Epilepsy Flashcards
Epilepsy is
Tendency to have seizures
Seizures are
Transient episodes of abnormal electrical activity
Most common seizures
Generalise tonic-clonic
Features of generalised tonic-clonic seizures
- loss of consciousness
- tonic (muscle tensing)
- clonic (muscle jerking)
- tongue biting
- incontinence
- groaning
- irregular breathing
Duration & timing of post-ictal period
- prolonged
- after seizures
Features of post-octal period
- confused
- drowsy
- irritable
- depressed
1st line Mx generalised tonic-clonic seizures
Sodium valproate
2nd line Mx generalised tonic-clonic seizures
- lamotrigine
- carbamazepine
Location of focal seizures
Temporal bone
Effects of focal seizures
- hearing
- speech
- memory
- emotions
Presentations of focal seizures
- hallucinations
- memory flashbacks
- deja vu
- doing strange things on autopilot
1st line Mx of focal seizures (reverse tonic-clonic)
- carbamazepine
- lamotrigine
2nd line Ms of focal seizures (reverse tonic-clonic)
- sodium valproate
- levetiracetam
Absence seizures are common in
Children
Describe journey of absence seizures
Patient becomes blank, stare into space, return to normal
Unaware of surrounding, unresponsive
Duration of absence seizures
10-20 secs
If kids dont grow out of absence seizures what is 1st line Tx
- sodium valproate
- ethosuximide
Atomic seizure is (drop attacks)
Brief lapses in muscle tone
Duration of atomic seizure
<3 mins
Syndrome associated with atomic seizures in children
Lennox-Gastaut syndrome
1st line Mx atomic seizures
Sodium valproate
2nd line Mx atomic seizures
Lamotrigine
Presentation of myoclonic seizures
Sudden brief muscle contractions
Is the patient awake during myoclonic seizures?
Yes
Epi of myoclonic seizures
- children
- juvenile myoclonic epilepsy
Infantile spasms are seen in (rare)
- west syndrome
- children (6m)
How many with infantile spasms die by 25
1/3rd
If Tx is possible for infantile spasms, what is 1st line
- prednisolone
- vigabatrin
Status epilepticus are how many seizures in an hour and how long do they last for
- > 3
- >3mins
1st line Mx status epilepticus
IV lorazepam
2nd line Mx status epilepticus
- phenobarbital
- phenytoin
