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The One Deck To Rule Them All > Seizures > Flashcards

Seizures Flashcards

(56 cards)

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1
Q

Genetics for Neurofibromatosis Type 1

A

Autosomal Dominant
Chromosome 17
Affects 1/4000

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2
Q 
Neurofibromas
Cafe-au-lait spots
Axillary freckling (Crowe's sign)
Liche nodules (Iris hamartomas)
Developmental delay 
Scoliosis
Pheochromocytomas
A

Neurofibromatosis Type 1

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3
Q

Genetics for Neurofibromatosis Type 2

A

Autosomal Dominant
Chromosome 22
Affects 1/ 100,000

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4
Q

Multiple intracranial schwannomas
- Bilateral acoustic neuromas
Meningiomas
Ependymomas

A

Neurofibromatosis Type 2

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5
Q

Genetics for Tuberous Sclerosis

A

Autosomal dominant
TSC1 Gene: Hamartin protein
TSC2 Gene: Tuberin protein

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6
Q 
Poliosis (patch of grey hair)
Angiofibromas (Adenoma sebaceum)
  - Butterfly rash of small spots
Ash leaf spots (depigmented lesions)
  - Fluoresce under UV light (Wood's lamp)
Shagreen patches (rough skin over lumbar spine)
Sub/peri-ungal fibromata (under nails)
Cafe-au-lait spots
Developmental delay
A

Tuberous Sclerosis

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7
Q

Tuberous Sclerosis is associated with

A 
Seizures
Rhamdomyomas in heart 
Gliomas in brain 
PCKD
Hamartomas in retina 
     - dense white areas (phakomata)
Lymphangioleiomyomatosis in lungs
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8
Q

Age 4-8 months
Repeated flexion + extension (salaam attacks)

  • up to 50
  • Last a few seconds
A

Infantile spasms (West Syndrome)

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9
Q

Investigations for infantile spasms

A

EEG: dramatic hypsarrhythmia
CT: diffuse or localised brain disease
- tuberous sclerosis

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10
Q

Management for infantile spams (West syndrome)

A

Poor prognosis
Vigabatrin
ACTH

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11
Q

Teenage girls
Infrequent generalised seizures (morning)
Daytime absences
Sudden shock like myoclonic seizures

A

Juvenile myoclonic epilepsy (Janz syndrome)

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12
Q

Management for Juvenile myoclonic epilepsy (Janz syndrome)

A

Sodium valproate

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13
Q

Paraesthesia upon waking up

- usually unilateral face

A

Benign rolandic epilepsy

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14
Q

1-5 years old
Hx of infantile spasms
Severe mental disability
Atypical absences, falls and jerks

A

Lennox-Gastaut Syndrome

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15
Q

Investigations for Lennox-Gastaut Syndrome

A

EEG: Slow spike

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16
Q

Management for Lennox-Gastaut Syndrome

A

Ketogenic diet may help

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17
Q

Signs favouring pseudo-seizures

A 
Pelvic thrusting
Crying post seizure
Gradual onset
Doesn't occur when alone
FHx of epilepsy 
Female
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18
Q

Widespread convulsions with absence of decreased consciousness

A

Pseudo-seizure

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19
Q

Investigation for pseudo-seizure

A

Video recording

Prolactin should be low (prolactin is raised in true seizures)

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20
Q

Febrile convulsions are associated with

A

Acute epiglottis

Roseola infantum

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21
Q

Tonic clonic seizure in 6 months - 5 year olds

- occur early in viral infections

A

Febrile convulsion

  • 3% of kids
  • 30% reoccur
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22
Q

Management of febrile convulsions

A

> 5 mins or first seizure = call 999
If recurrent: Rectal diazepam
Buccal midazolam

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23
Q

Seizure > 5 mins

2 seizures within 5 mins

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A

Status epilepticus

24
Q

Management of status epilepticus in community

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A 
Buccal midazolam (mouth)
Rectal diazepam (derrière)
25
Management of status epilepticus in hospital
IV Lorazepam - repeat every 10 mins IV Phenytoin - start cardiac monitoring
26
When can you stop taking medication for epilepsy
Seizure free for > 2 years + meds being stopped for 2-3 months
27
Stiff seizure
tonic
28
Jerky seizure
Clonic
29
2 main types of seizures
Generalised (primary) | Focal
30
5 types of Generalised seizures (primary)
``` Absence Myoclonic Tonic-Clonic Tonic Atonic ```
31
3 - 10 year olds Female Unresponsive staring multiple times a day Hx of stress/ hyperventilation
Absence seizure | - "Petit mal"
32
Contraindicated in Absence and Myoclonic seizures
Carbamazepine - worsens seizure
33
EEG in Absence seizures
Bilateral spike pattern
34
Management of Absence seizures
1. Sodium valproate 2. Ethosuximide Self resolve in adulthood
35
Muscle jerk seizures
Myoclonic seizure
36
Management of Myoclonic seizures
1. Sodium valproate 2. Clonazepam Lamotrigine
37
Tongue biting Groaning Incontinence Post-ictal period
Tonic-clonic seizure
38
Management for tonic-clonic seizures
1. Sodium valproate 2. Lamotrigine Carbamazepine
39
Drop attack seizures
Atonic seizures
40
Activity in both sides of the brain | Consciousness is lost
Primary generalised seizures
41
Management for primary generalised seizures
1. Sodium valproate | 2. Lamotrigine
42
Activity in one side of the brain
Focal seizure
43
Management for focal seizures
1. Carbamazepine Lamotrigine 2. Levetiracetam Oxcarbazepine Sodium valproate
44
Consciousness is not lost = aware No control over movement (twitching of hand) Memory flashbacks Post-ictal weakness (Todd's Paresis)
Focal seizures
45
Non-motor focal seizures
Deja vu | Jamais vu
46
Motor focal seizures
Jacksonian march
47
Starts on one side of the brain then moves to both sides Focal > generalised seizure
Secondary generalised seizure - common for focal impaired awareness seizures
48
``` Smacking lips (automation) Memory of seizure is unclear/ altered ```
Focal impaired awareness seizure - can progress to secondary generalised seizure
49
Sensory seizures are located in | - parasthesia
Parietal lobe
50
Visual seizures are located in - floaters - flashes
Occipital lobe
51
HEAD seizures are located in Hallucinations Epigastric/emotional Automatisms Deja vu/ dysphagia (post-ictal)
Temporal lobe
52
Motor seizures are located in - Movements - Posturing - Post-ictal weakness (Todd's paresis) - Jacksonian march
Frontal lobe
53
Driving: First unprovoked seizure
if no abnormalities: 6 months off | if abnormalities: 12 months off
54
Driving: Established epilepsy
1 year seizure free = can drive
55
Driving: Stopped epilepsy medication
6 months off
56
Driving: Any seizures in HGV driver
10 years off

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