Epilepsy Flashcards
What is epilepsy?
Abnormal firing of neurones
- associated with reduced GABA levels in the brain
- leading to abnormal cell - cell firing
- neurones require less input to fire
What is a febrile seizure? Implications and signs?
Seizure
- in children who have a fever
Signs
- fever
- eyes rolling upwards
- loss of consciousness
- limb jerk
If a child has one they are more likely to have another
How would one manage a febrile seizure?
Cool child down
- antipyretics
- remove tight clothing
- cool sponge or bath
How can epilepsy be classified?
Generalised
Partial
What may trigger epilepsy?
idiopathic
head trauma
CNS disease
- tumour
- stroke
- meningitis
Social
- late nights
- alcohol
- flashing lights
- hypoglycaemia
What is the difference between generalised and local epilepsy?
Generalised has a central focus
- leading to abnormal neurone activity in all areas of brain
Localised has a focus in a certain area of cortex
- leading to abnormal neurone firing in one area of the brain
What different types of generalised seizures can occur?
Tonic clonic
Petit mal (absence)
What indicated a tonic clonic seizure?
Prodromal aura
- anger/irritability
- anxiety
- general mood change in that you know something is coming
Loss of conscience
Initial is tonic (stiff)
Moves to clonic (contraction / relaxation)
Drowsiness after
What is a petit mal seizure?
Generalised seizure affecting consciousness
- Short episodes of 5-15s and can be multiple attacks in one day
- absence of convulsions
Loss of awareness
- eyelid flutter
- vacant stare
What are the complications of tonic clonic seizures?
Medical
- injury due to muscle contractions (protect and remove anything from mouth)
- asphyxia - supplemental oxygen with guedel airway, suction for secretions
Social
- pregnancy - metabolism upset and drug interactions can affect children
- sudden death from asphyxiation or aspiration
- driving issues and employment issues
What often causes tonic-clonic seizures?
poor medication compliance often due to unwanted side FX
- ask if they take them regularly
Fatigue and stress
Infection
Menstruation
What drugs can be given to treat epilepsy?
Tonic - clonic
- carbamazapine, phenytoin, lamotrigine, valproate
Petit mal
- levitiracetam
How doe epilepsy drugs work?
Stabilise sodium channel actions - carbamazapine
Acts as a GABA trasaminase inhibitor - valproate
Dental implications of epilepsy?
find out what type of seizures they have
- and the treatment for them in an emergency
- ask compliance for medication
- ask when last 3 fits were and about good or bad phases
Fits can cause oral injury
Epilepsy drugs can cause
- gingival hyperplasia
- xerostomia
- bleeding tendency
