Epilepsy Flashcards
NICE Guidelines regarding EEG in diagnosis of Epilepsy
Ideally within 72 hours
If normal consider sleep deprived study
If both are negative consider 48hr ambulatory
NICE guidelines regarding MRI in diagnosis of Epilepsy
To look for structural abnormalities
Within 6 weeks
If contraindicated then CT
NICE guidelines regarding CT in Epilepsy
Do not routinely offer in known seizure disorder where it is typical, unless other features
NICE guidelines regarding genetic and antibody testing in Epilepsy
Gene testing
- whole genome kids ASD, LD, structural abnormality, cognitive decline
-Started between age 2-3 in epilepsy of unknown cause
Antibody testing - If auto-immune encephalitis is suspected
Refer to a tertiary service when…
Cause or diagnosis is unclear or unknown
Drug resistant
Clinical Trial
Generalised Tonic Clonic
Treatment
- Sodium Valproate
- Lamotrigine vs Levetiracetam (1st line women)
- Clozebam, Lamotrigine, levetiracetam, sodium valporate, topirarate, perampanel
Women and Sodium Valproate?
Okay for women who can’t have children or
Girls <10 years who can complete treatment before puberty/children
Should be avoided unless no other option
Focal seizures
Treatment
- Lamotrigine or Levetiracetam
- Carbamazepine, Oxcarbamazapine, zonisamide
- Lacrosamide
Absent Seizures
Treatment
- Ethosuximide
- Sodium Valproate
- levetiracetam vs lamotrigine
What medications can make absent seizures worse?
Carbamazepine, Oxcarbazepine, phenobarbital, phenytoin, pregabalin, tiagabine, vigabatrin
Monoclonic Seizures
Treatment
1st line- Sodium valproate
2nd line - Levetiracetam (1st line For women)
Tonic or Atonic Seizures
Treatment
1st line- Sodium valproate
2nd line - Lamotrigine (1st line for women)
Dravet Synrome, lennox Gastraught
Treatment
Sodium Valrpoate
Phenytonin Side effects
Skin reactions
Effects contraceptives
oestomalacia
Carbamazepine side effects
Skin reactions
oestomalacia
effects contraceptives
