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Year 4 Longterm Conditions > Neurology - Epilepsy > Flashcards

Neurology - Epilepsy Flashcards

1
Q

What are seizures?

A

transient episodes of abnormal electrical activity in the brain

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2
Q

Investigations

A

EEG
MRI brain
ECG

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3
Q

what do tonic and clonic mean?

A

tonic - muscle tensing

clonic - muscle jerking

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4
Q

what comes first tonic or clonic phase?

A

tonic

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5
Q

associated features of generalised tonic-clonic seizures

A 
tongue biting 
incontinence 
groaning 
irregular breathing 
post-ictal period
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6
Q

post-ictal period - tonic clonic

A

prolonged

confused, drowsy and irritable

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7
Q

managing tonic-clonic seizures

A

sodium valproate

lamotrigine/carbamazepine

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8
Q

where do focal seizures start?

A

temporal lobe

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9
Q

what do focal seizures affect?

A

hearing, speech, memory and emotions

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10
Q

how can focal seizures present?

A

hallucinations
memory flashbacks
deja vu

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11
Q

treatment for focal seizures - 1st line

A

carbamazepine or lamotrigine

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12
Q

second line treatment focal seizures

A

sodium valproate

levetiracetam

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13
Q

who do absence seizures typically occur in?

A

children

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14
Q

describe an absence seizure

A

blank, stares into space and abruptly return to normal

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15
Q

treating absence seizures

A

sodium valproate or ethosuximide

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16
Q

atonic seizures

A

lapses in muscle tone

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17
Q

what can atonic seizures be indicative of?

A

lennox-gastaut syndrome

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18
Q

managing atonic seizures

A

sodium valproate

2nd - lamotrigine

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19
Q

what do myoclonic seizures typically occur as part of?

A

juvenile myoclonic epilepsy

20
Q

describe myoclonic seizure

A

sudden jump

patient usually awake

21
Q

treating myoclonic seizures

A

sodium valproate

lamotrigine, topiramate

22
Q

infantile spasms

A

rare starts at 6 months

clusters of full body spasms

23
Q

infantile spasms prognosis

A

1/3 die by 25 but 1/3 are seizure free

24
Q

treating infantile spasms

A

prednisolone

vigabatrin

25
Q

what is first line for most types of epilepsy? what is the exception?

A

sodium valproate

focal epilepsy

26
Q

how does valproate work?

A

increase GABA activity

relaxing effect on the brain

27
Q

sodium valproate side effects

A

teratogenic
liver damage and hepatitis
hair loss
tremor

28
Q

side effects of carbamazepine

A

agranulocytosis
aplastic anaemia
induces p450 - interactions

29
Q

phenytoin side effects

A

folate and vit D deficiency

osteomalacia

30
Q

ethosuximide side effects

A

night terrors

rashes

31
Q

lamotrigine side effects

A

SJS or DRESS

leuokopenia

32
Q

define status epilepticus

A

seizures lasting >5 minutes or more than 3 seizures in 1 hour

33
Q

non-pharmacological treatment status epilepticus

A

secure airway
high concentration oxygen
ABCDE - check glucose, IV access

34
Q

medical treatment status epilepticus community

A

10-20mg rectal diazepam

10mg buccal midazolam

35
Q

medical treatment status epilepticus hospital

A

IV lorazepam 4mg repeat after 10 mins

IV phenytoin or phenobarbital

36
Q

final diagnosis for people presenting with first seizure

A

25% epilepsy

syncope, single seizure, psychiatry, narcolepsy etc

37
Q

important history from patient

A 
preceding seizure 
warning symptoms 
level of awareness
first recollection 
seizure markers - tongue biting, incontinence
38
Q

3rd party history - seizure

A 
very important 
how were they before seizure
eyes open or closed
describe movements 
pallor, breathing, pulses
duration 
time to recover
39
Q

3 categories of syncope

A

reflex (neurocardiogenic)
orthostatic
cardiogenic - arrhythmia

40
Q

provoked seizures

A

alcohol/drug withdrawal
24hrs after head injury
eclampsia

41
Q

name some generalised seizures

A

tonic-clonic
myoclonic
absence
atonic

42
Q

name some focal seizures

A

simple partial
complex partial
temporal lobe

43
Q

generalised vs focal seizures

A 
generalised = no warning, under 25, absences, EEG general abnormality, FH
focal = aura, any age, MRI
44
Q

automatisms

A

lip smacking

repetitive picking at clothing

45
Q

invesigations

A

ECG, bloods (glucose)

MRI, EEG

46
Q

DVLA rules

A

single seizure - 6 month ban if investigations normal and no further events
seizure free for a year

Year 4 Longterm Conditions (32 decks)

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