Neurology - Epilepsy Flashcards
(28 cards)
What are the main types of seizures seen in adults?
- Generalised tonic-clonic seizures
- Partial seizures (focal seizures)
- Myoclonic seizures
- Tonic seizures
- Atonic seizures
What types of seizures are more common in children?
- Absence seizures
- Infantile spasms
- Febrile convulsions
What characterises generalised tonic-clonic seizures?
Involves tonic (muscle tensing) and clonic (muscle jerking) movements
Complete loss of consciousness
Grand mal seizures
Patient may experience an aura
What can occur during a seizure?
Tongue biting
Incontinence
Groaning
Irregular breathing
What is an aura in relation to seizures?
An abnormal sensation that gives a warning that a seizure will occur
What happens during the post-ictal period after a seizure?
The person may be confused, tired, and irritable or low
What are partial seizures?
Focal seizures
Occur in isolated part of the brain, often the temporal lobe
Patient remains awake
Remain aware during simple partial seizures
Lose awareness during complex partial seizures
What symptoms can be associated with partial seizures?
- Déjà vu
- Strange smells, tastes, sights, or sounds
- Unusual emotions
- Abnormal behaviours
What are myoclonic seizures characterised by?
Sudden, brief muscle contractions, like an abrupt jump or jolt
Remain awake
Can occur as part of juvenile myoclonic epilepsy in kids
What occurs during tonic seizures?
Sudden onset of increased muscle tone, resulting in stiffness of the entire body
Causes a fall if patient is standing, usually backwards
Lasts only a few seconds or minutes
What are atonic seizures?
Drop attacks
Sudden loss of muscle tone causing a fall
Last only briefly
Patient are aware
Being in childhood
What happens during absence seizures?
Usually seen in children
The patient becomes blank, stares into space, and then abruptly returns to normal
Unaware of surroundings and do not respond
Lasts 10-20 seconds
Most stop having seziures as they get older
What are infantile spasms?
West syndrome
Starts at 6 months of age
Presents with clusters of full-body spasms
Asscoiated with developmental regression and poor prognosis
Treatment with ACTH and vigabatrin
What is the characteristic EEG finding in infantile spasms?
Hypsarrhythmia
What are febrile convulsions?
Tonic-clonic seizures that occur in children during a high fever
Not due to any underlying pathology
Cause no lasting damage
1/3 will have another febrile convulsion, slightly increased risk of epilepsy
What age group is most affected by febrile convulsions?
Children aged between 6 months and 5 years
What investigations are used for epilepsy?
EEG
MRI brain - diagnose structural pathology
ECG
Serum electrolytes
Blood glucose - hypoglycaemia and diabetes
Blood culutres, urine cultures and LP - sepsis, encephalitis or meningitis
What safety precautions should be advised to patients with seizures?
- Remove driving licence until criteria are met (must be seizure-free for one year)
- Take showers instead of baths (major risk of drowning)
- Caution with swimming, heights, traffic, and dangerous equipment
What is the goal of epilepsy treatment?
To be seizure-free on the minimum anti-epileptic medications, ideally monotherapy
Complete the table
What are some less common anti-epileptic drugs used for epilepsy?
Carbamazepine
Phenytoin
Topiramate
How does sodium valproate work?
Increases GABA activity- calming effect on the brain
What notable side effects are associated with sodium valproate?
- Teratogenic effects
- Liver damage and hepatitis
- Hair loss
- Tremor
- Reduced fertility
What does sodium valproate cause in pregnancy?
Neural tube defects
Developmental delay
