Epilepsy Flashcards
What is epilepsy?
Epilepsy is a condition associated with reduced GABA levels in the brain that leads to abnormal cell-cell message propagation
What are the signs and symptoms of a febrile seizure?
- fever
- face may turn blue or red
- eyes rolling upwards
- loss of consciousness
- muscles and limbs jerk
At what temperature are patients more at risk of a seizure?
above 38 degrees
What are the main classifications of epilepsy?
- Generalised
- Partial
What are the divisions of generalised epilepsy?
- tonic/clonic
- absence
- myclonic/atonic
What are the divisions of partial epilepsy?
- simple partial
- complex partial
- simple sensory
What are the triggers for epilepsy?
- idiopathic
- trauma (head injury)
- CNS disease
- social
what are examples of CNS diseases that can trigger epilepsy?
- tumour
- stroke
- CJD
- meningitis
- encephalitis
what are examples of social triggers for epilepsy?
- late nights
- alcohol
- hypoglycaemia
- flashing lights
What are the features of Tonic Clonic seizures?
- prodromal aura
- loss of consciousness/continence
- initial tonic
- clonic phase
- post-ictal drowsiness
what does tonic mean in relation to seizures?
Body becomes extremely stiff
- can be dangerous to spine
what does clonic mean in relation to seizures?
Contraction/relaxation of body
- jerky movements at this point
how long do tonic clonic seizures typically last for?
1-3mins
- can be recurrent however and this is dangerous
Why are status epilepticus (recurrent seizures) so dangerous?
Patient becomes increasingly hypoxic which can affect the brain
What are the features of Petit Mal (absence) seizures?
- short lived episodes (5-15 seconds)
- loss of awareness
- eyelids flutter, vacant stare, stops activity, loss of response
How do tonic-clonic seizures affect the medical status of a patient?
INJURY prone
- may fall & get hurt
- must remove objects from mouth
Asphyxia
- use supplemental oxygen
- suction any secretions
What epilepsy medication can affect pregnancy?
Sodium Valproate
- if taken during pregnancy it can significantly damage baby
what are some precipitators for tonic-clonic seizures?
- poor medication compliance
- GA agents
- alcohol
- tricyclics & SSRIs (antidepressants)
- fatigue/stress
- infection
- menstruation
What are partial seizures?
Seizures that are localised to ONE region of the brain
- may move/spread to other ares
What preventative treatment is used for epilepsy patients?
Anticonvulsant drugs
- carbamazepine
- gabapentin
- phenytoin
- valproate
What emergency treatment is used for epilepsy patients?
- airway & oxygen
- status epilepticus requires BENZODIAZEPINES
how do epilepsy drugs work?
Act on either:
- GABA receptor actions
- sodium channel actions
what are examples of GABA receptor epilepsy drugs?
- valproate
- benzodiazepine
what are examples of sodium channel acting epilepsy drugs?
- carbamazepine
- phenytoin
how does valproate work?
GABA transaminase inhibitor
how do benzodiazepines work?
GABAa receptor action on Cl enhanced
How does epilepsy affect dentistry?
Complications of fits
- oral soft tissue injury
- dental injury/fracture
Complication of treatment
- gingival hyperplasia
- bleeding tendency
- folate deficiency
what epilepsy drug can cause gingival hyperplasia?
phenytoin
what epilepsy drug can increase bleeding tendency?
valproate
An epileptic patient comes into your practise requiring treatment, how would you know it is safe to do so?
- ask when last three fits took place
- ask about compliance with medication
- ask about any changes in medication
