Epilepsy Flashcards

(45 cards)

1
Q

What is it

A

Condition where brain is affected by recurrent seizures

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2
Q

Types of seizures

A

Partial

Generalised

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3
Q

Describe partial seizure

A

Seizure that occurs in one discrete part of the brain

These seizures may be simple or complex

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4
Q

What is meant by a partial seizure being simple or complex

A

Simple - Without alteration in consciousness

Complex - With alteration in consciousness

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5
Q

Describe generalised seizure

A

Seizures that affect the brain globally

Consciousness is always altered

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6
Q

Examples of generalised seizures

A
Absence seizure
Tonic-clonic seizure
Atonic seizure
Myotonic
Secondary generalised
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7
Q

Describe Absence seizure

A

Often picked up in children who ‘stare into space’

Usually only lasts for afew seconds

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8
Q

Describe Tonic-clonic seizure

A

Involves convulsions and muscle rigidity

Usually lasts minutes

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9
Q

Describe Atonic seizure

A

Involves a loss of muscle tone

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10
Q

Describe myotonic seizure

A

Involves jerky muscle movement

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11
Q

Describe secondary generalised seizure

A

Generalised seizure that originates from a partial seizure

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12
Q

Cause of seizures

A

Abnormal paroxysmal neuronal discharges in the brain, which result from some form of traumatic brain injury.
These discharges display hypersynchronisation.

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13
Q

3 types of causes of epilepsy

A

Idiopathic
Cryptogenic
Symptomatic

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14
Q

What is meant by idiopathic cause

A

Cause is unknown

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15
Q

What is meant by cryptogenic cause

A

Cause is unknown

Signs suggesting it may be linked to brain injury e.g. patient has autism or learning difficulties

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16
Q

What is meant by symptomatic cause

A

Cause known

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17
Q

Symptomatic causes of epilepsy

A
VINDICATE
Vascular - history of stroke
Infection - history of meningitis or malaria
Neoplasms - brain tumour
Drugs - alcohol and illicit drug use
Iatrogenic - drug withdrawal
Congenital - family Hx of epilepsy
Autoimmune - vasculitis
Trauma - history of brain injury
Endocrine - Low Na+, Low Ca2+ or Loe/High Glucose
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18
Q

What do Signs and symptoms of epilepsy depend on

A

The region of the brain affected

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19
Q

Signs and symptoms of seizure affecting frontal lobe

A

JAM
Jacksonian march
pAlsy (postictal Todd’s palsy)
Motor features

20
Q

Signs and symptoms of seizure affecting the temporal lobe

A
ADD FAT
Aura that the epileptic attack will occur
Deja vu
Delusional behaviour
Fear/panic (hippocampal involvement)
Automatisms
Taste/smell - uncal involvement
21
Q

Signs and symptoms of seizure affecting the temporal lobe - what part of brain is also involved is presentation of Fear/Panic

22
Q

Signs and symptoms of seizure affecting the parietal and occipital lobe

A

Visual and sensory dsturbances

23
Q

Other Signs and symptoms of seizure (not resulting from seizures of particular lobes of brain)

A

Partial or generalised seizure with or without convulsions
Tongue biting
Migraines
Depression

24
Q

Investigations

A

Bloods - FBC, U and Es, LFTs, ESR, glucose, calcium levels
Radiology - CT scan, MRI scan
Other - ECG, LP, EEG

25
Conservative treatment
``` Patient and family education Inform DVLA (UK) ```
26
Medical treatment
Anticonvulsant therapy
27
Surgical treatment
Anterior temporal lobe resection Corpus callosotomy Tumour removal
28
Examples of Anticonvulsants
``` Carbamazepine Phenytoin Sodium valproate Ethosuximide Phenobarbital ```
29
How does carbazepine or phenytoin work
Blocks voltage dependent Na+ channels
30
How does ethosuximide work
Inhibits T-type Ca2+ channels
31
How does phenobarbital work
Acts of GABA receptors - enhancing synaptic inhibition
32
Complications
``` Injuries whilst having seizure Depression Anxiety Brain damage Sudden unexplained death in epilepsy (SUDEP) ```
33
Differential diagnosis
``` Migraine Hypoclycaemia Dystonia Cardiogenic syncope Hyperventilation ```
34
Is it epilepsy? | Causes of blackouts
Primary disturbance of brain function | Secondary disturbance of brain function
35
Examples of secondary disturbances of brain function
Low blood pressure | Related to heart
36
Examples of primary disturbances of brain function
Dissociative/non-epileptic seizures (psychological) | Epileptic seizures
37
Types of epileptic seizures
Genetic generalised epilepsy Unclassifiable epilepsy Structural/metabolic epilepsy
38
What is an Epileptic seizure
Paroxysmal event in which changes of behaviour, sensation or cognitive processes are caused by excessive (too much voltage), hypersynchronous neuronal discharges in the brain
39
Duration of epileptic seizure
30-120 seconds
40
Features of epileptic seizures
Postictal symptoms (Positive-itcal symptoms) Stereotypical seizures May occur from sleep May be associated with other brain dysfunction
41
What is meant by postictal symptoms
"positive" of something (feeling touch when not being touched; hearing something thats not there etc) - opposite of negative symptoms
42
Examples of typical seizure phenomena
Lateral tongue bite | Deja vu
43
Differences between an epileptic and non-epileptic seizure
Non-epileptic tends to last longer Eyes open in Epileptic Non-epileptic involved hip thrusting Incontinence associated with Epileptic
44
Pathophysiology of an epileptic seizure
Excessive, unsynchronised neuronal discharges | Causes paroxysmal changes in behaviour, sensation and cognitive processes
45
Example of antiepileptic and side effect
Carbamazepine | Heart problems