Epilepsy Flashcards by Naseem Basit

What is epilepsy?

Neurological disorder

Characterised by seizures

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What is a seizure?

Signs or symptoms due to abnormal excessive electrical activity in the brain

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What are the signs and symptoms of a seizure?

Sensory disturbance

Convulsions

Loss of consciousness

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What is an aura?

Sensory disturbance

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When do auras occur?

Before a seizure begins, for some patients only

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What are some examples of an aura?

Strange light
Unpleasant smell
Confusing thoughts

Depending on which part of the brain is affected

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What are the types of seizures?

Partial

Generalised

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What is a partial seizure?

Source of seizure is localised in the brain

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What is a generalised seizure?

Source of seizure is distributed throughout the brain

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What are the types of partial seizures?

Simple

Complex

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What is a simple partial seizure?

Consciousness is maintained throughout the seizure

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What is a complex partial seizure?

Consciousness is impaired throughout the seizure

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What are some examples of partial seizures?

Temporal lobe epilepsy

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What is temporal lobe epilepsy?

Focal seizures that originate in the temporal lobe

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What age group does temporal lobe epilepsy occur in?

Young age e.g. children, adolescents

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What are the causes of temporal lobe epilepsy?

Head injury

Brain infections

What are the signs and symptoms of temporal lobe epilepsy?

Auditory or olfactory hallucinations

Rush of memories

How is consciousness affected in generalised seizures?

Loss of consciousness

What are the types of generalised seizures?

Tonic-clinic

Absence

Myoclonic

Atonic

Tonic

What is a tonic-clonic seizure?

Increased muscle tone followed by convulsions

What is an absence seizure?

Patient stops what they’re doing for a short while and then carries on as normal

What is a myoclonic seizure?

Muscle spasms with breaks in between

What is an atonic seizure?

Lack of muscle tone

What do atonic seizures look like?

Drop attacks e.g. if standing up then fall down, if sitting down then neck drops backwards

What is a tonic seizure?

Increased muscle tone

What is status epilepticus?

Epileptic seizures occurring continuously without recovery of consciousness in between

How is status epilepticus managed?

As a medical emergency

What is a convulsion?

Uncontrolled shaking movement due to rapid repeated contraction and relaxation of muscles

How is epilepsy diagnosed?

History EEG MRI head ECG

What are the parts of a history for a patient who’s had a seizure?

Before the seizure e.g. past medical history, family history, triggers, aura, first sign or symptom During the seizure e.g. description of seizure, duration, abrupt or gradual end, maybe by a collateral history After the seizure e.g. post-ictal state, tongue biting, incontinence, neurological deficit

Why is an MRI head done for a patient who’s had a seizure?

To look for structural changes in the brain to rule out other causes

Why is an EEG done for a patient who’s had a seizure?

To support the diagnosis The assess the risk of seizure recurrence

How is an EEG done for a patient who’s had a seizure?

Use photic stimulation e.g. flashing lights, hyperventilation to induce a seizure

If an EEG of a patient who’s had a seizure gives unclear results, what is done?

Repeat standard EEGs Do sleep EEGs or when the patient is sleep-deprived Ambulatory EEG, done when patient is at home

What are some other conditions that may also cause seizures?

Vascular - stroke, transient ischaemic attack Infection - abscess, meningitis, febrile seizure Trauma - intracerebral haemorrhage Metabolic - hypoxia, hypoglycaemia, electrolyte imbalance Iatrogenic - drugs Neoplastic - intracerebral tumour

Why is an ECG done for a patient who’s had a seizure?

To look for any cardiac abnormalities causing syncope to rule it out

How are seizures managed?

ABCDE approach for emergencies Benzodiazepines

What are some examples of benzodiazepines given to patients with seizures?

Lorazepam Midazolam

How are benzodiazepines given to patients with seizures?

If pre-hospital, give through cheek or rectally If in hospital, give intravenously