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Neurology SOH > Epilepsy > Flashcards

Epilepsy Flashcards

(54 cards)

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1
Q

Epilepsy = seizure. True or false?

A

False

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2
Q

What is a seizure

A

Abnormal discharge of electrical activity in the brain

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3
Q

What is epilepsy?

A

Tendency to get recurrent seizures

Interruption of normal brain activity due to abnormal synchronisation of neuronal activity

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4
Q

Epileptic attacks are usually long/short?

A

Short

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5
Q

Focal seizures - definition

A

Discharge is confined to one area of the brain and doesn’t spread elsewhere.
Part of the brain is structurally abnormal which causes irritation and focal seizures in that area.

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6
Q

Simple focal seizure vs complex focal seizure

A

Simple - without impaired consciousness

Complex - with impaired consciousness

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7
Q

Focal epilepsy is more common in younger/older people?

A

Older

- because as you get older, you are more likely to have a structural brain abnormality

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8
Q

Generalised seizure - definition

A

Discharge spreads to more than 1 area of the brain.

There is more than one pathway involved.

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9
Q

Generalised seizures start a which networks?

A

Cortical networks

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10
Q

Generalised epilepsy is more common in younger/older people?

A

Younger

- has a genetic predisposition

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11
Q

Name the seizure: patient gets interrupted from participating in an activity and gives a vacant blank stare then resumes to activity

A

Absence seizure

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12
Q

What does myoclonus mean?

A

Body jerks

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13
Q

What is an atonic seizure?

A

Patient collapses to the ground and looses muscle tone

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14
Q

What are the characteristics of a tonic seizure?

A

Patient’s body goes rigid

There is an abnormal discharge in both motor cortices in the brain

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15
Q

Describe a tonic clonic seizure

A

Initially part of the body goes rigid and then later, the clonic component (jerking) occurs

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16
Q

Types of movements

A 
Stiff 
Rigid
Jerking 
Tongue biting 
Urinary incontinence
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17
Q

Questions to ask about after the event?

A

How long did it take to recover?

Sleepiness/disorientation

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18
Q

Which types of drugs can precipitate seizures?

A

Antibiotics

Tramadol

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19
Q

If a patient presents with their first seizure, they are routinely examined. True or false?

A

False

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20
Q

What are the rules of driving after first seizure?

A

Can’t drive car for 6 months

Can’t drive HGD/PCV for 5 years

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21
Q

For anyone who presents with a seizure, what is the first line investigation?

A

ECG

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22
Q

Imaging

Study These Flashcards
A

MRI scan

CT scan

23
Q

EEG - what is it

Study These Flashcards
A

Stick electrodes on the head and look for brainwave changes

24
Q

EEG is a useful investigation. True or false?

25
What are the 4 purposes of EEG
How you classify someone's epilepsy To confirm non-epileptic attacks Surgical evaluation Conformation of non-convulsive status
26
You should do an EEG in anyone under 30. Why is this?
To differentiate between generalised and focal seizures
27
Management of focal epilepsy
Carbamazepine | Lamotrigine
28
Considerations of drugs with carbamazepine
Makes contraceptive pill and morning after pill less effective
29
Generalised epilepsy management
Sodium valproate | Lamotrigine
30
Sodium valproate - side effets
Teratogenic
31
Sodium valproate is more/less effective than lamotrigine.
More
32
Management of generalised epilepsy - which drug is used more often: lamotrigine, sodium valproate?
Lamotrigine
33
What is the first line treatment in generalised epilepsy
Lamotrigine
34
Why must you start low and go slow with lamotrigine dosage?
If you start immediately on a high dose then it can cause steven johnson syndrome
35
Management of absence seizures
Sodium valproate | Ethosuximide
36
Management of myoclonic seizures
Sodium valproate | Clonezapam
37
Patients on anti-convulsant medication should avoid which contraceptive pill?
Progesterone only pill
38
Anti-convulsants affect the efficacy of the combined oral contraceptive pill and the morning after pill. True or false?
True
39
Status epilepticus - definition
Recurrent epileptic seizures without full recovery of consciousness
40
Status epilepticus - onging seizure activity for over _____ mins
30
41
Status epilepticus - causes
Abrupt withdrawal from anti-convulsants Head trauma Sub-arachnoid haemorrhage Infections
42
Management of status epilepticus - if controlled
50ml 50% glucose if there is any suggestion of hypoglycaemia IV thiamine if there is any suggestion of alcohol abuse or nutrient insufficiency
43
SUDEP - definition
Sudden Unexpected Death in Epilepsy
44
SUDEP - risk factors
Increased seizure frequency Aspiration Nocturnal seizures Poor compliance with medications
45
Non epileptic attack - definition
Unable to envisage where in the brain the abnormal discharge is coming from
46
Non epileptic attack - causes
Traumatic events Physical/Sexual abuse Stress, anxiety, depression
47
Non epileptic attacks - clinical features
``` Coordinated movements - patient kicks legs - pelvic thrusts Patient has no control of the attacks Patient is conscious Patient is definite and absolute in what they experience ```
48
Manage non epileptic attacks with anti-convulsants. True or false?
False | - these make the attacks worse
49
Management of non epileptic attacks
Counselling | The patient will only recover once they accept what the underlying trauma is
50
Nocturnal seizures are always the same. True or false ?
True
51
``` A patient presents with hypo pigmented skin, generalised seizures and fibromatas. What is the most likely diagnosis? A men2 B men1 C neurofibromatosis 1 D neurofibromatosis 2 E tuberous sclerosis ```
Tuberous sclerosis
52
Which anticonvulsant should never be given in generalised epilepsy? Sodium valproate Lamotrigine Carbamazepine
Carbamazepine
53
Febrile convulsions are a recognised risk factor for the development of focal onset seizures in which brain lobe in later life?
Temporal lobe
54
``` Which type of seizure involves characteristic pelvic thrusting and head turning movements? Epilepsia partialis continua Non epileptic disorder Primary seizure Generalised seizure Status epilepticus ```
Non epileptic disorder

Neurology SOH (31 decks)

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