Flashcards in Epilepsy Deck (29)
Give 7 risk factors for epilepsy.
birth, development, previous seizure (including febrile fits), alcohol, drugs, FH
What in social history is particularly relevant?
Would you examine in 1st seizure clinics?
What is important in diagnosis of syncope?
cardiovascular examination and BP important
What is an absolute mandatory investigation for the fallen?
When would you do a CT scan acutely?
not returned to 15/15 GCS 4 hrs after injury
head injury with seizure
How long post seizure should you not drive?
1st seizure – car = 6 months, 5 years for HGV/PCV
How long if epileptic should you not drive?
1 year for a normal car and awake when the seizure occurred
3 years for a normal car but the seizure occurred during sleep
10 years without seizures and cannot be on medication for HGV/PCV
IS generalized epilepsy likely to be genetic?
Treatment for primary generalized epilepsy?
Sodium valproate treatment of choice, but
teratogenic. Lamotrigine as alternative.
Describe the symptoms of primary generalized epilepsy e.g. juvenile myoclonic epilepsy.
– Early morning jerks
– Generalized seizures
– Risk factors: sleep deprivation, "flashing light
What may be helpful in identifying subtype of epilepsy?
Age of onset of primary generalized epilepsy?
Age of onset of focal onset epilepsy?
What is treatment for focal onset epilepsy?
Carbamazepine or lamotrigine
Why is sodium valproate not first line for focal onset epilepsy?
side effects (stomach irritation, unsteadiness, tremor, weight gain)
Are focal onset seizures frequent?
What type of seizures occur with focal onset epilepsy?
complex partial seizures with
Is lamotrigine well tolerated?
An issue with Lamotrigine?
Takes a long time to titrate up
Issue with levatiracetum?
can cause mood swings
Side effects of topiramate?
Sedation, dysphasia, weight loss
Gabapentin, Pregabalin are used less as anticonvulsants and more for what?
Do anticonvulsants induce hepatic enzymes?
some do yes
What can anticonvulsants affect in women?
efficacy of OCP
- do not use progesterone only pill/implant
depot needs to be more frequent
morning after pill not effective
Symptoms of primary generalized epilepsy?
bit clumsy and jerky in the
mornings recently, e.g. dropping hairbrush or coffee cup.
What is status epilepticus?
Recurrent epileptic seizures without full recovery of
Continuous seizure activity lasting more than 30
3 types of status epilepticus?
1.Generalized convulsive status epilepticus
2.Non convulsive status (conscious but in “altered state”)3.Epilepsia partialis continua (continual focal seizures, consciousness preserved)