Epilepsy Flashcards
What is epilepsy?
The tendency to have recurrent seizures
What is a seizure?
Transient episodes of abnormal electrical activity in the brain.
How do tonic-clonic seizures present?
Tongue biting Muscle jerking Incontinence Foaming at the mouth Loss of consciousness
What does the patient experience after the seizure?
Post ictal period
What is the post ictal period?
Person is confused, drowsy and feels irritable or low for about 15 minutes after the seizure
What is the first line management of tonic clonic seizures?
Sodium valporate
Who is sodium valporate not recommended for use in?
Girls
Why is sodium valporate not recommended in girls?
It is teratogenic
What is an alternative to sodium valporate?
Lamotrigine
Where do focal seizures start in the brain?
In the temporal lobe
What do focal seizures affect?
Hearing
Speech
Memory
Emotions
How do focal seizures present?
- Hallucinations
- Memory flashbacks
- Déjà vu
- Doing strange things on autopilot
What is the first line management for focal seizures?
Carbamazepine
Who do absence seizures mainly affect?
Children
How does a child having an absence seizure present?
The patient becomes blank, stares into space and then abruptly returns to normal
How long do absence seizures normally last?
About 10 to 20 seconds
What is the main management of absence seizures?
Ethosuximide
What are atonic seizures also known as?
Drop attacks
What are atonic seizures characterised by?
Brief lapses in muscle tone.
How long do atonic seizures last?
Less than 3 minutes
When do atonic seizures typically start?
In childhood
What is the main management of an atonic seixure?
Sodium valproate
How does a myoclonic seizure normally present?
Sudden brief muscle contractions, like a sudden “jump”.
What is the main management of myoclonic seizures?
Sodium valproate
What are infantile spasms also referred to as?
West syndrome
When do infantile spasms/ west syndrome occur?
About 6 months of age
How are infantile spasms/west syndrome characterised?
Clusters of full body spasms.
What is the prognosis of West syndrome/infantile spasm?
Poor prognosis: 1/3 die by age 25,
What is the problem with infantile spasms/ west syndrome?
Difficult to treat
What is the management of infantile spasms/west syndrome?
- Prednisolone
* Vigabatrin
What is the key to diagnosing epilepsy?
A good history
What imaging investigations can you do for Epilepsy?
EEG
MRI
What general advice can you give to a parent with an epileptic child?
• Take showers rather than baths
• Be very cautious with swimming unless seizures are well controlled and they are closely supervised
• Be cautious with heights
• Be cautious with traffic
• Be cautious with any heavy, hot or electrical equipment
Older teenagers with epilepsy will need to avoid driving unless they meet specific criteria regarding control of their epilepsy
What would you find on EEG if the child had West syndrome?
Hypsarrhythmia
What is West syndrome characterised by?
Flexion of the head and limbs, extension of the arms
