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Y3 Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

what questions should you ask a patient who has presented with a seizure?

A

what happened before/during/after

how did they feel

what were they doing

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2
Q

what is a vital part of a history of a seizure?

A

eye witness account

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3
Q

what investigation is mandatory following a seizure?

A

ECG

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4
Q

what imaging can be done to look for a possible cause of a seizure?

A

MRI or CT

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5
Q

what are the indications for EEG following a seizure?

A

classification of epilepsy
confirming non-epileptic attacks
surgical evaluation

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6
Q

how long must you be seizure free after your first seizure before you can drive a car?

A

six months

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7
Q

how long must you be seizure free after your first seizure before you can drive a HGV/PCV?

A

five years

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8
Q

how long must you be seizure free if you have epilepsy before you can drive a car?

A

1 year

3 years if during sleep

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9
Q

how long must you be seizure free if you have epilepsy before you can drive a HGC/PCV?

A

10 years off of medication

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10
Q

what is epilepsy?

A

a tendency to recurrent, usually spontaneous, epileptic seizures

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11
Q

what are epileptic seizures?

A

abnormal synchronisations of neuronal activity

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12
Q

what does focal interruption of brain activity result in?

A

a focal seizure

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13
Q

what does generalised interruption of normal brain activity result in?

A

a generalised seizure

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14
Q

how long do seizures tend to last?

A

seconds to minutes

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15
Q

when is epilepsy most common?

A

infancy to old age

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16
Q

what are the two main types of epilepsy?

A

focal

general

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17
Q

what is the seizure focus?

A

the part of the brain that is structurally abnormal in epilepsy

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18
Q

how does structural abnormality result in an epileptic seizure?

A

the seizure focus irritates the surrounding brain, resulting in a seizure

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19
Q

what part of the brain is irritated in focal epilepsy?

A

just the area around the seizure focus

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20
Q

what is another name for focal epilepsy?

A

partial epilepsy

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21
Q

what are the possible types of seizures seen in focal epilepsy?

A

tonic

tonic clonic

22
Q

what are the two types of focal epilepsy?

A

simple

complex/dyscognitive

23
Q

what is simple focal epilepsy?

A

without impaired consciousness

24
Q

what is complex focal epilepsy?

A

with impaired consciousness

25
Q

what motor symptoms can be seen in focal epilepsy?

A

rhythmic jerking
posturing
head and eye deviation
vocalisation

26
Q

what psychiatric symptoms can be seen in focal epilepsy?

A

deja vu
depersonalisation
aphasia
complex visual hallucinations

27
Q

what is it called when focal epilepsy becomes generalised?

A

second degree generalisation

28
Q

when can focal epilepsy come on?

A

any age

28
Q

what is the management for focal epilepsy?

A

carbamazepine or lamotrigine

28
Q

what is the pathophysiology behind general epilepsy?

A

irritation from the seizure focus spreads throughout the brain, irritating other areas

28
Q

what seizure types can be seen in general epilepsy?

A 
absence 
myoclonic 
atonic 
tonic 
tonic clonic
28
Q

what is primary generalised epilepsy?

A

general epilepsy with tonic clonic seizures

28
Q

when does general epilepsy often present?

A

childhood or teenage years

28
Q

what is the treatment of choice for general epilepsy?

A

sodium valproate

28
Q

what is the alternative management of general epilepsy and when is this given?

A

lamotrigine

pregnancy - sodium valproate is teratogenic

28
Q

how is general epilepsy with absence seizures managed?

A

sodium valproate

ethosuximide

28
Q

how is general epilepsy with myoclonic seizures managed?

A

sodium valproate
levetiracetam
clonazepam

28
Q

name four anticonvulsant drugs

A

phenytoin
sodium valproate
carbamazepine
lamotrigine

28
Q

what drug can be given for acute management of a seizure?

A

phenytoin

28
Q

name some possible side effects of sodium valproate

A

weight gain
teratogenic
hair loss
fatigue

28
Q

what is a possible serious side effect of lamotrigine?

A

stevens johnson syndrome

29
Q

what is status epilepticus?

A

recurrent epileptic seizures without full recovery of consciousness

continuous seizure activity for >30 minutes

30
Q

what are the three types of status epilepticus?

A

generalised convulsive status
non convulsive status
epilepsia partíalis continua

31
Q

what happens in generalised convulsive status?

A

generalised convulsions without cessation

32
Q

what can generalised convulsive status cause?

A

respiratory insufficiency
hypotension
hyperthermia
rhabdomyolysis

33
Q

how does non-convulsive status present?

A

conscious, but in an altered state

34
Q

how does epilepsy partialis continua present?

A

continual focal seizures

preserved consciousness

35
Q

what are some possible precipitants of status epilepticus?

A 
metabolic disorders 
infection 
head trauma 
abrupt withdrawal of anti-convulsants 
subarachnoid haemorrhage
36
Q

how is status epilepticus managed?

A

anti-convulsants = phenytoin, valproate

benzodiazepines

37
Q

what should be give if a patient in status epilepticus is hypoglycaemic?

A

50ml 50% glucose

38
Q

what should be given if there is indications that a patient with status epilepticus is an alcoholic or has impaired nutritional status?

A

thiamine

39
Q

what should be done if status epilepticus persists?

A

transfer to ITU
general anaesthesia
monitor with full EEGs

Y3 Neurology (31 decks)

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