Epilepsy Management Flashcards Preview

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Flashcards in Epilepsy Management Deck (18)
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1
Q

what investigations are indicated after a first fit

A

blood test and ECG
EEG- usefull for categorizing epilepsy
Sleep recordings and 24h EEG
MRI - not essential in young pts with electro-clinical diagnosis of PGE

2
Q

How can prolonged seizure or repeated seizure be terminated

A

rectal diazepam
IV lorazepam
buccal midazolam

3
Q

What is status epilepticus

A

medical emergency
Continous seizures for 30 mins or longer (or 2+ seizures without recovery of consciousness between)
Mortality 10-15 percent
Rhabdomyolisis may lead to AKI
50 percent occur without previous epilepsy history
can be absence seizures too - ie a continuous state of stuporose

4
Q

What is first line Tx for partial/focal seizures

A

carbamazepine

Lamotrigine

5
Q

What is second line/add on drugs for partial seizures

A

gabapentin
Tiagabine
Pregabalin

6
Q

What is first line treatment for absence seizures

A

Sodium valoproate

Ethosuximide

7
Q

What is first line treatment for myoclonic seizures

A

sodium valproate
levetiracetam
clonazepam

8
Q

What is first line treatment for GTCS

A

sodium valproate

levetiracetam

9
Q

What is second line/add on treatment for GTCS

A

phenobarbital

clobazam

10
Q

Which drug can make PGE worse

A

carbamazepine

Oxcarbazepine

11
Q

what are the side effects of sodium valproate

A

weight gain, tetatrogenic, hair loss, fatigue

12
Q

whne is phenytoin used

A

Acute management only eg status epilepticus

13
Q

what are the side effects ot topiramate

A

sedation
dysphasia
weight loss

14
Q

What is the side effect of levetiracetam

A

mood swings

15
Q

Which anticonvulsants induced hepatic enyzmes

A

carbamazepine, phenobarbital, phenytoin, primidone, topiramate

16
Q

Why is it important to consider the enzyme inducing effects of anticonvulsants

A

Alters efficacy of COC, progesterone implants and POP
If on depot progesterone then need more frequent dosing
morning after pill not adequete

17
Q

when can withdrawal from AEDs be considered

A

if seizure free for 2-3 yrs

50 percent reccurence rate with withdrawal

18
Q

when is surgery indicated

A

temporal lobectomy will result in seizure freedom in 50-70 percent of pts with uncontrolled seizures due to hippocampal sclerosis