epilepsy Flashcards

1
Q

when can you drive if you have epilepsy ? for car and HGV

A

one year seizure free - car
HGV - 10 years seizure free and off meds

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2
Q

when can you drive if youve had a single seizure

A

car - 6months
HGV - 5 years

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3
Q

what are the broad categories of seizures

A

focal and generalised

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4
Q

if a seizure starts on on eside of the brain and spreads bilaterally what is it called

A

focal to bilateral seizure

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5
Q

if someone has a motor focal seizures where is it occuring in the brain

A

frontal libe

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6
Q

if someone has a sensory seizure where is it occuring

A

parietal lobe- parastehsia

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7
Q

if someone has a jamais vu seizure where is it occuring

A

temporal lobe

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8
Q

what are automatism symptoms in temporal lobe seizures

A

lip smacking and plucking

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9
Q

a focal seizure in what lobe has an aura and what would this typically be

A

temporal - rising feeling in stomach

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10
Q

what would a frontal lobe focal seizure present as

A

motor - jacksonian march, post ictal weakness, posturing , hand and leg moveemnt

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11
Q

what are the terms used to describe awareness in focal seizures

A

focal aware
focal impaired awareness

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12
Q

what tends to cause focal seizures and who gets them

A

due to structural brain abnormality e.g post trauma or MS or Tumour

older adults

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13
Q

when would anti-epileptics tend to be started

A

after second seizure

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14
Q

for generalised tonic clonic seizures what is first line treatment

A

sodium valproate
women - lamotrigene or levetiracetam

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15
Q

treatment of juvenile myoclonic epilepsy

A

sodium valpraote

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16
Q

treatment of absent seizures

A

ethosuximide

17
Q

treatment of focal seizures

A

lamotirgene or levetiracetam

18
Q

mechanism of action for sodium valproate

A

enhances GABA synthesis

19
Q

what shoudl females with myoclonic seizured get

A

levetiracetam

20
Q

side effect of lamotrigene

A

stevens johnson syndrome

21
Q

is breastfeeding safe on anti-epileptics

A

yes but not barbituates

22
Q

what should pregnant women taking phenytoin be given and why

A

vit k in last month to prevent clotting disorders of the newborn

23
Q

what contracpetion can women on any anti-epileptic have

A

Depo IUd, IUs

24
Q

what contracetion can women on lamotigene have

A

depo, IUS, IUD , POP, IMPLANT

25
Q

what is status epilepticus defined as

A

a single seizure lasting >5 minutes, or
>= 2 seizures within a 5-minute period without the person returning to normal between them

26
Q

management of status epilepticus - in community and hospital

A

ABC
prehospital setting PR diazepam or buccal midazolam
in hospital IV lorazepam is generally used

27
Q

how long after Iv lorazepam can more benzos be given in status

A

10-20 mins

28
Q

if benzos unsuccessgul at terminating status what may be given ? what is done if this is unsucessful adn after how long

A

phenytoin or phenobarbitol infusion
45mins then general ansthetsia

29
Q

how many rounds of benzos can be given in status

A

ONLY TWO

30
Q

what doese of benzos are given in status

A

4mg lorazepam IV
10mg buccal or rectal

31
Q

what are pseudoseizures or functional seizures called

A

psychogenic non epileptic seizures