, incontinence
After- recovery, any residual weakness

4

Main classification of seizures (2)

Partial (focal onset) or generalised (throughout cortex)

5

What proportion of partial/focal seizures go on to become generalised?

Around 2/3rds

6

Brief pauses of around 10 seconds, present in childhood

Absence seizures

7

Loss of consciousness, limbs stiffen and then jerk

Tonic-clonic seizures

8

Todd's palsy

Post-ictal flaccid weakness seen in focal frontal lobe seizures

9

Investigations in epilepsy (3)

CT (if fracture, head injury, deteriorating GCS, focal signs)
ECG
EEG

10

Atonic seizure

Sudden loss of muscle tone, causing fall, with no LOC

11

How long must a patient be seizure-free in order to drive?

At least one year

12

Definition of status epilepticus

Seizures lasting for more than 30 mins, or repeated seizures without intervening consciousness

13

Status usually occurs in...

Known epileptics

14

Management of status (3)

Manage ABC (DEFG)
Rectal diazepam (10mg adult dose)
2nd line- phenytoin, valproate

15

What type of drug is lorazepam and how does it work?

Long-acting Benzodiazepene
Works by enhancing GABA binding to its receptor, causing a widespread depression of synaptic transmission

16

Why would thiamine be considered in treatment of status?

Alcoholics and malnourished are often thiamine-deficient

17

When should anti-epileptic therapy be commenced?

After a second seizure

18

Treatment of choice in generalised juvenile epilepsy

Sodium valproate

19

Treatment of choice in partial epilepsy?

Carbamazepine

20

Side effects of sodium valproate (4)

Teratogenicity
Hair loss
Weight gain
Fatigue

21

First-line in generalised tonic-clonic epilepsy (2)

Sodium valproate or lamotrigine

22

What can be the issues for women of child-bearing age taking AEDs? (2)

Can alter effectiveness of the oral contraceptive pill and morning after pill
Teratogenicity

23

Possible severe side effect of lamotrigine

Stevens Johnson syndrome

24

Difference between simple and complex partial seizures

In complex, awareness is impaired and there is more likely to be post-ictal symptoms e.g. confusion

25

In a history of a first seizure what should be enquired?

Whether there has ever been any similar "funny turns"

26

When can anti-epileptic drugs be stopped?

Two years seizure-free, drugs stopped over 2-3 months under supervision of a specialist

27

DDx of seizure? (5)

Epilepsy
Isolated due to brain insult e.g. infection, trauma, metabolic
Febrile convulsions
Alcohol withdrawal
Psychogenic non epileptic seizures

28

What characterises a generalised seizure?

Immediate loss of consciousness

29

Treatment of absence seizures?

Sodium valproate or ethosuximide