EPILEPSY Flashcards
Epilepsy
reduced GABA levels in the brain leading to abnormal discharge of neurones
types of epilepsy
generalised - tonic/clonic, absence (petit mal)
partial - simple, complex, simple sensory
febrile seizure
affect children with fevers
causes of epilepsy
vascular disease
trauma
CNS disease; tumour, stroke, CID, meningitis, encephalitis
social; late nights, alcohol, hypoglycaemia, flashing lights
tonic part of seizure
pt has awareness of change in brain function before onset of seizure
they become stiff and lose consciousness and may fall to floor
clonic part of seizure
jerking/ contracting/ relaxing uncontrollably
postictal state in tonic/ clonic seizure
termination after 1-3 minutes
pt feels drowsy
status epilepticus
tonic clonic seizure
repeating
petit mal (absence) seizure
black out or stare into space for a few seconds
- eyelid flutter
- vacant stare
- stops activity
- loss of response
epilepsy precipitators
withdrawal/ poor med compliance
epileptogenic drugs
fatigue/ stress
infection
menstruation
epileptogenic drugs
some GA agents
alcohol
tricyclics
SSRIs
partial seizures
motor localised to one region of the brain
Jacksonian seizure
partial seizure that spreads to other motor areas
sensory partial seizure
affects any sensory modality - visual, auditory, taste, smell
often aura and may involve deja vu
complex partial seizure
automatism; repetitive purposeless movements - lip smacking, grimacing
preventative epilepsy tx
anticonvulsant drugs - valproate, carbamazepine
anticonvulsant drug for tonic clonic
phenytoin
anticonvulsant drug for absence
levetiracetam
emergency epilepsy tx
airway and O2
benzodiazepines for status epilepticus
valproate and benzodiazepine mode of action
GABA receptor actions
Carbamazepine and phenytoin mode of action
sodium channel action
surgery for epilepsy
removal of focal neurological lesions (benign brain tumours)
dental aspects of epilepsy
fits
gingival hyperplasia (caused by phenytoin)
bleeding tendency (caused by valporate)
folate deificiency
must treat during quiescent phases
how to assess the risk of fits
ask when the last 3 fits took place
ask about compliance with medication
ask about changes in medication
