Epilepsy Flashcards
What is epilepsy?
Umbrella term for conditions where there is a tendency to have seizures
What is a seizure?
Transient episodes of abnormal electrical activity in the brain
Focal seizures (1)
1) What are focal seizures?
2) What are the 3 main types of focal seizures?
3) Which of these types usually arise from the temporal lobe?
1) Seizures that start in a specific area, on one side of the brain
2) Seizures with impairment of consciousness (complex), seizures without impairment of consciousness (complex) and seizures that focally but spreads widely causing a generalised seizure (secondary generalised seizure)
3) Seizures with impairment of consciousness
Focal seizures (2)
1) Name a way a focal seizure from the temporal lobe would present
2) Name a way a focal seizure from the frontal lobe would present
3) Name a way a focal seizure from the occipital lobe would present
4) Name a way a focal seizure from the parietal lobe would present
1) Automatisms i.e. lip-smacking, déjà vu, emotional disturbance, olfactory, gustatory, or auditory hallucinations
2) Motor features i.e. Jacksonian features, dysphasia, or Todd’s palsy
3) Visual symptoms such as spots and lines in the visual field
4) Sensory symptoms such as tingling and numbness and motor symptoms
What is a generalised seizure?
Seizures involve networks on both sides of the brain at the onset
1) Name 3 features of a tonic-clonic seizure
2) Name a symptom that may be associated with a tonic-clonic seizure
3) Name a feature of a post-ictal period
4) What happens in an absence seizure?
5) Who do they most commonly occur in?
1) Patients lose consciousness; their limbs stiffen (tonic) and start jerking (clonic), tonic phase comes before the clonic phase, prolonged post-ictal period
2) Tongue biting, incontinence, groaning and irregular breathing
3) Confusion, drowsiness, irritability, depression
4) Patient becomes blank, stares into space and then abruptly returns to normal. During the episode they are unaware of their surroundings and won’t respond
5) Children
1) What happens in an atonic seizure?
2) What happens in a myoclonic seizure?
3) What are infantile spasms also known as?
4) When does it usually present?
5) How is it characterised?
6) What condition is it associated with
1) Brief lapses in muscle tone resulting in a fall
2) Sudden brief muscle contractions
3) West syndrome
4) Infancy at around 6 months of age
5) Clusters of full body spasms
6) Tuberous sclerosis
What 2 investigations are most commonly used in epilepsy diagnosis?
Electroencephalogram (EEG) and brain MRI
Name 2 possible triggers for an epileptic fit
- Poor sleep
- Alcohol and drugs (and their withdrawal)
- Stroke
- Intracranial haemorrhage
- Space-occupying lesions
- Metabolic disturbances
1) What is first line medication for tonic clonic seizures?
2) What is second line?
3) What is first line medication for focal seizures?
4) What is second line?
5) What is first line medication for absence seizures?
1) First line: sodium valproate (males + women unable to have children). Lamotrigine or levetiracetam for women able to have children
2) Second line: lamotrigine, topiramate, carbamazepine
3) First line: levetiracetam or lamotrigine
4) Second line: carbamazepine, oxcarbazepine or zonisamide
5) First line: ethosuximide
1) What is the first line medication for atonic seizures?
2) What is second line?
3) What is the first line medication for myoclonic seizures?
4) Name another medication that can be used
5) What is the first line treatment for infantile spasm?
1) First line: sodium valproate (males). Lamotrigine for females of childbearing age
2) Second line: lamotrigine
3) First line: sodium valproate (males), levetiracetam for females of childbearing age
4) Other options: lamotrigine, levetiracetam or topiramate
5) Prednisolone or vigabatrin
1) What is status epilepticus/how is it defined?
2) What medication is given first line?
3) If the seizures persist what is given?
1) Medical emergency where seizures lasting more than 5 minutes or more than 3 seizures in one hour
2) IV lorazepam/rectal diazepam (10mg)
3) IV phenobarbital or phenytoin
