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neuro > DISEASE- Epilepsy > Flashcards

DISEASE- Epilepsy Flashcards

1
Q

what is an epileptic seizure?

A

An abnormal synchronisation of neuronal activity
-usually excitatory with high frequency action potentials
-sometimes predominantly inhibitory

Interruption of normal brain activity (either focally or generalised)
Usually brief (seconds to minutes)

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2
Q

epileptic seizures= abnormal synchronisation of neuronal activity
-are these excitatory or inhibitory?

A

Usually excitatory with high frequency action potentials but sometimes predominently inhibitory

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3
Q

how long are epileptic seizures?

A

usually brief (seconds to minutes)

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4
Q

what causes epileptic seizures/ the abnormal synchronisation of neuronal activity?

A

Too much excitation/ too little inhibition

Changes to:
-Cell numbers/ types
-Connectivity
-Synaptic function
-Voltage gates ion channel function

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5
Q

what can cause epilepsy?

A

-genetic
-acquired brain
-metabolic
-toxic
-environmental factors

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6
Q

at what age do people experience epileptic seziures?

A

Occur at any age
-most common in infancy and old age

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7
Q

Difference between epilepsy and seizures?

A

Seizure= abnormal discharge of electrical activity in the brain

Epilepsy= tendency to recurrent epileptic seizures

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8
Q

what are the types of epileptic seizures and where does the electrical discharge occur?

A

Generalised= electrical discharge happens in many different parts of the brain (both sides) at the same time

Partial (focal site of origin)= electrical discharge is only on one side of the brain and may stay there

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9
Q

What are the types of generalised epileptic seziures?

A

Absence
Myoclonic
Atonic
Tonic Clonal

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10
Q

What are the types of partial (focal site of origin) epileptic seizures?

A

Simple: without impaired consciousness
Complex: with impaired consciousness

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11
Q

how are secondary generalised seizures linked to partial/ focal seizures?

A

Focal seizures can become secondary generalised seizures by spreading to the whole brain

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12
Q

Presentation of primary generalised epilepsy?

A

-Often presents in childhood/ teens
-Early morning jerks
-Generalised seizures

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13
Q

Risks for primary generalised seizures?

A

-Sleep deprivation
-Flashing lights
-Birth problems
-Past seizure (e.g. febrile)
-Head injury
-FH
-Drugs/ alcohol

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14
Q

what medication can make primary generalised seizures worse?

A

Carbamazepine (used to treat focal seizures)

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15
Q

Presentation of absence seizures (type of primary generalised seizures)?

A

-Often in Children
-Lasts 10-20 seconds
-Patient becomes blank, stares into space and abruptly returns to normal
-During episode will become unaware of surroundings and won’t respond

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16
Q

Treatment for absence seizure?

A

Ethosuzimide/ Sodium Valproate

90% will grow out of it as they get older

Sodium Valproate= for all primary generalised seizures

17
Q

Presentation of myclonic seizures (type of primary general epileptic seizure)?

A

-sudden brief muscle contractions like a SUDDEN JUMP
-Patient usually remains awake

18
Q

treatment myoclonic seizures?

A

Sodium Valproate, Leveteracetam, Clonazepam

19
Q

presentation atonic epileptic seizures?

A

Typically begins in childhood
</=3 minutes
Brief lapses in muscle tone
‘DROP ATTACKS’

20
Q

treatment atonic epilepsy?

A

Sodium valproate
Or
Lamotrigine

(atonic, tonic and generalised tonic clonic is the same treatment)

21
Q

Presentation of generalised tonic clonic

A

-What most people think of when they think of epileptic seizures

-Loss of consciousness, 1st tonic (muscle tensing) episode and 2nd clonic (muscle jerking) episode.

-After seizure there is a prolonged post- ictal period where the person is confused, drowsy and feels irritable and depressed

-May be associated with tongue biting, incontinence, groaning, irregular breathing

22
Q

treatment for generalised tonic clonic seizures?

A

Sodium Valproate
OR
Lamotrigine
(atonic, tonic and generalised tonic clonic is the same treatment)

23
Q

investigation for primary generalised epilepsy?

A

EEG- will show spike wave abnormalities in generalised

24
Q

who should not receive sodium valproate, why and what is usually given instead?

A

Women of child bearing age
-it is teratogenic and associated with neuronal tube defects
-Give lamotrigine instead

25
Q

SE of Sodium valproate?

A

-weight gain
-teratogenic (neuronal tube defects)
-hair loss
-fatigue

26
Q

Motor presentation of focal (partial) seizures?

A

Autonomic movements from temporal lobe: chewing, repetitive body movements (jerking, posturing etc)

Other movements from frontal lobe: head/eye deviation, urinary incontinence, vocalisation, bizarre behaviour

27
Q

Sensory presentation of focal (partial) seizures?

A

Altered somatosensation (from parietal lobe)

Olfactory sensation, rising feeling in stomach, auditory (from temporal lobe)

Visual symptoms (from occipital lobe)

28
Q

Psychic presentation of focal (partial) seizures?

A

Memories, déjà vu, jamais vue (staring blankly) -from temporal lobe

29
Q

Treatment of focal (partial) seizures?

A

Carbamazepine or Lamotrigine

30
Q

After 1st seizure (not diagnosed with epilepsy)- when can you next drive?

A

6 months for car
5 years for HGV/PCV

31
Q

After epilepsy diagnosis- when can you next drive?

A

1 year or 3 years during sleep for car

10 year off medication for HGV/PCV

32
Q

A 23-year-old woman presents to her GP, complaining of “falls”. Upon further questioning, she explains that around every week, she falls to the floor, feeling as though her “muscles go all loose and floppy”. These episodes are not associated with loss of consciousness or additional symptoms. Neurological examination shows no physical abnormalities. Her GP suspects epilepsy. What is the most appropriate treatment for this patient’s epileptic syndrome?

A

Lamotrigine
-she is having an atonic seizure (drop attacks) and is a woman of child bearing age so would not give her sodium Valproate

33
Q

what are the types of status epilepticus?

A

Generalized convulsive status epilepticus

Non-convulsive status

Epilepsia partialis continua

34
Q

Presentation of status epilepticus?

A

-Recurrent epileptic seizures without full recovery of consciousness
-Continuous seizure lasting >5minutes

35
Q

how may a partial seizure in the frontal lobe present?

A

-head/leg movements
-posturing
-post ictal weakness
-Jacksonian march (clonic movements travelling proximally)

36
Q

how may a partial seizure in occipital lobe present?

A

floaters/ flashers

37
Q

how may a partial seziure in parietal lobe present?

A

paraesthesia

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