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Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What are the seizure types?

A

focal, generalised, unknown

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2
Q

What are the epilepsy types?

A

focal, generalised, combined generalised and focal, unknown

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3
Q

Someone has had a single episode of seizure. Should you treat with antiepileptic drug therapy?

A

not immediately, recommended after second unprovoked seizure

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4
Q

In which circumstances should antiepileptic drugs be considered after first unprovoked seizure?

A
  1. EEG demonstrates epileptic activity
  2. Brain imaging shows structural abnormality
  3. Ongoing neurological deficit or abnormality
  4. Patient/family considers the risk of further seizures unacceptable
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5
Q

Which antiepileptic drug is contraindicated in pregnancy/child bearing potential?

A

sodium valproate

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6
Q

What are the categories of adverse effects associated with antiepileptic drugs?

A
  1. Acute, related to MOA
  2. Idiosyncratic
  3. Chronic
  4. Delayed
  5. Secondary to drug interactions
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7
Q

What is the driving advice for first unprovoked seizure? (group 1 car and motorcycles)

A

no driving for 6 months

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8
Q

Driving advice for cars after multiple unprovoked seizures?

A

no driving for 12 months

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9
Q

Group 2 bus and lorry for first unprovoked seizure? what about multiple?

A

one- no driving for 5 years

multiple- no driving for 10 years

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10
Q

General tips for safety for someone with epilepsy?

A

avoid using locks on doors, shower instead of a bath, don’t go swimming or do water sports on your own, avoid busy roads + roads by rivers, be careful of heights

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11
Q

What is convulsive status epilepticus?

A

continuous seizure activity for a prolonged period of time or repetitive seizures that occur without regaining consciousness

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12
Q

Which benzodiazepines would you administer in status epilepticus?

A

4mg lorazepam IV

or up to 10mg IV diazepam

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13
Q

If you can’t get IV access, how can you administer benzodiazepines?

A

rectal diazepam

buccal midazolam

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14
Q

If the seizure persists after benzodiazepine administration, which second line treatment should be used?

A

IV phenytoin

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15
Q

Why might someone not respond to anti-epileptic medication?

A

seizure classification, diagnosis of epilepsy, dose, compliance, lifestyle e.g. drugs and alcohol

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16
Q

What are the non pharmacological management options for epilepsy?

A

surgery, vagal nerve stimulation, ketogenic diet

17
Q

Which is an appropriate antiepileptic in pregnancy/ women of child bearing age?

A

Lamotrigine (2nd line in non pregnant)

18
Q

What are three causes of epilepsy?

A

2/3 idiopathic
Congenital
Acquired: CVA, Space OL, trauma

19
Q

Differentials for provoked/non-epileptic seizures?

A

Withdrawal: EtOH, opiates, benzos
 Metabolic: glucose, Na, Ca, urea, NH 3
 ↑ICP: trauma, haemorrhage, cortical venous
thrombosis
 Infection: meningitis, encephalitis, cycticerosis,
HIV
 Eclampsia
 Pseudoseizures

20
Q

List three presenting features of complex partial seizure

A

5 A’s
Aura
Autonomic: change in skin colour, temperature, palps
Awareness lost: motor arrest, motionless stare
Automatisms: lip-smacking, fumbling, chewing,
swallowing
Amnesia

21
Q

What is the first line drug for tonic-clonic and absent seizure?

A

valproate

22
Q

Side effects of valproate?

A 
ALPROATE
appetite incr
pancreatitis
reversible hair loss
oedema
ataxia
teratogenicity
encephalopathy
23
Q

List two reversible causes of status epilepticus?

A

alcohol excess (therefore treat with thiamine) and hypoglycaemia

24
Q

List three investigations for status epilepticus?

A

antiepileptic drug levels
tox screen
U+E, LFT, FBC, glucose, calcium

25
Q

Which drugs are used in the slow IV bolus phase and IV infusion phase?

A

slow bolus: lorazepam

IV infusion: phenytoin or diazepam

26
Q

What are risk factors for seizure reoccurence in first time seizures

A

cerebral palsy, brain abscess, trauma, abnormal EEG, abnormal brain scan

27
Q

What are the differences between syncope and seizure?

A

syncope: always prodrome, onset is gradual, duration 1-30sec, incontinence is uncommon. Seizure- sometimes prodrome, sudden onset, longer duration, convulsions prolonged, incontinence, slow recovery, confusion

28
Q

What is Todd’s paresis?

A

limb weakness following seizure

29
Q

Which disease that results in neurological symptoms is caused by tick bites?

A

Lyme’s disease

Neurology (13 decks)

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