Epilepsy Flashcards
define absence (petit mal) seizures
brief episodes (3-20s) of staring with impairment of awareness and responsiveness
characteristics of petit mal seizures
sudden onset and end no warning prior immediate alertness and attention following occur 4-14yrs and resolve by 18yrs provoked by hyperventilation
characteristic of petit mal seizures lasting >10s
eye blinks
brief automatic mouth of hand movements
changes in muscle tone
EEG appearance of petit mal seizures
generalised 3Hz spike-wake discharge
characteristics of atypical absence seizures
last 5-30s begin before 6yrs not provoked by rapid breathing incomplete reduction in responsiveness eye blinking lip twitching
EEG appearance of atypical absence seizures
generalised ‘slow spike waves’ of < 2.5Hz
define tonic-clonic seizures (grand-mal or convulsive)
seizures that cause a loss of consciousness associated with an initial tonic phase of stiffening, falling or a cry
characteristics of grand-mal seizures
extension of lower limbs extension/flexion of upper limbs jerking of extremities - increases in amplitude then decreases in frequency drooling or foaming biting of mouth bladder or bowel incontinence post lethargy and confusion
EEG characteristics of a grand-mal seizure
generalised polyspikes
management of seizures
anti-epileptics such as lamotrigine, levetiracetam and valproate can be used in all seizure types
anti-epileptics used for treatment of focal seizures
carbamazepine
gabapentin
phenytoin
anti-epileptics used in absence seizures
ethosuximide
management of epilepsy in women
lamotrigine should be used in women of child bearing age - AVOID valproate
characteristics of complex epileptic seizures
patient loses consciousness after an aura or at seizure onset
post-ictal symptoms
characteristics of simple epileptic seizures
no loss of consciousness
only experience focal symptoms
no post-ictal symptoms
characteristics of secondary generalised seizures
focal seizure developing into a generalised seizure (tonic-clonic)
features of temporal lobe focal seizure
lip-smacking
deja vu or jamais vu
emotional disturbance
olfactory or auditory hallucinations
features of frontal lobe focal seizures
Jacksonian features
dysphasia
Todd’s Palsy
features of parietal lobe focal seizures
tingling and numbness
motor symptoms
potential triggers of seizures
poor sleep alcohol and drugs stroke intracranial haemorrhage space-occupying lesions metabolic disturbance
management of absence seizures
sodium valproate
ethosuximide
management of tonic-clonic seizures
sodium valproate
lamotrigine
management of myoclonic seizures
sodium valproate
topiramate
levetiracetam
management of atonic seizures
sodium valproate
lamotrigine
characteristics of myoclonic seizures
sudden jerking motion of limbs, trunk or face
characteristics of atonic seizures
sudden loss of muscle tone causing fall
retain consciousness
side effects of topiramate
abdominal pain
cognitive behavioural change/impairment
weight loss
bowel habit change
side effects of lamotrigine
blurred vision ataxia diarrhoea headache rash
side effects of carbamazepine
skin problems
oedema
fatigue
blood disorder
side effects of sodium valproate
weight gain
headache
transient hair loss
anaemia
