Flashcards in Epilepsy NOT FINISHED Deck (26)
1
How do you determine the class of seizure
location of onset, type of discharge, pattern of spread
2
describe the 2 types of seizures
partial( starts in a focus and spreads) and generalised (boths hems)
3
list the type of generalised seizures
typical absence, myoclonus, tonic clonic, atypical absence tonic, atonic
4
describe an absence seizure
mainly childhood onset
frequent short lived brief attacks
sudden loss and return of consciousness
no aura no post ictal
some involuntary movement eg walking around, gaze everted
5
describe a myoclonus
sudden bilateral arm jerking, often worse in the mornings, precipitated by sleep deprivation and alcohol
6
when does myoclonus occur
epilepsy syndromes and certain non epileptic causes
7
describe tonic clonic seizures
sudden onset fall. tonic phase - muscles stiffen
clonic phase limbs jerk. tongue bitten and incontinence, noisy breathing. headache and muscle pain after
8
describe an atonic seizure
muscles suddenly lose strength and you drop
very short and common in children
9
what does atonic seizure often occur in
learning disability
10
name the 3 categorise of partial seizures
simple - aware
complex - areness lose
2y generalised - evolves to TC
11
Describe a temporal lobe seizure
AURA - epigastric rising, olfactory gustation, deja vu
SEIZURE - blank stare, oral + manual automatisms (lip smacking and movements)
POST ICTAL
12
describe a frontal lobe seizure
wild vocalisation, quick recovery, movement (twisting grimicing) upper limbs tonic clonic
13
process of a seizure in relation to a neurone
1. initiation - increased frequency ossilations
2. depolarisation
3. oscillation
4. synchronisation - local and long range effect (synaptic and non synaptic e.g. gap junctions)
5. termination - synaptic inhibition
14
What goes wrong in absence seizures?
bursts of abnormal activity from the cortex --> thalamus
reticular nucleus inhibiting TC relay
15
drugs that can worsen absence seizures
carbamezapine, phenytoin, baclofen
16
what causes some epilepsys
mutations in Na channels therefor increased function
17
Name 4 mechanisms of epilepsy treatments
promote inhibition (benzodiazepines)
reducing gaba reuptake - longer inhibition
increasing potassium channels
blocking AMPA receptors
18
difference between idiopathic epilepsy and symptomatic epilepsy + how they respond to treatment
Idiopathic - no associated neurological damage
responds well to treatment
Symptomatic - treatment resistant - neurological deficit?
19
name some causes of symptomatic epilepsy
cerebal palsy, stroke, tumors, trauma, hoppocampal sclerosis
20
what must you do when starting epilepsy treatment
start low dose and explain side effects and interactions
21
main treatment for general epilepsy and partial epilepsy
G - sodium valproate
P - carbamazepine
22
describe carbamazepine
what is it NOT helpful for
1 -ve
acts on sodium channels to suppress bursts
absence and myoclonus
causes enzyme induction
23
Which seizure is valproate used for
1-ve
myoclonus, absence and photosensitive seizures
important side effect, especially women ( affects fertility)
24
phenytoin
not helpful for
not good for myoclonus and absence, inhibs Na channels, causes some enzyme induction
25
what is lamotrigine
new first line for G and P
26