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CNS > 7. Epilepsy > Flashcards

7. Epilepsy Flashcards

1
Q

What is epilepsy?

A

Recurrent unprovoked seizures caused by excessive electrical discharge from the cerebral cortex

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2
Q

Classify epilepsy by mode of onset

A

Generalised vs focal

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3
Q

What are the types of generalised seizure?

A

Absence
Tonic clonic
Myoclonic
Atonic

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4
Q

Classify epilepsy by aetiology

A 
Genetic
Structural
Metabolic
Immune
Infectious
Unknown
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5
Q

What are the risk factors for developing epilepsy?

A 
Febrile seizures as an infant
CNS infection
Trauma
Family history
Perinatal injury
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6
Q

What gene is associated with AD nocturnal frontal lobe epilepsy?

A

CHRNA2

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7
Q

What gene is associated with AD epilepsy with auditory features?

A

LGI 1

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8
Q

What factors can trigger epilepsy?

A 
Sleep deprivation
Illness
Psychological distress
Loud noise or music
Light
Hyperventilation
Not adhering to anti-epileptic medication
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9
Q

What investigations can be done into epilepsy?

A 
Clinical: 2+ seizures without a cause
CT and MRI
EEG
LP if infection or inflammatory disease present
Genetic studies
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10
Q

What is the acute treatment of epilepsy?

A

IV/IM/ buccal/rectal benzodiazepine and supportive

2nd line: phenytoin, levetiracetam, valprolate

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11
Q

What is a seizure lasting more than 5 mins known as?

A

Status epilepticus: medical emergency

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12
Q

When should long term epilepsy treatment be considered?

A

Not necessary if just one seizure unless abnormal EEG, remote symptomatic cause (tumour), first seizure nocturnal or abnormal neuro exam

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13
Q

What non-medication therapies can be considered in epilepsy?

A

Surgery if structural abnormality
Vagal nerve stimulator
Responsive neurostimulation device
Ketogenic diet

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14
Q

What is the MOA of benzodiazepines and phenobarbital?

A

Bind to GABA receptor

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15
Q

What are the adverse effects of benzodiazepines?

A

Sedation
Respiratory depression
Irritability
Ataxia

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16
Q

What is the MOA of phenytoin and carbamazepine?

A

Sodium channel blocker

17
Q

What are the adverse effects of phenytoin?

A

Increased body hair
Folic acid depletion
Decreased bone density
IV causes skin necrosis

18
Q

What are the adverse effects of phenobarbital?

A

Sedation and resp depression
Low vitamin D
Dupytren’s

19
Q

Name a prodrug that gets reduced into phenobarbitone?

A

Primidone

20
Q

What gene is associated with Dravet syndrome?

A

SCN1A

21
Q

What genes are associated with Lennox-Gastaut syndrome?

A

DNM1

SLC6A1

CNS (21 decks)

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