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Neurology: Headaches and Epilepsy COPY > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (29)
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1

Give 7 risk factors for epilepsy.

birth, development, previous seizure (including febrile fits), alcohol, drugs, FH

2

What in social history is particularly relevant?

driving
occupation

3

Would you examine in 1st seizure clinics?

no

4

What is important in diagnosis of syncope?

cardiovascular examination and BP important

5

What is an absolute mandatory investigation for the fallen?

ECG

6

When would you do a CT scan acutely?

focal signs
skull fracture
not returned to 15/15 GCS 4 hrs after injury
head injury with seizure

7

How long post seizure should you not drive?

1st seizure – car = 6 months, 5 years for HGV/PCV

8

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

9

IS generalized epilepsy likely to be genetic?

yes

10

Treatment for primary generalized epilepsy?

Sodium valproate treatment of choice, but
teratogenic. Lamotrigine as alternative.

11

Describe the symptoms of primary generalized epilepsy e.g. juvenile myoclonic epilepsy.

– Early morning jerks
– Generalized seizures
– Risk factors: sleep deprivation, "flashing light

12

What may be helpful in identifying subtype of epilepsy?

EEG

13

Age of onset of primary generalized epilepsy?

childhood/teens

14

Age of onset of focal onset epilepsy?

any age

15

What is treatment for focal onset epilepsy?

Carbamazepine or lamotrigine

16

Why is sodium valproate not first line for focal onset epilepsy?

side effects (stomach irritation, unsteadiness, tremor, weight gain)

17

Are focal onset seizures frequent?

yes

18

What type of seizures occur with focal onset epilepsy?

complex partial seizures with
hippocampal sclerosis

19

Is lamotrigine well tolerated?

yes

20

An issue with Lamotrigine?

Takes a long time to titrate up

21

Issue with levatiracetum?

can cause mood swings

22

Side effects of topiramate?

Sedation, dysphasia, weight loss

23

Gabapentin, Pregabalin are used less as anticonvulsants and more for what?

neuropathic pain

24

Do anticonvulsants induce hepatic enzymes?

some do yes

25

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

26

Symptoms of primary generalized epilepsy?

bit clumsy and jerky in the
mornings recently, e.g. dropping hairbrush or coffee cup.

27

What is status epilepticus?

Recurrent epileptic seizures without full recovery of
consciousness
Continuous seizure activity lasting more than 30
minutes

28

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)

29

What 4 things can convulsive state cause?

- respiratory insufficiency and hypoxia
– hypotension
– hyperthermia
– rhabdomyolysis