Epilepsy/ Seizures Flashcards
what is epilepsy
recurrent tendency to having episodes of abnormal electrical activity in the brain
these manifest as seizures
(there are >40 different types of epilepsy)
What is the aetiology of epilepsy
2/3 are idiopathic
structural= cortical scarring e.g. head injury, tumour, stroke
other= autoimmune e.g. SLE, sarcoidosis
What are the 5 types of seizure
Tonic-Clonic seizure= muscle tensing (tonic) followed by muscle jerking (clonic) followed by a post ictal period of drowsiness
Focal Seizure= seizure in one side of the brain- was called partial seizure. bizarre presentation- often vision problems
Absence seizures= staring blankly into space lasting for 10-30secs. often in kids
Atonic seizure= brief lapses in muscle tone-> randomly falling down- also in kids
Myoclonic Seizure= brief muscle contraction lasts for a fraction of a second but lots can happen in a short time
what is a tonic-clonic seizure and how do you treat it
muscle tensing (tonic) followed by muscle jerking (clonic) followed by a post ictal period of drowsiness
1st line= Sodium Valproate
2nd Line= Lamotrigine/ carbamzepine
what is a focal seizure and how do you treat it
seizure in one side of the brain- was called partial seizure. bizarre presentation- often vision problems
1st line= Lamotrigine/ carbamazepine
2nd line= sodium valproate
(opposite way round to tonic-clonic)
what is an absence seizure and how do you treat it
staring blankly into space lasting for 10-30secs. often in kids
1st line= sodium valproate
2nd line= lamotrigine
(same as tonic clonic)
What is an atonic seizure and how do you treat it
brief lapses in muscle tone-> randomly falling down- mainly in kids
1st line= sodium valproate
2nd line= lamotrigine
(same as tonic clonic and absence)
what is a myoclonic seizure and how do you treat it
brief muscle contraction lasts for a fraction of a second but lots can happen in a short time
aka jerk
1st line= sodium valproate
2nd line= lamotrigine
(same as tonic-clonic)
what is the general rule for treatment of seizures
1st line= sodium valproate
2nd line= lamotrigine or carbamazepine
exception is focal which is the other way around
how does sodium valproate treat seizures
increases GABA in the brain which causes relaxation by reducing GABA metabolism
(GABA inhibits neuronal activity by inhibiting nerve transmission)
what is status epilepticus and how do you treat it
seizure lasting >5mins or >3 seizures in an hour
medical emergency
IV Lorazepam (sedative)
how do you investigate epilepsy
look for provoking causes
EEG (Electroecephalography)- cant use it to excluse epilepsy as often misses stuff
MRI brain for structural lesions
