EPILEPSY

Question 1

Flashcard 1:
Q: What is the general approach to epilepsy treatment in the UK?

Answer 1

A: The general approach to epilepsy treatment is individualized based on the seizure type, epilepsy syndrome, comorbidities, and the person’s lifestyle and preferences.

Question 2

Flashcard 2:
Q: What is the first-line treatment for focal seizures?

Answer 2

A: First-line treatment for focal seizures typically includes carbamazepine, lamotrigine, or levetiracetam.

Question 3

Flashcard 3:
Q: How does carbamazepine work in the treatment of epilepsy?

Answer 3

A: Carbamazepine stabilizes neuronal membranes by inhibiting sodium channels, reducing the repetitive firing of neurons.

Question 4

Flashcard 4:
Q: What are common side effects of carbamazepine?

Answer 4

A: Common side effects can include dizziness, drowsiness, unsteadiness, nausea, and rash.

Question 5

Flashcard 5:
Q: How does lamotrigine work in the treatment of epilepsy?

Answer 5

A: Lamotrigine works by stabilizing neuronal membranes and inhibiting the release of glutamate, an excitatory neurotransmitter.

Question 6

Flashcard 6:
Q: What are common side effects of lamotrigine?

Answer 6

A: Common side effects can include dizziness, headache, blurred or double vision, sleepiness, and rash.

Question 7

Flashcard 7:
Q: How does levetiracetam work in the treatment of epilepsy?

Answer 7

A: Levetiracetam works by binding to synaptic vesicle protein SV2A, which is thought to impede nerve conduction across synapses.

Question 8

Flashcard 8:
Q: What are common side effects of levetiracetam?

Answer 8

A: Common side effects can include sleepiness, weakness, dizziness, and behavioral changes.

Question 9

Flashcard 9:
Q: What is the first-line treatment for generalized tonic-clonic seizures?

Answer 9

A: First-line treatment for generalized tonic-clonic seizures typically includes sodium valproate, lamotrigine, or levetiracetam.

Question 10

Flashcard 10:
Q: How does sodium valproate work in the treatment of epilepsy?

Answer 10

A: Sodium valproate works by increasing the amount of gamma-aminobutyric acid (GABA) in the brain and by preventing the breakdown of this neurotransmitter.

Question 11

Flashcard 11:
Q: What are common side effects of sodium valproate?

Answer 11

A: Common side effects can include nausea, tremor, weight gain, and hair loss. Importantly, sodium valproate can cause birth defects if taken during pregnancy.

Question 12

Flashcard 12:
Q: What is the first-line treatment for absence seizures?

Answer 12

A: First-line treatment for absence seizures typically includes ethosuximide or sodium valproate.

Question 13

Flashcard 13:
Q: How does ethosuximide work in the treatment of epilepsy?

Answer 13

A: Ethosuximide works by reducing the low-threshold calcium currents in thalamic neurons, thus modulating the rhythmic firing of these neurons.

Question 14

Flashcard 14:
Q: What are common side effects of ethosuximide?

Answer 14

A: Common side effects can include nausea, vomiting, drowsiness, headache, and rash.

Question 15

Flashcard 15:
Q: What non-pharmacological treatments can be considered for epilepsy?

Answer 15

A: Non-pharmacological treatments, such as the ketogenic diet, vagus nerve stimulation, and epilepsy surgery, may be considered for some people with epilepsy who do not respond to medication.

Question 16

Flashcard 16:
Q: What role do regular reviews play in the management of epilepsy?

Answer 16

A: Regular reviews allow healthcare providers to assess seizure control, monitor for side effects, evaluate the need for continued treatment, and provide ongoing support and education.

Question 17

Flashcard 17:
Q: What are the considerations for women with epilepsy who are pregnant or planning to become pregnant?

Answer 17

A: Women with epilepsy who are pregnant or planning to become pregnant should be managed with a specialist to balance seizure control with the safety of medications during pregnancy. Sodium valproate should be avoided due to the risk of birth defects.

Question 18

Flashcard 18:
Q: What is the first-line treatment for status epilepticus?

Answer 18

A: The first-line treatment for status epilepticus is typically a benzodiazepine, such as lorazepam or diazepam.

Question 19

Flashcard 19:
Q: How do benzodiazepines work in the treatment of epilepsy?
A:

Answer 19

Benzodiazepines enhance the effect of the neurotransmitter GABA in the brain, reducing neuronal excitability and thus terminating seizures.

Question 20

Flashcard 20:
Q: What are common side effects of benzodiazepines?
A:

Answer 20

Common side effects can include drowsiness, confusion, and loss of balance or coordination. Prolonged use can lead to dependence.

Question 21

Flashcard 21:
Q: What is the role of epilepsy specialist nurses (ESNs) in the management of epilepsy?
A:

Answer 21

ESNs provide information, support, and advice to people with epilepsy and their families. They also play a key role in facilitating communication between the person with epilepsy and the multidisciplinary team.

Question 22

Flashcard 22:
Q: What is topiramate, and how does it work in the treatment of epilepsy?

Answer 22

A: Topiramate is an antiepileptic drug that blocks voltage-dependent sodium channels, enhances GABA activity, antagonizes glutamate receptors, and inhibits carbonic anhydrase enzymes.

Question 23

Flashcard 23:
Q: What are the common side effects of topiramate?

Answer 23

A: Common side effects can include tiredness, dizziness, confusion, difficulty with concentration, and numbness or tingling in the hands or feet.

Question 24

Flashcard 24:
Q: What is clobazam, and when is it used in the treatment of epilepsy?

Answer 24

A: Clobazam is a benzodiazepine medication used as an adjunctive treatment for seizures in conditions like Lennox-Gastaut syndrome. It enhances the activity of GABA in the brain.

Question 25

Flashcard 25:
Q: What are common side effects of clobazam?

Answer 25

A: Common side effects can include drowsiness, dizziness, constipation, cough, and fever.

Question 26

Flashcard 26:
Q: How are breakthrough seizures managed in the outpatient setting?

Answer 26

A: Breakthrough seizures might indicate the need for a change in antiepileptic drug regimen and should be evaluated by a healthcare provider. If seizures become more frequent or severe, emergency care may be necessary.

Question 27

Flashcard 27:
Q: What is the ketogenic diet, and how does it help in epilepsy?

Answer 27

A: The ketogenic diet is a high-fat, low-carbohydrate diet that can reduce seizure frequency in some individuals with epilepsy, particularly children with drug-resistant epilepsy. The exact mechanism is unknown.

Question 28

Flashcard 28:
Q: What is vagus nerve stimulation (VNS), and when is it used in epilepsy treatment?

Answer 28

A: VNS is a type of therapy where a device is implanted under the skin that sends electrical signals to the vagus nerve, reducing seizure frequency. It’s typically used for individuals who haven’t responded well to medications.

Question 29

Flashcard 29:
Q: What is the role of epilepsy surgery in the treatment of epilepsy?

Answer 29

A: Epilepsy surgery, such as resective surgery or disconnection procedures, can be considered for individuals with drug-resistant focal epilepsy to potentially achieve seizure freedom.

Question 30

Flashcard 30:
Q: How are triggers managed in the treatment of epilepsy?

Answer 30

A: Identifying and managing triggers—like missed medication, lack of sleep, stress, or certain foods—can be a key part of epilepsy treatment. Trigger management varies widely depending on the individual.