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2a Neuro > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Epilepsy is an i_____ cause of seizures

A

idiopathic

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2
Q

Epilepsy consists of _ or more episodes more than 24 hours apart

A

2

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3
Q

What are risk factors for epilepsy?

A

Familial inheritance
Dementia (10x more likely)

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4
Q

In a seizure, what happens between the normal balance of GABA and glutamate?

A

Glutamate has larger effect than GABA so more excitatory stimulation

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5
Q

How long do epileptic seizures normally last?

A

Under 2 minutes

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6
Q

What are the stages of an epileptic seizure?

A

Prodrome
Aura
Ictal event (seizure)
Postictal period

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7
Q

What happens in the prodrome period of epilepsy?

A

Mood changes may occur a few day before

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8
Q

What happens during the aura stage of an epileptic seizure?

A

Deja vu and automatisms may be present a few minutes before the seizure

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9
Q

What are examples of automatisms (semi-coordinated, repetitive motor activities)

A

Lip smacking, rapid blinking

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10
Q

What occurs in the postictal period of epilepsy?

A

Headache
Confusion and low GCS
Todd’s paralysis
Dysphasia
Amnesia
Sore tongue - can often get bitten in seizure

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11
Q

What is Todd’s paralysis?

A

If motor cortex affected, may have temporary paralysis and muscle weakness after seizure

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12
Q

What is amnesia?

A

Memory loss - “what the heck happened”

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13
Q

Epileptic seizures can either be g_____ or f___

A

generalised or focal

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14
Q

In a generalised epileptic seizure, the brain is affected unilaterally/bilaterally and there is always/sometimes a loss of consciousness

A

bilaterally
always a loss of consciousness

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15
Q

Describe what happens in a generalised tonic-clonic epileptic seizure (used to be called grand mal seizure)

A

Tonic phase followed by clonic muscle contractions.

No aura
Tonic phase: rigidity and fall to floor
Clonic phase: jerking of limbs

Up-gazing of eyes
Incontinence
Tongue bitten

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16
Q

What happens in a generalised absence seizure (used to be called petit mal seizures)?

A

A short period of “blanking out” or staring into space, brief abnormal electrical activity in brain.

All activity is stopped without warning, eyelids may turn upwards and eyelids flutter, momentarily confused but then back to normal.

17
Q

What group of people are generalised absence seizures most common in

A

Children and adolescence

18
Q

What frequency spike is shown on an ECG during a generalised absence seizure?

A

3 Hz

19
Q

In a f___ seizure, the features are confined to one region, may progress to a secondary generalised seizure

A

focal

20
Q

What occurs in a simple focal seizure?

A

There is no loss of consciousness, patient is awake and aware
Uncontrollable muscle jerking

21
Q

True or false: there is basal ganglia and thalamus involvement in a simple focal seizure

A

False, no basal ganglia or thalamus involvement, there is in a complex focal seizure.

22
Q

What occurs in a complex focal seizure?

A

Loss of consciousness
Patient unaware
Symptoms depend on where focal neurology is

23
Q

What symptoms are shown in a temporal complex focal seizure?

A

Aura
Dysphasia
Post ictal period

24
Q

What symptoms are shown in a frontal complex focal seizure?

A

Jacksonian March and Todd’s Palsy

25
Q

What is Jacksonian march?

A

Seizure /tingling and twitching spreads from distal part of limb toward the ipsilateral face

26
Q

What symptoms are shown in a parietal complex focal seizure?

A

Parathesia

27
Q

What symptoms are shown in an occipital complex focal seizure?

A

Changes to the vision

28
Q

True or false: must have had at least 2 seizures more than 24 hours apart to consider diagnosis of epilepsy

A

True

29
Q

How do you diagnose epilepsy?

A

CT head and MRI:
Examine hippocampus
Check for bleeds and tumours

EEG:
3Hz wave in absence

Bloods:
To rule out metabolic or infective causes

30
Q

How do you treat epilepsy and when is it contradindicated?

A

Sodium Valproate
Except in females of childbearing age (15-45) as it is teratogenic

31
Q

What medication is given for epilepsy in 15-45 y/o females?

A

Lamotrigine

32
Q

What is a complication of epilepsy called?

A

Status epilepticus

33
Q

What is status epilepticus?

A

Epileptic seizures without a break, back-to-back
or
A seizure lasting over 5 minutes

34
Q

How do you treat status epilepticus?

A

Benzodiazepines: IV Lorazepam 4mg

If not working:
do second dose of lorazepam

If still not working:
Phenytoin

2a Neuro (42 decks)

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