Epilepsy Flashcards
Epilepsy
2 seizures that occurs with more than 24hrs in between
types
focal or generalised
focal
stays on one hemisphere of the brain
- focal with no impairment of consciousness
- focal with impairment of consciousness
originates from one area of the brain:
temporal - sensation, lips flickering, plucking of clothes
frontal - Jacksonian march, odd behaviour, dysphasia, Todd’s paresis
parietal - numbness, tingling
can go on to be a generalised seizure
generalised
occurs on both sides of the brain
usually always presents unconsciousness
tonic - stiffening of body clonic - jerking movements atonic - sudden loss of muscle tone absence - blanking out, common in kids myoclonic - sudden jerk of limbs
investigations
refer to neuro specialist
EEG
MRI
ECG
management
Focal:
1st - Lamotrigine/Carbamazepine
2nd - Sodium Valproate
Generalised:
1st - Sodium Valproate
2nd - Lamotrigine/Carbamazepine
what changes in lifestyle should occur
Notify DVLA
Be aware of contraception
Sodium Valproate is contradicted in pregnancy
Pseudoepilepsy
not a true seizure occurring
back of psychological stress
builds up gradually
management:
CBT, talking therapies
Status Epilepticus
seizure last more than 5 minutes or multiples seizures over 30 minutes
what should be monitored:
blood glucose and oxygen
EEG
management: Rectal diazepam/IV lorazepam/buccal midazolam (x2 doses) Infusion of phenytoin phenobarbital Anaesthetic review
what can be used to differentiate between pseudoseizures and actual seizures
prolactin levels
what extra features can occur with focal seizures
emotional
what diet is recommended
ketogenic
