Epilepsy Flashcards
What is the definition of a seizure?
The transient occurrence of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
How many people does epilepsy affect worldwide?
~ 70 million people
What is SUDEP?
Sudden Unexpected Death in Epilepsy
What are the risk factors for epilepsy?
- Premature birth
- Complicated febrile seizures
- Brain development malformation
- Family history
- Head trauma
- Infections e.g. meningitis
- Tumours
- Cerebrovascular disease/stroke
- Dementia and neurodegenerative disorders
- Drugs and alcohol withdrawal
What investigations are done in order to diagnose epilepsy?
- EEG
- Blood tests
- ECG
- Neuro-imagining
- Genetic testing
- Antibody testing
- Neuropsychological assessment
How is epilepsy diagnosed in neonates?
EEG
What are the three main groups of seizures?
Focal, generalised, unknown
What are epilepsy-related deaths thought to be caused by? (3)
- Epileptic condition
- The antiepileptic treatment
- Co-morbidities
What are focal seizures?
Increased neuronal activity originating and remaining in one hemisphere of the brain.
What are simple focal seizures?
Focal seizures with no loss of consciousness.
What are complex or focal dyscognitive seizures?
Focal seizures with impaired awareness.
What are generalised seizures?
Increased neuronal activity which is widespread across both hemispheres of the brain.
What 2 sub groups are generalised seizures divided into?
- Motor
- Non motor
What is a tonic seizure?
Sustained increased muscle contraction (tense and rigid muscles)
What is a myoclonus seizure?
Muscle twitching (can involve one or multiple muscle groups)
What is an atonic seizure?
Muscles becoming limp.
What is a clonic seizure?
Jerking rhythmic twitching movements.
What is a tonic-clonic seizure?
Where the seizure starts off in the tonic phase then moves into clonic phase.
What is an absence seizure?
Vacant staring, movement stops.
What is status epilepticus?
A prolonged convulsive seizure lasting 5 minutes or longer, or recurrent seizures one after the other without recovery in between.
MEDICAL EMERGENCY
What can cause status epilepticus? (4)
- Head injury
- Metabolic disturbance (hypoglycaemia)
- Cerebrovascular event (stroke)
- Alcohol withdrawal
Overview of anti-epileptic treatment
- Mono therapy of an AED
- If that fails switch to another AED
- If second AED fails, consider combination therapy
Are regular blood tests required during anti-epileptic treatment?
No
What are the possible reasons for blood tests and/or therapeutic monitoring during anti-epileptic treatment? (5)
- To identify non-adherence
- Investigate suspected toxicity
- Adjustment of phenytoin doses
- Managing interactions with other medications
- For specific clinical conditions e.g. organ failure or pregnancy
