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Neurology week 5 > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (23)
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1

What specific aspects are important in a patient who has fallen?

Before, during and after events

Eye witness account- phone if necessary

2

Risk factors for epilepsy?

Birth
Developmental
Previous seizure (inc. febrile)
Head injury (incl LOC)
FH
Drugs
Alcohol

3

What role does examination play in 1st seizure clinics?

Little to no role, history most important

4

What should be performed in a diagnosis of syncope?

Full cardio exam including L + S Blood pressure

5

Which investigations are useful in the fallen patient?

ECG compulsary

CT or MRI brain

6

Which patients get a CT scan acutely?

Clin or radiological skull fracture
Deteriorating GCS
Focal signs
Head injury w/ seizure
Not GCS 15 after 4 hrs
Suggestion of other pathology eg SAH

7

What are the rules of driving after a seizure

1st seizure - 6 months car, 5 years HGV

Epilepsy - 1 year or 3 years during sleep, 10 years off meds for HGV

8

Features of primary generalised seizure?

Often childhood or teens

Early morning jerks
Generalised sizure
Often sleep depiravtion or flashing lights

9

Treatment for primary generalised seizure

Sodium Valproate (Teratogenic)

Lamotrigine as alternative

10

Features of focal onset epilepsy

Underlying structural cause
Focal onset at any age

Frequent complex partial seizures with hippocampal sclerosis

11

Treatment of focal onset epilepsy

Carbamazepine or lamotrigine (Not sodium valproate because S/E)

12

Side effects of sodium valproate?

Weight gain

Teratogenic

Hair loss

Fatigue

13

What effect does carbamazepine have on generalised epilepsy?

It makes primary generalised epilepsies worse

14

Disadvantage of Lamotrigine

Takes a long time to titrate dose up

15

Side effect of Levetiracetam

Can cause mood swings

16

Side effects of Topiramate?

Sedation

Dysphagia

Weight loss

17

What is the method of interaction between anti convulsants and the contraceptive pill?

They can induce hepatic enzymes which alter the efficacy of the OCP

18

What is status epilepticus

Recurrent epileptic seizures without full recovery of conciousness, can last more than 30 mins

19

What are the 3 types of status epilepticus?

Generalised convulsive status epilepticus

Non convulsive (Concious but in altered state)

Epilepsia partialis continua (Continual focal seizures, conciousness preserved)

20

Precipitants of status epilepticus

Hyponatraemia, pyridoxine deficiency

Infection

Head trauma

SAH

Abrupt withdrawal of anti convulsants

Treating absence seizures with CBZ

21

What is a convulsive status?

Generalised convulsions without cessation

Excess cerebral energy demand and poor substrate delivery causes lasting damage

22

Complications of convulsive status?

Resp insufficiency and hypoxia

Hypotension

Hyperthermia

Rhabdomyolysis

23

Which Anti convulsants in acute setting

Phenytoin
Keppra
Valproate
Benzodiazepenes