Epilepsy Flashcards
Define seizure
Transient episode of abnormal electrical activity in the brain
What is needed for a diagnosis of epilepsy?
More than 2 seizures 24 hours apart
What is a tonic clonic seizure?
Gand mal
Loss of consciousness
tonic muscle tensing and clonic muscle jerking
Tongue biting
Incontinence
Groaning
What is the 1st line treatment for tonic clonic seizures?
Sodium valporate
Lamotrigine in girls
What is an absence seizure?
Transient staring into space for seconds
Often grow out of it
Shows a 3Hz spike on EEG
What is the 1st line treatment for absence seizures?
Ethosuximide
Lamotrigine in girls
What is an atonic seizure?
Loss of tone of less than 3 minutes
What is the 1st line treatment for atonic seizures?
Sodium valporate
Lamotrigine in girls
What is a myoclonic seizure?
Muscle jerking
What is the 1st line treatment for myoclonic seizures?
Sodium valporate
Leveltiracetam in girls
What is west syndrome?
Clusters of full body spasms that starts from 6 months old
Give prednisolone
What is benign rolandic epilepsy?
Tonic seizures that occur in sleep from 3-10 years old
May find child asleep on the floor
What is a frontal lobe seizure?
Clonic movements that may travel proximally - jacksonian march
What is a temporal lobe seizure?
Strange aura, lip smacking, deja vu
How does a parietal lobe seizure present?
Contralateral altered sensation
What is the 1st line management for focal seizures?
Lamotrigine or Levetiracetam
What are the phases of a seizure?
Prodrome
Early ictal
Ictal
Post ictal
How does sodium valporate work?
Increases GABA activity
What does VALPORATE stand for in terms of sodium valporate side effects?
Vomiting and nausea - take with food
Appetite increase - weight gain
Liver damage
Pancreatitis
Oedema
Ataxia
Teratogenic and thrombocytopenia
Encephalopathy
When is carbmazepine indicated?
2nd line for focal seizures
Can cause agranulocytosis
What is status epilepticus and how is it treated?
ABCDE
Benzodiazepines - buccal midazolam or rectal diazepam
Repeat dose after 10 minutes
IV Phenytoin
Phenobarbital or general anaesthesia
How long should you not drive for after a one-off seizure?
6 months
Give some general lifestyle advice for epilepsy?
Use a safety alarm in the shower
Avoid baths
Don’t swimming alone
Limit alcohol intake
Avoid recreational drugs
Avoid sleep deprivation
What is the only contraceptive not affected by epilepsy medication?
Copper IUD
What are some side effects of phenytoin?
Teratogenic
Hirsutism and acne
Gingival hyperplasia
Peripheral neuropathy
Coarsening of facial features
Give a serious side effect of Lamotrigine?
Stevens-Johnson syndrome
Give some side effects of carbmazepine
Agranulocytosis
Aplastic anaemia
Ataxia
What is Juvenile Myoclonic Epilepsy?
Myoclonic jerking seizures
Worse when patients are sleep deprived
Diagnose with a sleep deprived EEG
What is the treatment for Juvenile Myoclonic Epilepsy?
Sodium valporate
What is SLIDE in terms of epilepsy triggers?
Sleep deprivation
Lights - flashing
Infection
Drugs - alcohol and withdrawal
Exhaustion
