Epilepsy Flashcards
What causes epilepsy?
Increased excitatory neurotransmission via glutamate, and decreased inhibitory neurotransmission via GABA - this causes hyper-excitability
What are the types of generalised seizures?
Tonic-clonic
Tonic
Myoclonic
Atonic
Absence
What are the types of partial (focal) seizures?
Simple and complex
What is the difference between an enzyme inducing and an enzyme inhibiting drug?
Enzyme inducing: a drug which promotes enzymes to metabolise another drug quicker, so a higher dose of the affected drug is needed
Enzyme inhibiting: inhibits enzymes, so a lower dose of the affected drug is needed
What are some examples of enzyme-inducing anti epileptics?
Carbamazepine
Phenytoin
Phenobarbital
Topiramate
What are some examples of enzyme-inhibiting anti epileptics?
Lamotrigine
Sodium valproate
Levetiracetam
Acetazolamide
Why should you avoid sudden withdrawal of any anti-epileptic drug?
Because it can cause rebound seizures
What certain tests are done to diagnose epilepsy?
EEG
CT scan
MRI scan
How long should the seizure-free period be in an epileptic patient who wants to drive again?
1 year
How long can a patient not drive for after they’ve had an epileptic episode?
6 months
What emergency contraception can be given for a female who is taking any anti-epileptic drug?
Double dose levonorgestrel
Alternatively offer a C-IUD
Why should valproate never be used in females of child-bearing age?
Because there is a risk of teratogenicity
What is the 1st and 2nd line treatment of tonic-clonic seizures?
1st - sodium valproate
2nd - lamotrigine or carbamazepine
What is the 1st and 2nd line treatment of absence seizures?
1st - sodium valproate
2nd - lamotrigine
Which drugs should NOT be given with absence, myoclonic and tonic/atonic seizures?
Gabapentin
Pregabalin
Phenytoin
Carbamazapine
