Epilepsy Flashcards
why does epilepsy occur
anormal discharge of neurones in the brain
changes in GABA levels
what does the reduced GABA levels in the brain have an effect on
normal cell-cell message propagation - takes less stimulation for neurone to fire and pass message to other cell
what is the abnormal chain reaction in the brain in epilepsy
discharge of lots of neurones in one particular area of the brain or in many areas of the brain
what are febrile seizures
same symptoms as someone having tonic clonic epilepsy but these happen in children and only when the child has a fever
how do you preventively manage febrile seizures
cool children
paracetamol
ibuprofen
remove clothes
cool sponging/ bath
what are the two broad brackets of epilepsy
generalised and partial
what are the three aspects of generalised epilepsy
tonic/ clonic
absence (petit mal)
myoclonic/ atonic
what are the three aspects of partial epilepsy
simple partial
complex partial
simple sensory
what are epilepsy triggers
idiopathic
trauma - head injury
tumours/ stroke/ meningitis
encephalitis
alcohol overuse
hypoglycaemia
flashing lights
what occurs in generalised epilepsy
there is a central focus which spreads signal to all parts of the cortex and the seizure includes all parts of the body
what occurs in partial epilepsy
if the focus is much closer to a particular part of the cortex, that is the area where the seizure while primarily affect
what are tonic clonic seizures associated with
prodromal aura - patient has awareness of change in brain function
what does a tonic reaction mean
stiff
what does clonic mean
contractions
what is tonic clonic reaction followed by
post-ictal drowsiness
what is petit mal epilepsy associated with
short lived episodes that are loss of awareness - eyelids flutter, vacant stare, stop activity
what are the medical affects of tonic-clonic seizures
injury
asphyxia - use supplemental oxygen, guard airway, suction
what are the social affects of tonic-clonic seizures
pregnancy - metabolism upset, drug reactions
sudden death from asphyxiation
driving/ employment
what can cause tonic-clonic seizures
poor compliance with medicine
fatigue/ stress
infection
menstruation
drugs can precipitate seizures - GA, alcohol and tricyclics
what can be the sensory changes that occur in partial seizures
visual, auditory, taste, smell
what are aspects of complex partial seizures
happens when different areas of the brain are affected but produce connected movement - grimacing, lip smacking these become automatic
how is epilepsy treated
anticonvulsant drugs
supportive treatment
what anticonvulsant drugs are used in tonic-clonic epilepsy
valporate, carbamazapine, phenytoin, gabapentine, phenobarbitone, lamotrigine
what anticonvulsant drugs are used in absence epilepsy
levitiracetam
what is emergency treatment of epilepsy seizueres
airway and oxygen only if unconscious
benzodiazepines
what are the two broad types of epilepsy drugs
GABA receptor actions
sodium channel actions
what drugs work on GABA receptors
valporate
benzodiazepines
what drugs work on sodium channels
carbamazepine
PHENYTOIN
what complications of epilepsy treatment can affect dentistry
gingival hyperplasia - phenytoin
bleeding tendency - vaplorate
what should the dentist ask an epileptic patient
when last three fits took place
compliance with medicine
changes in medication
