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Neurology Year 3 > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (53)
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1

What is the approach to a fallen patient.

History- Patient and eye witness before and after
Onset - environment and what they looked like
Event itself - movement, responsiveness awareness
Afterwards - Speed of recovery deficits

2

List some risk factors for epilepsy.

Difficult birth
Seizures in the past
Head injury
Drugs

3

Why is social history very important?

Driving is illegal whilst uncontrolled and un medicated need to alert the DVLA.

4

List some respiratory drugs which can trigger a fit.

Theophyline
Aminophyline

5

Give an example of an analgesic that can precipitate a fit.

Tramadol

6

Give an example of an anti emetic which can trigger a fit.

Prochlorperazine

7

Which opioid can trigger a fit?

Diamorphine

8

What investigations should someone who has presented with a new onset seizure/fall undergo?

ECG
CT/MRI

9

Why is an ECG so important for someone who has fallen?

To rule out syncope or Long QT syndrome all of which can present with falls.

10

When is a CT used instead of an MRI?

Residual focal signs
Trauma - e.g. skull fractures
Faling GCS
Suggestion of other pathology

11

List some differential diagnosis for epilepsy.

Syncope
Panic attack
Sleep phenomena
TIA
MIgraine
Hypoglycaemia
MS - tonic spasms

12

What is epilepsy?

The tendency to have recurrent usually spontaneous epileptic seizures.

13

In counselling the patient what should be explained?

Seizures doesn't mean epilepsy is certain
Risk of recurrence
Driving and the risks

14

What is the physiology behind an epileptic fit?

Abnormal synchronisation of neuronal activity. Causing focal or generalised cessation of normal activity.

15

What is the most common cause of lack of synchronisation behind epilepsy?

Too much excitatory AP
Too much inhibitory is rarer

16

Focal seizures can be divided into what?

Simple - no impairment of consciousness
Dicognative - impaired consciousness

17

Focal Motor seizure

Rhythmic jerking.
Head and eye deviation
Vocalisation

18

Focal Sensory Seizure

Auras - floating lights
Somatosensory changes

19

Conscious Focal Seizures

Deja Vu
Depersonalisation
Hallucination

20

What is the physiology behind focal seizures.

Due to structural abnormality i.e too many synaptic connection

21

How can focal seizures become generalised?

If the AP irritates enough tissue it can be propagated throughout the brain.

22

When do most people present with Primary Generalised Epilepsy?

Childhood early teens

23

How do most people with Primary generalised epilepsy present?

Early morning jerks
Generalised Seizures

24

What are risk factors for triggering a seizure in someone with Primary Generalised Epilepsy?

Sleep deprivation
Flashing Lights

25

Are EEGs useful in Primary Generalised Epilepsy?

Yes as they can help identify the subtype

26

What is the mainstay of treatment for someone with Primary Generalised Epilepsy?

Sodium Valproate

27

If someone with Primary Generalised Epilepsy is looking to conceive what must happen?

Sodium Valproate stopped before trying to conceive as it is teratogenic.
Lamotrigine is used

28

A Focal seizure which has become a generalised seizure is classified as what?

Secondary Generalised

29

Focal seizures present themselves at what age?

Any age

30

How do Focal Seizures present?

Frequent complex seizures
Hippocampal Sclerosis