25 Epilepsy Flashcards
What are the 3 main types of epilepsy?
- Partial seizures
- Generalised seizures
- Status epilepticus
Outline the ‘partial seizures’ type of epilepsy?
Patient retains conciousness (but can be impaired)
Symptoms include:
- Involuntary muscle disturbances
- Auras
- Behavioural changes
Outline the ‘generalised seizures’ type of epilepsy?
Electrical charge changes across both hemipheres of brain
Loss of conciousness
Types include:
- Tonic-clonic
- Absence
What is status epilepticus? Why is it a medical emergency? What do you need to be mindful of?
CAN OCCUR WITH ANY TYPE OF EPILEPSY Seizures= prolonged (>5 mins) or repeated without recovery intervals
Medical emergency- brain uses up all resources and hypoxia occurs
Be mindful:
- Can lead to death/death months later due to effects on the brain
- Rhabdomyolysis- muscle contractions could lead to AKI
What is epilepsy?
Discharge of abnormal electrical activity in brain leading to a seizure.
(Diagnosis requires recurrent seizure activities)
What causes epilepsy?
Mostly idiopathic
Secondary causes (most commonly seen in elderly):
- Vascular disease
- Tumours
What can precipitate an epileptic fit?
Flashing lights
Brain injury
Drugs and alcohol
Sugar levels
Drugs
Anti-epileptic drugs are teratogenic.
Which one is the safest to use in pregnancy?
Which one can specifically cause neural tube defects?(What can be given to reduce these risks)
What should be given as a supplement in the third trimestre (if mother on antiepileptics)?
Safest in pregnancy:
- Lamotrigine
Neural tube defects:
- Valproate (give folate supplement)
Give Vitamin K supplement
- Anti-epileptic drugs associated with Vitamin K deficiency in new borns- coagulopathy and haemorrhage
What should we give first line in each case?:
Partial seizure
Generalised seizure
Status epilepticus
Partial seizure
Carbamazapine
Generalised seizure
Valproate (switch to another drug if this fails)
Status epilepticus
- Benzodiazepine by i.v.
- If at home: diazepam (rectal or buccal)
- Up dosage
- Give phenytoin infusion
- Induce coma