Epilepsy Flashcards

1
Q

What is epilepsy?

A

Epilepsy is a condition associated with reduced GABA levels in the brain that leads to abnormal cell-cell message propagation

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2
Q

What are the signs and symptoms of a febrile seizure?

A
  • fever
  • face may turn blue or red
  • eyes rolling upwards
  • loss of consciousness
  • muscles and limbs jerk
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3
Q

At what temperature are patients more at risk of a seizure?

A

above 38 degrees

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4
Q

What are the main classifications of epilepsy?

A
  • Generalised
  • Partial
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5
Q

What are the divisions of generalised epilepsy?

A
  • tonic/clonic
  • absence
  • myclonic/atonic
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6
Q

What are the divisions of partial epilepsy?

A
  • simple partial
  • complex partial
  • simple sensory
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7
Q

What are the triggers for epilepsy?

A
  • idiopathic
  • trauma (head injury)
  • CNS disease
  • social
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8
Q

what are examples of CNS diseases that can trigger epilepsy?

A
  • tumour
  • stroke
  • CJD
  • meningitis
  • encephalitis
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9
Q

what are examples of social triggers for epilepsy?

A
  • late nights
  • alcohol
  • hypoglycaemia
  • flashing lights
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10
Q

What are the features of Tonic Clonic seizures?

A
  • prodromal aura
  • loss of consciousness/continence
  • initial tonic
  • clonic phase
  • post-ictal drowsiness
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11
Q

what does tonic mean in relation to seizures?

A

Body becomes extremely stiff
- can be dangerous to spine

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12
Q

what does clonic mean in relation to seizures?

A

Contraction/relaxation of body
- jerky movements at this point

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13
Q

how long do tonic clonic seizures typically last for?

A

1-3mins
- can be recurrent however and this is dangerous

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14
Q

Why are status epilepticus (recurrent seizures) so dangerous?

A

Patient becomes increasingly hypoxic which can affect the brain

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15
Q

What are the features of Petit Mal (absence) seizures?

A
  • short lived episodes (5-15 seconds)
  • loss of awareness
  • eyelids flutter, vacant stare, stops activity, loss of response
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16
Q

How do tonic-clonic seizures affect the medical status of a patient?

A

INJURY prone
- may fall & get hurt
- must remove objects from mouth

Asphyxia
- use supplemental oxygen
- suction any secretions

17
Q

What epilepsy medication can affect pregnancy?

A

Sodium Valproate
- if taken during pregnancy it can significantly damage baby

18
Q

what are some precipitators for tonic-clonic seizures?

A
  • poor medication compliance
  • GA agents
  • alcohol
  • tricyclics & SSRIs (antidepressants)
  • fatigue/stress
  • infection
  • menstruation
19
Q

What are partial seizures?

A

Seizures that are localised to ONE region of the brain
- may move/spread to other ares

20
Q

What preventative treatment is used for epilepsy patients?

A

Anticonvulsant drugs
- carbamazepine
- gabapentin
- phenytoin
- valproate

21
Q

What emergency treatment is used for epilepsy patients?

A
  • airway & oxygen
  • status epilepticus requires BENZODIAZEPINES
22
Q

how do epilepsy drugs work?

A

Act on either:
- GABA receptor actions
- sodium channel actions

23
Q

what are examples of GABA receptor epilepsy drugs?

A
  • valproate
  • benzodiazepine
24
Q

what are examples of sodium channel acting epilepsy drugs?

A
  • carbamazepine
  • phenytoin
25
how does valproate work?
GABA transaminase inhibitor
26
how do benzodiazepines work?
GABAa receptor action on Cl enhanced
27
How does epilepsy affect dentistry?
Complications of fits - oral soft tissue injury - dental injury/fracture Complication of treatment - gingival hyperplasia - bleeding tendency - folate deficiency
28
what epilepsy drug can cause gingival hyperplasia?
phenytoin
29
what epilepsy drug can increase bleeding tendency?
valproate
30
An epileptic patient comes into your practise requiring treatment, how would you know it is safe to do so?
- ask when last three fits took place - ask about compliance with medication - ask about any changes in medication