Epilepsy

Question 1

why does epilepsy occur

Answer 1

anormal discharge of neurones in the brain
changes in GABA levels

Question 2

what does the reduced GABA levels in the brain have an effect on

Answer 2

normal cell-cell message propagation - takes less stimulation for neurone to fire and pass message to other cell

Question 3

what is the abnormal chain reaction in the brain in epilepsy

Answer 3

discharge of lots of neurones in one particular area of the brain or in many areas of the brain

Question 4

what are febrile seizures

Answer 4

same symptoms as someone having tonic clonic epilepsy but these happen in children and only when the child has a fever

Question 5

how do you preventively manage febrile seizures

Answer 5

cool children
paracetamol
ibuprofen
remove clothes
cool sponging/ bath

Question 6

what are the two broad brackets of epilepsy

Answer 6

generalised and partial

Question 7

what are the three aspects of generalised epilepsy

Answer 7

tonic/ clonic
absence (petit mal)
myoclonic/ atonic

Question 8

what are the three aspects of partial epilepsy

Answer 8

simple partial
complex partial
simple sensory

Question 9

what are epilepsy triggers

Answer 9

idiopathic
trauma - head injury
tumours/ stroke/ meningitis
encephalitis
alcohol overuse
hypoglycaemia
flashing lights

Question 10

what occurs in generalised epilepsy

Answer 10

there is a central focus which spreads signal to all parts of the cortex and the seizure includes all parts of the body

Question 11

what occurs in partial epilepsy

Answer 11

if the focus is much closer to a particular part of the cortex, that is the area where the seizure while primarily affect

Question 12

what are tonic clonic seizures associated with

Answer 12

prodromal aura - patient has awareness of change in brain function

Question 13

what does a tonic reaction mean

Answer 13

stiff

Question 14

what does clonic mean

Answer 14

contractions

Question 15

what is tonic clonic reaction followed by

Answer 15

post-ictal drowsiness

Question 16

what is petit mal epilepsy associated with

Answer 16

short lived episodes that are loss of awareness - eyelids flutter, vacant stare, stop activity

Question 17

what are the medical affects of tonic-clonic seizures

Answer 17

injury
asphyxia - use supplemental oxygen, guard airway, suction

Question 18

what are the social affects of tonic-clonic seizures

Answer 18

pregnancy - metabolism upset, drug reactions
sudden death from asphyxiation
driving/ employment

Question 19

what can cause tonic-clonic seizures

Answer 19

poor compliance with medicine
fatigue/ stress
infection
menstruation
drugs can precipitate seizures - GA, alcohol and tricyclics

Question 20

what can be the sensory changes that occur in partial seizures

Answer 20

visual, auditory, taste, smell

Question 21

what are aspects of complex partial seizures

Answer 21

happens when different areas of the brain are affected but produce connected movement - grimacing, lip smacking these become automatic

Question 22

how is epilepsy treated

Answer 22

anticonvulsant drugs
supportive treatment

Question 23

what anticonvulsant drugs are used in tonic-clonic epilepsy

Answer 23

valporate, carbamazapine, phenytoin, gabapentine, phenobarbitone, lamotrigine

Question 24

what anticonvulsant drugs are used in absence epilepsy

Answer 24

levitiracetam

Question 25

what is emergency treatment of epilepsy seizueres

Answer 25

airway and oxygen only if unconscious
benzodiazepines

Question 26

what are the two broad types of epilepsy drugs

Answer 26

GABA receptor actions
sodium channel actions

Question 27

what drugs work on GABA receptors

Answer 27

valporate
benzodiazepines

Question 28

what drugs work on sodium channels

Answer 28

carbamazepine
PHENYTOIN

Question 29

what complications of epilepsy treatment can affect dentistry

Answer 29

gingival hyperplasia - phenytoin
bleeding tendency - vaplorate

Question 30

what should the dentist ask an epileptic patient

Answer 30

when last three fits took place
compliance with medicine
changes in medication