Blackouts, Seizures and Epilepsy Flashcards
1
Q
key characteristics of epilepsy
A
- 2 or more seizures, occurring >24hrs apart
- UNPROVOKED
- or 1 and a high probability of another occurrence over the next 10 yrs
blood test
- high lactate
- high BP
- high prolactin?
2
Q
characteristics of SE
A
- seizure lasting for >5mins
- or more than >1 seizure <5mins
3
Q
temporal lobe (focal) characteristics
frontal lobe
parietal lob
occipital lob
A
temporal
- automatisms eg. lip smacking
- deja vu / jamais vu
- emotional disturbance eg. sudden terror
- olfactory / gustatory / auditory hallucinations
frontal
- motor features eg. Jacksonian features
- dysphasia
- todd’s palsy (temp paralysis after seizure)
parietal
- sensory tingling/numbness
- may have motor symptoms due to spread to the pre-central gyrus in frontal
occipital
-visual
4
Q
management of acute seizures
management of SE
A
acute seizure:
give benzodiazepine rectally/intranasally/under tongue
if does not resolve by 5mins - treat as SE
SE:
- ABCDE
- IV bolus lorazepam 4mg ; give 2nd dose after 10-20min
- thiamine 250mg over 30min if alcoholism/malnourishment suspected
- IV infusion phenytoin 15-18mg/KV at 50mg/min whilst monitoring ECG and BP
- general anaesthesia +/- ventilation with continuous EEG in ICU
5
Q
common anti-eplileptics + SE
A
sodium valproate (increases GABA, used for generalised)
- vomiting
- anorexia
- liver toxicity
- pancreatitis
- retention of weight (gain)
- oedema
- alopecia
- teratogenic , Tremor
- enzyme inhibitor
Carbamazepine (binds to sodium channels increasing refractory period, used for focal)
- enzyme inducer
- leucopenia
- agrunolocytosis
- SIADH
- Steven johnson syndrome
- ataxia/dizziness
- visual disturbance
phenytoin (binds to sodium channels)
- enzyme inducer
- gingivial hyperplasia
- hirsutism
- hepatic impairment
- lymphadenopathy
- enhanced vit D metabolism–> osteomalacia
Lamotrigine (sodium channel blocker)
-Steven johnson syndrome
topiramate
6
Q
what drug reverses benzodiazepine
A
flumazenil
