Epilepsy (include pharmacology) Flashcards
(52 cards)
What is epilepsy?
Epilepsy is the most common neurological disorder, characterised by recurrent seizures
How many different types of seizures are there?
Over 40
How can you diagnose epilepsy?
EEG/MRI/CAT(CT) (hard to see anything in an MRI or CAT scan
According to the international league against epilepsy (ILAE), what are the main categories of epilepsy?
Focal and generalised
What are the characteristics/auras of a temporal onset of seizure?
Auras: smell/taste, ‘déjà vu’, ‘jamais vu’, emotional changes
Oral automatisms: gestures eg dystonic or fidgetting
What are the characteristics/auras of a frontal onset of seizure?
Motor seizures: Brief, frequent, cluster,
Often bilateral eg kicking, cycling, violent, bizarre. Head version
Commonly on waking from sleep
What are the characteristics/auras of a parietal onset of seizure?
Sensory seizures: somatosensory (tingling/warmth)
Auras: Nausea, choking, sinking sensations, Illusions of body distortion
Look at these symptoms: Visual hallucinations – simple or complex (shapes to scenes)
Vision may black out
Visuo-spatial distortions
Head turning, headache, nausea
An epilepsy induced from which location would get these symptoms?
Occipital
What is the main characteristic of focal aware seizures?
No loss of consciousness or post-ictal confusion
Which lobe of the brain are focal aware seizure mostly found?
Temporal lobe
What are the main characteristic of focal with impaired awareness seizures?
Altered consciousness, but may seem fully aware. There may be some post-ictal confusion
May experience auras
If the patient presented with automatisms (chewing, swallowing, repeated displacement behaviour), what type of focal seizure is this?
Focial with impaired awareness
Which lobe of the brain are focal with impaired awareness seizures mostly found?
Temporal lobe
What are the two types of jacksonian seizures?
Focal aware motor and focal aware sensory
What are the characteristics of a focal aware motor (jacksonian) seizure?
Short-lasting, ripple of muscle activity, may be localised to one group of muscles or progress, usually distal to proximal, through the limbs and trunk (following HAL)
What are the characteristics of a focal aware sensory (jacksonian) seizure?
Short lasting sensory changes, may be localised to one area or progress, usually distal to proximal, through the limbs and trunk (following HAL)
What are the characteristics of a focal to bilateral tonic clonic seizure?
Focal seizure progressing to generalised (tonic-clonic)
If a patient presented with unilateral motor effects during the seizure and experienced an aura prior to the onset, what type of seizure do they have?
Focal to bilateral tonic clonic
What are the symptoms of a generalised tonic clonic seizure?
Tonic phase - whole body stiffness, breathing may stop (cyanosis), loss of bladder control
Clonic phase – muscle jerks
Followed by unconsciousness, muscle relaxation, slow regain of consciousness, confusion, sleepy, headaches and aching limbs, no recall of episode
What is a generalised obsence seizure?
Rare in adults, generally starts between 6-12 yrs
Girls > Boys
Symptoms: seem to ‘switch-off’ but cannot be alerted or woken up
Whole brain involved, low level activity
Responds well to anti-epileptics
Why is a status epilepticus generalised tonic clonic seizure treated as a medical emergency?
Whole brain involved
Ictal period of > 5 mins
Repeated seizures with no recovery between (>30 mins)
Other forms: long-lasting, absence or focal-type seizures
What is the type of seizure which Sav, Risheka and Arpita have?
Generalised myoclonic - sudden jerks (like when falling asleep), possibly familial
What are the symptoms of each form of seizure?
Generalised clonic
Generalised tonic
Generalised Atonic
Generalised clonic – repeated twitches and jerks no stiffness
Generalised tonic – all muscle contract, whole body stiffness
Generalised Atonic – ‘drop attacks,’ muscle tone lost
How can you diagnose an NEAD?
Diagnosis can be made through a video EEG. There may be differences in: Duration Eye opening Location of tongue biting - tips Recollection