epilepsy Flashcards
when can you drive if you have epilepsy ? for car and HGV
one year seizure free - car
HGV - 10 years seizure free and off meds
when can you drive if youve had a single seizure
car - 6months
HGV - 5 years
what are the broad categories of seizures
focal and generalised
if a seizure starts on on eside of the brain and spreads bilaterally what is it called
focal to bilateral seizure
if someone has a motor focal seizures where is it occuring in the brain
frontal libe
if someone has a sensory seizure where is it occuring
parietal lobe- parastehsia
if someone has a jamais vu seizure where is it occuring
temporal lobe
what are automatism symptoms in temporal lobe seizures
lip smacking and plucking
a focal seizure in what lobe has an aura and what would this typically be
temporal - rising feeling in stomach
what would a frontal lobe focal seizure present as
motor - jacksonian march, post ictal weakness, posturing , hand and leg moveemnt
what are the terms used to describe awareness in focal seizures
focal aware
focal impaired awareness
what tends to cause focal seizures and who gets them
due to structural brain abnormality e.g post trauma or MS or Tumour
older adults
when would anti-epileptics tend to be started
after second seizure
for generalised tonic clonic seizures what is first line treatment
sodium valproate
women - lamotrigene or levetiracetam
treatment of juvenile myoclonic epilepsy
sodium valpraote
treatment of absent seizures
ethosuximide
treatment of focal seizures
lamotirgene or levetiracetam
mechanism of action for sodium valproate
enhances GABA synthesis
what shoudl females with myoclonic seizured get
levetiracetam
side effect of lamotrigene
stevens johnson syndrome
is breastfeeding safe on anti-epileptics
yes but not barbituates
what should pregnant women taking phenytoin be given and why
vit k in last month to prevent clotting disorders of the newborn
what contracpetion can women on any anti-epileptic have
Depo IUd, IUs
what contracetion can women on lamotigene have
depo, IUS, IUD , POP, IMPLANT
what is status epilepticus defined as
a single seizure lasting >5 minutes, or
>= 2 seizures within a 5-minute period without the person returning to normal between them
management of status epilepticus - in community and hospital
ABC
prehospital setting PR diazepam or buccal midazolam
in hospital IV lorazepam is generally used
how long after Iv lorazepam can more benzos be given in status
10-20 mins
if benzos unsuccessgul at terminating status what may be given ? what is done if this is unsucessful adn after how long
phenytoin or phenobarbitol infusion
45mins then general ansthetsia
how many rounds of benzos can be given in status
ONLY TWO
what doese of benzos are given in status
4mg lorazepam IV
10mg buccal or rectal
what are pseudoseizures or functional seizures called
psychogenic non epileptic seizures
