Epilepsy

Question 1

Define seizure

Answer 1

Transient episode of abnormal electrical activity in the brain

Question 1

What is needed for a diagnosis of epilepsy?

Answer 1

More than 2 seizures 24 hours apart

Question 2

What is a tonic clonic seizure?

Answer 2

Gand mal
Loss of consciousness
tonic muscle tensing and clonic muscle jerking
Tongue biting
Incontinence
Groaning

Question 3

What is the 1st line treatment for tonic clonic seizures?

Answer 3

Sodium valporate
Lamotrigine in girls

Question 4

What is an absence seizure?

Answer 4

Transient staring into space for seconds
Often grow out of it
Shows a 3Hz spike on EEG

Question 5

What is the 1st line treatment for absence seizures?

Answer 5

Ethosuximide
Lamotrigine in girls

Question 6

What is an atonic seizure?

Answer 6

Loss of tone of less than 3 minutes

Question 7

What is the 1st line treatment for atonic seizures?

Answer 7

Sodium valporate
Lamotrigine in girls

Question 8

What is a myoclonic seizure?

Answer 8

Muscle jerking

Question 9

What is the 1st line treatment for myoclonic seizures?

Answer 9

Sodium valporate
Leveltiracetam in girls

Question 10

What is west syndrome?

Answer 10

Clusters of full body spasms that starts from 6 months old
Give prednisolone

Question 11

What is benign rolandic epilepsy?

Answer 11

Tonic seizures that occur in sleep from 3-10 years old
May find child asleep on the floor

Question 12

What is a frontal lobe seizure?

Answer 12

Clonic movements that may travel proximally - jacksonian march

Question 13

What is a temporal lobe seizure?

Answer 13

Strange aura, lip smacking, deja vu

Question 14

How does a parietal lobe seizure present?

Answer 14

Contralateral altered sensation

Question 15

What is the 1st line management for focal seizures?

Answer 15

Lamotrigine or Levetiracetam

Question 16

What are the phases of a seizure?

Answer 16

Prodrome
Early ictal
Ictal
Post ictal

Question 17

How does sodium valporate work?

Answer 17

Increases GABA activity

Question 18

What does VALPORATE stand for in terms of sodium valporate side effects?

Answer 18

Vomiting and nausea - take with food
Appetite increase - weight gain
Liver damage
Pancreatitis
Oedema
Ataxia
Teratogenic and thrombocytopenia
Encephalopathy

Question 19

When is carbmazepine indicated?

Answer 19

2nd line for focal seizures
Can cause agranulocytosis

Question 20

What is status epilepticus and how is it treated?

Answer 20

ABCDE
Benzodiazepines - buccal midazolam or rectal diazepam
Repeat dose after 10 minutes
IV Phenytoin
Phenobarbital or general anaesthesia

Question 21

How long should you not drive for after a one-off seizure?

Answer 21

6 months

Question 22

Give some general lifestyle advice for epilepsy?

Answer 22

Use a safety alarm in the shower
Avoid baths
Don’t swimming alone
Limit alcohol intake
Avoid recreational drugs
Avoid sleep deprivation

Question 23

What is the only contraceptive not affected by epilepsy medication?

Answer 23

Copper IUD

Question 24

What are some side effects of phenytoin?

Answer 24

Teratogenic Hirsutism and acne Gingival hyperplasia Peripheral neuropathy Coarsening of facial features

Question 25

Give a serious side effect of Lamotrigine?

Answer 25

Stevens-Johnson syndrome

Question 26

Give some side effects of carbmazepine

Answer 26

Agranulocytosis Aplastic anaemia Ataxia

Question 27

What is Juvenile Myoclonic Epilepsy?

Answer 27

Myoclonic jerking seizures Worse when patients are sleep deprived Diagnose with a sleep deprived EEG

Question 28

What is the treatment for Juvenile Myoclonic Epilepsy?

Answer 28

Sodium valporate

Question 29

What is SLIDE in terms of epilepsy triggers?

Answer 29

Sleep deprivation Lights - flashing Infection Drugs - alcohol and withdrawal Exhaustion