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neuro > epilepsy > Flashcards

epilepsy Flashcards

1
Q

what are the types of seizures?

A

myoclonic seizures
tonic clonic
atonic
generlaised tonic -clonic
partial or focal seizures

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2
Q

what seizures are most common in children?

A

febrile
absence
infantile spasms

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3
Q

what are tonic clonic seizures?

A

tonic - muslce tensing
clonic - muscle jerking
associated with complete loss of consciousness

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4
Q

what is involved within tonic clonic seizures?

A

aura - warning pre seizure
during; tongue bititng, incontinence, groaning and irregular breathing
post ictal: confused, tired, irritable and low

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5
Q

where do partial seizures occur?

A

one area in the brain - usual temporal

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6
Q

what does partial seizures affect?

A

hearing, speech, memory, emotions

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7
Q

what occurs during partial seizures?

A

remain awake
can remain aware in simple but lose awareness in complex partial seizures

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8
Q

what symptoms occur during partial seizures?

A

deja vu
strange smells, taste, sights or sound sensation
unusual emotions
abnormal behaviours

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9
Q

what are myoclonic seizures?

A

sudden, brief msucle contractions like abrupt, jump or jolt
remain awake

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10
Q

what are tonic seizure’s?

A

sudden onset of increased muscle - often results in fall
last briefly
begin in childhood

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11
Q

what are atonic seizures?

A

drop attacks - sudden loss in muscle tone - results in a fall

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12
Q

what are absence seizures?

A

usually in children
Patient becomes blank, stares in space
then abruptly returns to normal
do not respond and unaware of surroundings

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13
Q

what are infantile spasms?

A

also known as west syndrome
presents at 6mths
clusters of full body symptoms

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14
Q

how do you detect infantile spasms?

A

hypsarrhthymias - on EEG

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15
Q

how is infantile spasms managed?

A

associated with developmental regression and has poor prognosis
treat with ACTH and vigabatrin

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16
Q

what are febrile convulsions?

A

tonic clonic seizures occurring in children with high fevers

17
Q

are febrile convulsions linked to epilepsy?

A

do not cause lasting damage
have a slight risk of developing epilepsy

18
Q

how do you investigate epilepsy and why?

A

EEG: typical patterns show different forms of epilepsy
MRI brain: diagnose structural pathology
ECG
serum electrolytes- sodium, potassium , calcium and magnesium
blood glucose: hypoglycaemia and diabetes
blood cultures, urine cultures and LP

19
Q

what general management need to be taken with seizures?

A

DVLA remove their driving licence - until seizure free for one year
taking showers rather than baths
caution with swimming, heights, traffic and dangerous equipment

20
Q

for men, what is 1st line management for generalised tonic -clonic?

A

sodium valproate

21
Q

for women of childbearing age, what management should they have for generalised tonic clonic seizures?

A

lamotrigine
levetiracetam

22
Q

what management is given for partial or focal seizures?

A

lamotrigine
levetiracam

23
Q

what medication is given in myoclonic seizures?

A

sodium valproate - men
levetiracim - women of childbearing age

24
Q

what medication is given to tonic atonic seizures?

A

men- sodium valproate
women of childbearing age - lamotrigine

25
Q

what medication should be given to absence seizures?

A

ethosuximide

26
Q

how does sodium valproate work?

A

increasing activity of GABA - calming effect on the brain

27
Q

what are the side effects are sodium valproate?

A

teratogenic - harmful in pregnancy
liver damage and hepatitis
hair loss
tremor
reduce fertility

28
Q

why is sodium valproate tetrogenic?

A

neural tube defects and developmental delay

29
Q

what is valproate pregnancy prevention?

A

ensure effective contraception
fill out annual acknowledgement form

30
Q

how do you define status epilepticus?

A

seizure lasting more than 5mmins
mulitple seizures without regaining consciousness between

31
Q

how do you manage status epilepticus?

A

ABCDE
secure airway
high flow oxygen
check BMs
gaining IV cannula

32
Q

what are medical management for status epilepticus?

A

benzopdiazepines - repeat after 5-10 mins after seizures
second line - after benzo = IV levetiracetam, phenytoin, sodium valproate
third line - phenobarbita or GA

33
Q
A

neuro (12 decks)

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