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3 Neurology > Epilepsy 1 > Flashcards

Epilepsy 1 Flashcards

1
Q

best way to take a seizure history

A

find out what happened before, during and after the event

take a collateral history

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2
Q

feel woozy and slump to the ground and get back up suggests…

A

syncope

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3
Q

stiff, rigid, spasming on the ground suggests a….

A

seizure

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4
Q

what should you ask in the O section of SOCRATES in a seizure history?

A

what were they doing?

what did they look like when it happened

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5
Q

what movements should you ask about in a seizure history

A

stiff/rigid movements
head turning right to the left
rigors

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6
Q

a tonic clonic seizure looks like…

A

rigid, stiff body with rigors and jerking

eyes open

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7
Q

risk factors for epilepsy

A 
birth problems
development
seizures in the past eg febrile fits
head injury
FH
drugs
alcohol
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8
Q

what should be covered in the social history

A

driving

occupation

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9
Q

what would you examine in a suspected epileptic patient

A

neurological exam

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10
Q

what drugs can precipitate epileptic seizures?

A 
penicillins, cephalosporins, quinolones
anti-emetics
opioids
tramadol
theophylline
the pill
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11
Q

main Ix of someone with a seizure

A

ECG

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12
Q

what cardiac syndrome can cause seizures

A

long QT syndrome

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13
Q

when would you image someone with a seizure acutely?

A

skull fracture
GCS going down
head injury
suggested pathology intracerebrally

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14
Q

an EEG is an essential investigation for someone with a seizure T or F

A

F, very ineffective

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15
Q

when would you do an EEG on a patient?

A

classify epilepsy (NOT TO DIAGNOSE IT)
confirm non-epileptic attack
confirm non-convulsive status

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16
Q

differentials for epilepsy

A

syncope
non-epileptic attack
panic attack
sleep phenomena

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17
Q

define epilepsy

A

a condition in which you have recurrent epileptic seizures

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18
Q

what are the driving regulations for someone with a seizure (not epilepsy)

A

dont drive for 6 months

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19
Q

what are the driving regulations for someone with epilepsy who has seizures while awake

A

cant drive for 6 months

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20
Q

what are the driving regulations for someone with eplepsy while asleep

A

can maybe still drive if its been more than a year since the last attack

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21
Q

pathophysiology of epileptic seizures

A

abnormal discharge of electricity in the brain from excitatory neurons with high freq APs

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22
Q

what is a focal seizure

A

abnormal electrical discharge only affecting 1 part of the brain

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23
Q

what is a generalised seizure

A

abnormal electrical discharge affecting more than 1 part of the brain

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24
Q

a fit lasting more than _ mins is pathological

A

10

25
Q

how long do epileptic seizures last

A

secs-mins

26
Q

main incidence of epilepsy

A

infancy and 50-80yrs old

27
Q

name the only jobs you cant do if youve got stable epilepsy

A

pilot a plane

carry a firearm for the military

28
Q

causes of death for epileptics

A

aspiration
cardiac event
slowed brain function which eventually stops

29
Q

there are _ types of epilepsy, what are they?

A

2
focal
generalised

30
Q

what is the problem in focal epilepsy

A

one part of the brain is structurally abnormal which causes focal seizures and if the seizure hits a pathway/cortical network you can also get generalised seizures

31
Q

what is the problem in generalised epilepsy

A

abnormality in the brain pathways, NOT structural problem so you get generalised seizures

32
Q

those with a genetic disposition of epilepsy are more likely to get ___ epilepsy

A

generalised

33
Q

name the types of generalised seizures

A 
absence
myoclonic 
atonic
tonic
tonic clonic
34
Q

if both arms are tonic, what is happening to the brain?

A

must be an abnormal electric discharge in the motor cortices of the brain on both sides

35
Q

what is clonus?

A

uncoordinated, shaking movement that becomes worse; happens because the abnormal electrical activity becomes less active after a while so it a form of abnormal relaxation

36
Q

in a tonic clonic fit, does tonicity or clonus happen first

A

tonicity

37
Q

sensory focal seizures described as..

A

a sensory problem that cannot be described well by the patient because it is abnormal i.e not stabbing, not warm sensation

38
Q

what epilepsy is more common over the age of 50? why?

A

focal

the older you get the more likely you are to have a structural abnormality

39
Q

what are the 3 types of focal epilepsy?

A

motor
sensory
psychic eg memories

40
Q

generalised epilepsies tend to manifest under the age of __

A

30

41
Q

Tx for primary generalised epilepsy

A

sodium valproate

42
Q

main contraindication to sodium valproate?

A

teratogenicity

43
Q

what drug can be given as a substitute for sodium valproate?

A

lamotrigine

44
Q

contraindications to carbamazepine?

A

on the pill

45
Q

presentation of juvenile myoclonic epilepsy

A

early morning jerks
generalised seizures
triggered by sleep deprivation, flashing lights

46
Q

Tx of focal onset epilepsy

A

carbamazepine

47
Q

__ of patients will have drug resistant epilepsy

A

1/3

48
Q

Tx for absence seizures

A

sodium valproate

49
Q

Tx for myoclonic seizures

A

sodium valproate
levetiracetam
clonazepam

50
Q

Tx for atonic, tonic, generalised tonic clonic seizures

A

sodium valproate

51
Q

what drug should never be given for a generalised seizures

A

carbamazepine

52
Q

side effects of sodium valproate

A

weight gain
teratogenic
hair loss
fatigue

53
Q

what epileptic drug can cause mood swings?

A

levetiracetam

54
Q

when should you treat an epileptic seizure

A

only if theyve had recurrent seizures ie epilepsy

increased risk if theres only been 1

55
Q

what epileptic drugs can affect womens contraception? what should be done

A

carbamazepine
topiramate

AVOID PROG-PILL, give higher dose of contraception

56
Q

the morning after pill doesnt work for epileptics T or F

A

T

57
Q

what should be given to epileptic women preconceptually ?

A

high dose folic acid

58
Q

hippocampal sclerosis is a type of __ epilepsy

A

focal

3 Neurology (41 decks)

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