Epilepsy

Question 1

What are the main types of seizures seen in adults?

Answer 1

Generalised tonic clonic
Partial
Myoclonic
Tonic
Atonic

Question 2

What are the main types of seizures seen in children?

Answer 2

Absence seizures
Infantile
Febrile convulsions

Question 3

Explain what tonic clonic seizures are like?

Answer 3

Tonic - muscle tensing
Clonic - muscle jerking
Loss of consciousness
Might have aura pre seizure
During seizure - tongue biting, incontinence, groaning, irregular breathing
Post-ictal period - confusion, fatigue

Question 4

In which partial seizures does the patient remain aware?

Answer 4

Simple partial seizures

Question 5

In which partial seizures do pts not have awareness?

Answer 5

Complex partial seizures

Question 6

What are partial seizures also known as?

Answer 6

focal

Question 7

Which lobe do partial seizures usually occur in?

Answer 7

Temporal

Question 8

What are some of the symptoms in partial seizures?

Answer 8

Remain awake
Deja vu
Strange sensations
Unusual emotions
Abnormal behaviours

Question 9

What are features of myoclonic seizures?

Answer 9

Sudden brief muscle contractions
Remain awake

Question 10

What do atonic seizures involve?

Answer 10

Sudden loss of muscle tone often resulting in a fall
Last briefly
Usually aware

Question 11

What are infantile spasms also known as?

Answer 11

West syndrome

Question 12

What age do infantile spasms start?

Answer 12

6 months

Question 13

What is the characteristic EEG finding in infantile spasms?

Answer 13

HypsarrythmiaWhat

Question 14

What is treatment of infantile spasms?

Answer 14

ACTH
Vigabatrin

Question 15

What age to febrile convulsions tend to occur?

Answer 15

6 months - 5 years

Question 16

What type of seizure are febrile convulsions?

Answer 16

Tonic clonic seizures

Question 17

What investigations would you do?

Answer 17

EEG
MRI head for structural pathology
ECG
Electrolytes
Glucose
Sepsis investigations

Question 18

How long does someone need to be seizure free before they can drive?

Answer 18

one year

Question 19

Give the treatment of men and women who can’t have children for generalised tonic clonic seizures?

Answer 19

Sodium valproate

Question 20

Give the treatment of men and women who can’t have children for partial seizures?

Answer 20

Lamotrigine or levetiracetam

Question 21

Give the treatment of men and women who can’t have children for myoclonic seizures?

Answer 21

Sodium valproate

Question 22

Give the treatment of men and women who can’t have children for Tonic and atonic seizures??

Answer 22

sodium valproate

Question 23

Give the treatment of men and women who can’t have children for absence seizures?

Answer 23

ethosuximide?

Question 24

What is the treatment for women able to have children in generalised tonic clonic seizures?

Answer 24

lamotrigine
levetiracetam

Question 25

What is the treatment for women able to have children in partial seizures?

Answer 25

Lamotrigine or levetiracetam

Question 26

What is the treatment for women able to have children in myoclonic seizures?

Answer 26

levetiracetam

Question 27

What is the treatment for women able to have children in tonic and atonic seizures

Answer 27

lamotrigine

Question 28

What is the treatment for women able to have children in absence seizures?

Answer 28

Ethosuximide

Question 29

What are side effects of sodium valproate?

Answer 29

Teratogenic Liver damage and hepatitis Hair loss Tremor Reduced fertility Weight gain

Question 30

Why is sodium valproate avoided in pregnancy?

Answer 30

Neural tube defects and developmental delay

Question 31

What is the definition of status epilepticus?

Answer 31

Seizure lasting more than 5 minutes Multiple seizures without regaining consciousness in the interim

Question 32

Give the medical management of status epilepticus

Answer 32

1. Benzodiazepine - buccal midazolam 10mg, rectal diazepam 10mg or IV lorazepam 4mg 2. IV levetiracetam, phenytoin or sodium valproate if 2 doses not working 3. Phenobarbital or GA

Question 33

What is cataplexy?

Answer 33

sudden and transient loss of muscular tone caused by strong emotion features range from knee buckling to collapse

Question 34

How long can a patient not drive for following a first unprovoked seizure with normal imaging and EEG

Answer 34

6 months

Question 35

How long must a patient not drive if they have a single episode of syncope, explained and treated

Answer 35

for 4 weeks

Question 36

How long must a patient not drive for if they have a single unexplained episode of syncope?

Answer 36

6 months

Question 37

How long must a patient not drive for if they have 2 or more episodes of syncope?

Answer 37

12 months