Epilepsy Flashcards
What is epilepsy
neurological disorder characterised by recurrent seizures
What are seizures
A seizure is defined as a paroxysmal alteration of neurological function as a result of excessive, hypersynchronous discharge of neurons within the brain
What causes a seizure
imbalance between excitation and inhibition within the neurons of the brain.
What is the imbalance between
NAME?
Inherited risk factors of epilepsy
NAME?
Acquired risk factors
NAME?
What can trigger a seizure
NAME?
How are seizures classified
1-Where the seizures began
2-Level of awareness during the seizure
3-Other features of the seizure e.g. motor
Pre - ictal phase features ?
NAME?
what to investigate during the Ictal stage ? 6
NAME?
What would jerking suggest
tonic clonic
What occurs in a tonic clonic seizure
NAME?
What is myoclonic
Some or all of the body suddenly twitches. Usually lasts less than a second
Muscle twitching and spasming
What is a behavioural arrest seizure and what does it suggest?
A type of focal non-motor seizure characterized by an arrest or pause of activities, freezing, or immobilization as the predominant semiological feature throughout the seizure
Arrest seizure? IDK Maryam’s retarded
What is atonic
Sudden loss of muscle strength. Can cause a person to drop to the ground
What occurs during an abscence seizure
- childhood moments of staring blankly into space
- 3hz spike on ecg
what to investigate in the post - ictal symptoms 5
post ictal symptoms:
- drowsiness
- headaches
- amnesia
- dysphagia
- sore tongue
Where can seizures originate?
NAME?
What is the most common location of focal seizures
temporal lobe
Temporal lobe focal seizure features
NAME?
frontal lobe features of a focal seizure
NAME?
occipital focal seizure features
NAME?
Initial investigations
Bedside
- Urinalysis: nitrites or leucocytes would suggest infection
- Capillary blood glucose: to exclude hypoglycaemia
- ECG: to exclude differentials such as cardiogenic syncope
Bloods
- FBC
- Inflammatory markers
- U&E,bone profile , mg2+
Imaging for a seizure
ct head - to exclude intracranial causes such as haemorrhage
Diagnosis for epilepsy must involve?
must have had 2 or more seizures withins 24hr periodq
Conservative management
NAME?
medical management ?
NAME?
who cant have sodium valproate
except females of child bearing age
mechanism of sodium valproate
NAME?
Acute complications
- Injury
- Tongue biting
- Shoulder dislocation: usually posterior
- Status epilepticus: state of prolonged seizure activity >5 minutes
Three types of focal seizures
NAME?
first line tx for focal seizures
Lamatrogine or levetiracetam
1st line for tonic clonic focal
What seizures have sodium valproate as first line tx
Abscence
Generalised - tonic-clonic
myoclonic
Complications of epilepsy
- Status epilepticus - >5 minutes of continuous seizures
- Depression
- Suicide
- Sudden unexpected death in epilepsy (SUDEP)
what medication may worsen myoclonic seizures
carbamezepine
asynchronous limb movements, trunk movements and eyes being closed would suggest ?
dissociative seizure
Side effects of lamotrigine
NAME?
’ crazy movements’ sudden jerking of a limb , trunk or face with preserved consciousness would indicate
Myoclonic seizure
jacksonian march ?
Seizure starts in one group but can then move to another
Classic to focal motor seizures
