Epilepsy

Question 1

What is epilepsy?

Answer 1

Common neurological condition characterised by recurrent seizures.

Question 2

What are the different types of seizures?

Answer 2

Focal impaired awareness
Absence
Atonic
Focal aware

Question 3

Where does a focal impaired awareness seizure start?

Answer 3

In the temporal lobe

Question 4

Why are focal seizures also referred to as partial seizures?

Answer 4

Start in a specific area, on one side of the brain

Question 5

How does a focal impaired awareness seizure present ?

Answer 5

• Stare into space
• Automatisms
• Hallucinations
• Déjà vu

Question 6

What is another term for a focal impaired awareness seizure?

Answer 6

Partial seizure

Question 7

what is the main management of a focal impaired awareness seizure?

Answer 7

Lamotrigene or levetiracetam

Question 8

Who do absence seizures normally affect?

Answer 8

Children

Question 9

How do absence seizures normally present?

Answer 9

Stare into space and don’t respond for about a minute

Question 10

What is the management of absence seizures?

Answer 10

Ethosuximide

Question 11

What is an example of an atonic seizure?

Answer 11

A woman falls to the ground and lays motionless

Question 12

What is another name for focal aware seizure?

Answer 12

Simple partial

Question 13

What is another name for focal impaired awareness?

Answer 13

Complex partial

Question 14

What are generalised seizures?

Answer 14

They are seizures that engage or involve networks on both sides of the brain at the onset

Question 15

What happens immediately with the onset of generalised seizures?

Answer 15

Consciousness is lost immediately

Question 16

What can generalised seizures be divided into?

Answer 16

Motor: Tonic-clonic

Non-motor: Absence

Question 17

How does a generalised seizure (Tonic-clonic) normally present?

Answer 17

Tongue biting
Incontinence 
Jerking 
Foaming at the mouth 
Loss of consciousness

Question 18

What investigation is normally carried out after first seizure?

Answer 18

Electroencephalogram (EEG)

Neuroimaging (MRI).

Question 19

What is the management of tonic-clonic seizure?

Answer 19

Males: Sodium valporate
Females: Lamotrigene or levetiracetam

Question 20

What is the period after a generalised seizure called?

Answer 20

Postictal phase

Question 21

What is the postictal phase?

Answer 21

Phase following a seizure where the patients feel drowsy and tired for around 15 minutes.

Question 22

What medication is recommended in pregnancy?

Answer 22

Lamotrigine

Question 23

How would epilepsy present if it affected the temporal lobe?

Answer 23

• (HEAD) Hallucinations (auditory/gustatory/olfactory),
• Epigastric rising/Emotional,
• Automatisms (lip smacking/grabbing/plucking),
• Deja vu/Dysphasia post-ictal)

Question 24

How would epilepsy present if it affects the frontal lobe?

Answer 24

• Head/leg movements
• Posturing
• post-ictal weakness
• Jacksonian march

Question 25

How would epilepsy present if it affected the parietal lobe?

Answer 25

• Paraesthesia

Question 26

How would epilepsy present if it affected the occipital lobe?

Answer 26

• Floaters/flashes

Question 27

What is status epilepticus defined as?

Answer 27

a single seizure lasting >5 minutes, or

> = 2 seizures within a 5-minute period without the person returning to normal between them

Question 28

What can status epilepticus lead to?

Answer 28

Irreversible brain damage

Question 29

How is status epilepticus diagnosed?

Answer 29

• Capillary blood glucose

Question 30

Why would you do capillary blood glucose in someone presenting with status epilepticus?

Answer 30

To rule out hypoxia and hypoglycaemia first

Question 31

What is the management of status epilepticus?

Answer 31

IV lorazepam

Question 32

How many doses would you give of lorazepam before trying different medication?

Answer 32

2 doses

Question 33

What would you give if lorazepam doesn’t work?

Answer 33

IV phenytoin