Corrections - Neurology Flashcards
What is the stepwise medical management of status epilepticus?
1) Buccal midazolam / IV lorazepam
2) IV lorazepam
3) IV phenytoin, sodium valproate or levetiracetam
4) RSI using thiopental sodium
Are girls or boys more commonly affected by JME?
Girls
What blood test can differentiate true seizures from pseudoseizures?
Prolactin (raised following a true seizure)
1st line antiepileptic in focal seizures?
Lamotrigine or levitiracetam
2nd line antiepileptic in focal seizures?
Carbamazepine
What is the only antiepileptic drug that is NOT safe in breastfeeding?
Barbiturates
What is a history of sudden collapse occurring soon after a rupture of membranes suggestive of?
Amniotic fluid embolism
When can you consider stopping antiepileptics?
Over how long should they be stopped?
Can be considered if seizure free for >2 years.
Antiepileptics should be stopped over 2-3 months.
What is a key contraindication for triptans?
Patients with a history of, or significant risk factors for, ischaemic heart disease or cerebrovascular disease.
What condition do cafe au lait spots indicate?
- Neurofibromatosis type 1
- Tuberous sclerosis
What is it important to screen for in people with Down syndrome who participate in sports that may carry an increased risk of neck dislocation (e.g. trampolining, gymnastics, boxing, diving, rugby and horse riding)?
Atlanto-axial instability
A maximum of how many doses of IV benzodiazepines can be administered during convulsive status epilepticus?
2
1st line antiepileptic in tonic or atonic seizures in females?
Lamotrigine
How long should complete recovery take in a ‘simple’ febrile convulsion?
Complete recovery within 1 hour
When do seizures in benign rolandic epilepsy typically occur?
At night
Describe seizures in benign rolandic epilepsy
Seizures are typically partial (e.g. paraesthesia affecting the face) but 2ary generalisation may occur (i.e. parents may only report tonic-clonic movements).
What does an EEG characteristically show in benign rolandic epilepsy?
Centrotemporal spikes
Prognosis of benign rolandic epilepsy?
The prognosis is excellent, with seizures stopping by adolescence.