Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What are the main causes for transient loss of consciousness?

A

Vasovagal, reflex syncope, cardiogenic syncope, epilepsy, metabolic and unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can cause loss of consciousnness?

A

Prolonged standing, postural change, pain, vomiting, passing urine, coughing, exercising, sleep deprived, excess alcohol and illicit drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some warning symptoms for syncope?

A

Light headed, nausea, hot, cold sweat, loss of hearing, tinnitus, loss of vision
Deja vu, sudden feeling anxiety or panic
Palpitations/ cardiac symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 categories of syncope?

A

Reflex (neuro-cardiogenic)
Orthostatic
Cardiogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What could cause reflex syncope?

A

Taking blood or medical situations
Cough, medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What could cause orthostatic syncope?

A

Dehydration, medication related, endocrine and autonomic nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What could cause cardiogenic syncope?

A

Arrhythmia and aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is included in patient history of syncope?

A

Need stimulus and context - blood taken, in bathroom, standing
Did they have a warning
Is clammy or sweaty, fully oriented quickly and if any urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the witness account of syncope?

A

Looked a bit pale, suddenly went floppy, few brief jerks and brief LOC
Rapid recovery or prolonged if propped up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the assessment of syncope

A

Exam - heart sounds, pulse, BP
Must have ECG - heart block and QT ratio
May need 24 hour ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the patients account of cardiogenic syncope?

A

Can have exertion before
Chest pain, palpitations and SOB
Can have these same symptoms after, can come around quickly but recovery longer
Usually clammy/ sweaty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the witness account for cardiac syncope?

A

Suddenly went floppy, looked grey, seemed to stop breathing, and unable to feel pulse
Variable duration of LOC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is cardiogenic syncope assessed?

A

FH important
Exam - heart sounds and pulse
ECG
Refer to cardiology
May need 24hr ECG/ ECHO or prolonged monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a pseudo-seizure?

A

Non epileptic attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the patient account for pseudo-seizures?

A

Events may occur at stress or while at rest, may describe dissociation, can maybe recall what people said during and can be prolonged episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the witness account of pseudoseizures?

A

May recognise stress as trigger, signs of patient retaining awareness, movements which are not typical of seizers, try catch episode on EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can cause provoked seizures?

A

Alcohol withdrawal, drug withdrawal, days after head injury, within 24hrs of stroke or neurosurgery, electrolyte disturbance and eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is epilepsy?

A

Tendency of recurrent seizures
If electrical activity in neurons is disrupted then can lead to seizure
Used if more than one unprovoked seizure but can be only after one if investigations show

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the pathophysiology of epilepsies

A

Synchronous discharge in cortical neurons - too much excitement, damaged neurons or too little excitement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes too little excitement in neurons?

A

GABA receptors

21
Q

What can cause damaged neurons?

A

Stroke, tumour, trauma or developmental causes

22
Q

What can cause too much excitement of neurons?

A

Glutamate receptors, Ion channels and excitatory amino acids

23
Q

How does Valproate help epilepsy?

A

Increases GABA turnover, decreases Na+ channels and decreases NMDA receptors

24
Q

What factors can increase the risk of seizure?

A

Missed medications, sleep disturbance, hormonal changes, drug/ alcohol use, drug interactions, stress/ anxiety, photosensitivity

25
Q

What is the basic classification of seizures?

A

Generalised and focal seizures

26
Q

What is included in generalised seizures?

A

Absence, generalised tonic-clonic, myoclonic, juvenile myoclonic and atonic seizures

27
Q

What is included in focal seizures?

A

Simple partial, complex partial, secondary generalised, or by localisation of onset (temporal, frontal)

28
Q

Describe primary generalised seizures

A

No warning, under 35, generalised abnormality on EEG and may have FH
Can have history of absences and myoclonic jerks as well as GTCS

29
Q

Describe focal/ partial seizures

A

May get an aura (warning)
Any age cause can be any focal brain abnormality, focal abnormality on EEG and MRI can show cause
Simple and complex partial can become secondary generalised

30
Q

What is the patient account of generalised tonic clonic seizure?

A

Unpredictable, tend to cluster, PMH - complication of birth, trauma, meningitis and brain injuries
May have vague warning or irritability before
Lateral tongue biting, incontinence, muscle pain

31
Q

What is the witness account of generalised tonic clonic seizure?

A

Groaning sound, tonic (rigid phase) then generalised jerking in all 4 limbs, foaming of mouth, staring/ roll upwards, jerking then groggy
May be agitated after and can be clustered

32
Q

Describe absence seizures

A

Often in children and they are unaware
May be provoked by hyperventilation/ photic stimulation
Brief staring then eye lid fluttering
Restarts what they were doing

33
Q

What is the patient account of complex partial seizures - temporal?

A

Rising feeling in stomach funny smell/taste, deja vu, no recollection and is disorientated for a spell

34
Q

What is the witness account for complex partial seizure?

A

Sudden arrest in activity, staring blank into space, automatisms - lip smacking and repetitive picking of clothes
May be disorientated after

35
Q

Describe frontal lobe seizures

A

Can be mistaken for non-epileptic attack as strange
Brief, bizarre and motor
Can be frequent with rapid recovery
Pattern of movement is stereotyped

36
Q

How is seizures clinically assessed?

A

Refer to seizure clinic, do ECG, routine bloods (GIc), A+E usually arrange CT
Neurology - may need MRI, EEG, antiepileptic drugs, epilepsy nurse and discuss driving

37
Q

What investigations are used for epilepsy?

A

EEG from primary generalised epilepsies
MRI for patients under 50 as possible focal onset seizure
Video telemetry if uncertainty

38
Q

What is the first line treatment for epilepsy?

A

Sodium Valproate, Lamotrigine, Levetiracetam for primary generalised epilepsy
Lamotrigine, Carbamazepine, Levetiracetam for partial and secondary generalised
Ethosuximide for absence

39
Q

What is the second line treatment for generalised epilepsy?

A

Topiramate and Zonisamide
Generally avoid Carbamazepine

40
Q

What is used for second line treatment for partial seizures?

A

Sodium valproate, topiramate, brivaracetam, gabapentin

41
Q

What are the side effects of sodium valproate?

A

Tremor, weight gain, ataxia, nausea, drowsiness, transient hair loss, pancreatitis and hepatitis
Avoid in women of child bearing age

42
Q

What are the side effects carbamazepine?

A

Ataxia, drowsiness, nystagmus, blurred vision, low sodium serum levels, skin rash

43
Q

What are the side effects of Lamotrigine?

A

Skin rash and difficulty sleeping

44
Q

What are the side effects of Levetiracetam?

A

Irritability and depression

45
Q

Describe status epilepticus

A

Generalised convulsive or non convulsive seizures going on for 5 mins or more either continuously or repetitively with no intervening recovery

46
Q

What are some risk factors of status epilepticus?

A

Non adherence to treatment, chronic alcoholism, refractory epilepsy, toxic or metabolic causes and acute brain injury

47
Q

What is the first line treatment of status epilepticus?

A

Midazolam - 10mg buccal or nasal route
Lorazepam

48
Q

What is the second and third line treatment for status epilepticus?

A

Valproate, Levetiracetam, Phenytoin
Third line - Anaesthesia with propofol or thiopentone

Neuro (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions