epilepsy

Question 1

what

Answer 1

tendency to have seizures

Question 2

seizures

Answer 2

transient episodes of abnormal electrical activity in the brain

Question 3

Ix

Answer 3

EEG

MRI brain

Question 4

generalised tonic-clonic seizure

Answer 4

loss of consciousness and tonic (muscle tensing) and clonic (muscle jerking) episodes

Question 5

generalised tonic-clonic seizure - can be associated..

Answer 5

tongue biting
incontinence
irregular breathing

Question 6

generalised tonic-clonic seizure - after seizure

Answer 6

prolonged post-ictal period

• confused
• drowsy
• irritable
• depressed

Question 7

generalised tonic-clonic seizure - Mx

Answer 7

1st line: sodium valproate

2. lamotrigine or carbamazepine

Question 8

Focal seizures

Answer 8

start in temporal llobes

can affect hearing, speech, memory and emotions

Question 9

focal seizures: features

Answer 9

hallucinations
memory flashbacks
deja vu
doing strange things on autopilot

Question 10

focal seizures: Mx

Answer 10

1. carbamazepine or lamotrigine

2. sodium valproate or levetiracetem

Question 11

absence seizures

Answer 11

usually kids

patient becomes blank, stares into space and then abruptly returns to normal

unaware of surroundings

lasts 10-20s

Question 12

absence seizures: Mx

Answer 12

sodium valproate or ethosuximide

Question 13

atonic seizures

Answer 13

aka drop attacks

breif lapses in muscle tone

Question 14

atonic seizures: can be indicitave of

Answer 14

lennox-gastaut syndorme

Question 15

atonic seizures Mx

Answer 15

1. sodium valproate

2, lamotrigine

Question 16

myoclonic seizures

Answer 16

sudden brief muscle contractions
pt awake during

typically happen as part of juvenile myoclonic epilepsy

Question 17

myoclonic seizures Mx

Answer 17

1. sodium valproate

2. lamotrigine, levetiracetam, topiramate

Question 18

infantile spasms

Answer 18

aka West syndrome

clusters of full body spasms
poor prognosis

Question 19

infantile spasms Mx

Answer 19

prednisolone

vigabatirn

Question 20

sodium valproate

Answer 20

first line option for most epilepsy minus focal seizures

increases activity of GABA

Question 21

sodium valproate : side effects

Answer 21

teratogenic
liver damage + hepatitis
hair loss
tremor

Question 22

sodium valproate : must be avoided in…

Answer 22

girls and women unless no suitable alternatives

Question 23

Carbamazepine

Answer 23

first line for focal seizures

Question 24

Carbamazepine - side effects

Answer 24

agranulocytosis

aplastic anaemia

Question 25

phenytoin - side effects

Answer 25

folate + vitamin D deficiency
megaloblastic anaemia
osteomalacia

Question 26

ethosuximide side effects

Answer 26

night terros

rashes

Question 27

lamotrigine side effects

Answer 27

stevens-johnson syndrome

leukopenia

Question 28

status epilepticus

Answer 28

seizures >5min
or
more than 3 seizures in an hour

Question 29

status epilepticus - Mx

Answer 29

IV lorazepam 4mg, repeat after 10min if needed

if seiuzures persist
-IV phenobarbital or phenytoin

Question 30

status epilepticus - Mx in community

Answer 30

buccal midazolam

rectal diazepam