Dementia & Epilepsy Flashcards

1
Q

Define what is meant by “dementia”

A

Dementia is an umbrella term for a progressive deterioration of higher cortical function and has a number of different causes.

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2
Q

When investigating cognitive impairment, what tool can we use to give a baseline score to use in the current assessment and future assessments?

A

Mini- Mental State Examination

(MMSE)

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3
Q

What investigations can we use to rule out other causes of cognitive impairment when assessing for dementia?

A

CT-see stroke

MRI- vascular & atrophy detail

FBC- TFTs, Vitamin B12

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4
Q

What tool can we use to clinically destinguish between dementia and delirium?

A

Confusion assessment method

(CAM score)

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5
Q

How might a brain in someone with demetina look on a CT scan?

A

Dilated ventricles

Generalised atrophy

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6
Q

With regard to the rate of progression of cognitive decline, explain the differences between:

AD

Vascular dementia

Dementia with Lewy Bodies

A

AD- slow, steady decline over many years with no recovery

Vascular dementia- step-wise decline in cognitive function, decline related to vascular event

LB dementia- fluctuating decline in cognition which may improve then drop back down

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7
Q

Which drugs can be used to slow the progression of mild-moderate AD in some patients?

A

Cholinesterase inhibitors

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8
Q

Define what is meant by a “seizure”.

A

A sudden, irregular discharge of electrical activity in the brain causing a physical manifestation such as sensory disturbance, unconsciousness or convulsions.

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9
Q

Define what is meant by a “convulsion”.

A

An uncontrolled shaking movement of the body dur to rapid and repeated contraction anf relaxation of muscles.

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10
Q

What is an “Aura” ?

A

A perceptual disturbance experienced by some prior to a seizure

e.g. a strange light, unpleasent smell, confusing thoughts

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11
Q

What is epilepsy?

A

A neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness or convulsions, associated with abnormal electrical activity in the brain.

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12
Q

Draw a diagram to show the classification of seizures.

A
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13
Q

What is the difference between simple and complex partical seizures?

A

Simple- same consciousness

Complex- consciousness is impaired

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14
Q

What is the most common type of epilepsy?

When does this occur in most people?

A

Temporal lobe epilepsy

1st/2nd decade

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15
Q

Name the different types of generalised seizure.

How do each of these seizures differ from one another.

A

Tonic-clonic: (tonic) muscle tension followed by (clonic) convulsions

Absence: “daydreaming” back to conversation/task as if nothing happened

Myoclonic: breif, shock-like muscle jerks

Atonic: loss of muscle tone “drop attack”

Tonic: increases muscle tone

Status epilepticus: continuous epileptic fits without recovery of consciousness inbetween- medical emergency!!!!

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16
Q

What clinical history is important when assessing a patient with ?epilepsy, hx of seizure?

A

PMH, FH, triggers aura, first sign/symptom

Description of seizure, duration, abrupt/gradual end?

Post-ictal state, tongue biting? incontinence? neurological deficit?

COLLATERAL HISTORY

17
Q

Give some differential diagnoses for ?seizure.

A

Vascular: stroke, TIA

Infection: abcess, meningitis

Trauma: intracerebral haemorrhage

Autoimmune: SLE

Metabolic: Hypoxia, electrolyte imbalance, hypoglycaemia

Iatrogenic: Drugs, alcohol withdrawl

Neoplastic: Intracerebral mass

18
Q

What is the function of EEG use in seizure investigation/epilepsy diagnosis?

What other investigations can be used to exclude any other suspected cause?

A

To support diagnosis and assess risk of seizure recurrance

Needs to be 2 or more seizures to have diagnosis unless very high recurrance risk

ECG, MRI

19
Q

What are the initial management steps for seizures?

A
  1. ABCDE
  2. Lorazepam or midazoplam

(PR or buccal) (IV if hosp.)

20
Q
A