Epilepsy Flashcards
What is epilepsy?
Common neurological condition characterised by recurrent seizures.
What are the different types of seizures?
Focal impaired awareness
Absence
Atonic
Focal aware
Where does a focal impaired awareness seizure start?
In the temporal lobe
Why are focal seizures also referred to as partial seizures?
Start in a specific area, on one side of the brain
How does a focal impaired awareness seizure present ?
- Stare into space
- Automatisms
- Hallucinations
- Déjà vu
What is another term for a focal impaired awareness seizure?
Partial seizure
what is the main management of a focal impaired awareness seizure?
Lamotrigene or levetiracetam
Who do absence seizures normally affect?
Children
How do absence seizures normally present?
Stare into space and don’t respond for about a minute
What is the management of absence seizures?
Ethosuximide
What is an example of an atonic seizure?
A woman falls to the ground and lays motionless
What is another name for focal aware seizure?
Simple partial
What is another name for focal impaired awareness?
Complex partial
What are generalised seizures?
They are seizures that engage or involve networks on both sides of the brain at the onset
What happens immediately with the onset of generalised seizures?
Consciousness is lost immediately
What can generalised seizures be divided into?
Motor: Tonic-clonic
Non-motor: Absence
How does a generalised seizure (Tonic-clonic) normally present?
Tongue biting Incontinence Jerking Foaming at the mouth Loss of consciousness
What investigation is normally carried out after first seizure?
Electroencephalogram (EEG)
Neuroimaging (MRI).
What is the management of tonic-clonic seizure?
Males: Sodium valporate
Females: Lamotrigene or levetiracetam
What is the period after a generalised seizure called?
Postictal phase
What is the postictal phase?
Phase following a seizure where the patients feel drowsy and tired for around 15 minutes.
What medication is recommended in pregnancy?
Lamotrigine
How would epilepsy present if it affected the temporal lobe?
- (HEAD) Hallucinations (auditory/gustatory/olfactory),
- Epigastric rising/Emotional,
- Automatisms (lip smacking/grabbing/plucking),
- Deja vu/Dysphasia post-ictal)
How would epilepsy present if it affects the frontal lobe?
- Head/leg movements
- Posturing
- post-ictal weakness
- Jacksonian march
How would epilepsy present if it affected the parietal lobe?
• Paraesthesia
How would epilepsy present if it affected the occipital lobe?
• Floaters/flashes
What is status epilepticus defined as?
a single seizure lasting >5 minutes, or
> = 2 seizures within a 5-minute period without the person returning to normal between them
What can status epilepticus lead to?
Irreversible brain damage
How is status epilepticus diagnosed?
• Capillary blood glucose
Why would you do capillary blood glucose in someone presenting with status epilepticus?
To rule out hypoxia and hypoglycaemia first
What is the management of status epilepticus?
IV lorazepam
How many doses would you give of lorazepam before trying different medication?
2 doses
What would you give if lorazepam doesn’t work?
IV phenytoin
