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Flashcards in Epilepsy Deck (28):
1

What visible things are important to note in a patient with a fall?

Pallor, breathing
posturing of limbs
Head turning

2

What are the different types of movements?

Tonic phase
Clonic movements
Corpopedal spasms
Rigor

3

What type of seizure is this: In bed, staring at onset of attack, unresponsive, had movements of upper limbs, some kicking of lower limbs

Generalised tonic-clonic seizure

4

What are important questions to ask regarding epilepsy?

Birth and development
Past seizures icluding febrile C
Head injuries
FHx, drugs, alcohol

5

What should always be taken with a first seizure?

ECG - look for abnormality such as Prolonged QT syndrome

6

Who gets an acute CT scan?

Clinical/Radiological skull fracture
Deteriorating GCS
Focal signs
Head injury with seizure
Suggestion of other pathology
Failure to be GCS 15/15 4 hours after arrival

7

How long can't you drive for if you've had a first seizure?

Car = 6 months
HGV/PCV = 5 years

8

How long can't you drive for if you are diagnosed with epilepsy?

Car = 1 year/3 years during sleep
HGV/PCV = 10 years off all medication

9

Do most epilepsies have a genetic predisposition about them?

Yes

10

What is seen with epilepsy on an EEG?

Generalsied spike-wave abnormalities, usually in a child or adolescence

11

When does primary generalized epilepsy present?

Childhood or teens

12

What is the treatment of choice for primary generalized epilepsy?

Sodium Valporate or Lamitrigine

13

Give and describe an example of a primary generalized epilepsy

Juvenile Myoclonic Epilepsy - early morning jerks
generalized seizures
Risk factors include sleep deprivation and flashing lights

14

When can focal onset epilepsy present?

Any age

15

What are possible treatments for focal onset epilepsy?

1st line = Carbamazepine or Lamotrigine
2nd line = Sodium valporate

16

Give 3 examples of old anticonvulsants?

Phenytoin - enzyme inducer, acute management
Sodium Valporate - many side effects
Carbamazepine = focal onset seizures, can worsen primary generalzied epilepsies worse

17

Give some examples of new anticonvulsants

Lamotrigine - generalized and focal epilepsies
Levetiracetam - can cause mood swings
Topiramate - Sedation and dysphasia are caused
Gabapentin/Pregabalin - more for neuropathic pain

18

What should women on anti-convulsants be warned about?

Alter the efficacy of combined oral contraceptive pill
Should use progesterone only pill

19

What isn't effective if on Enzyme Inducing AEDs?

Morning after pill

20

What is non-convulsive status?

Conscious but in altered state

21

What is Epilepsia partialis continua?

Continual focal seizures, consciousness preserved

22

What are other causes of a seizure?

Severe metabolic disorders - hyponatraemia, pyridoxine deficiency
Infection
Head trauma
Sub-arachnoid haemorrhage
Abrupt withdrawl of anti-convulsants

23

How long does syncope take to recover?

Seconds

24

How long does a seizure take to recover?

Minutes to hours

25

What seizures can a focal epilepsy cause?

Focal or generalised seizures

26

What seizures can generalised epilepsy cause?

Generalised seizure

27

How does an epilepsy be generalised?

The electrical signals hit a pathway and spread to a different part of the brain affecting that as well

28

What is sudden death caused by epilepsy called?

SUDEP