Epilepsy Flashcards
types of syncope
reflex
orthostaic
cardiogenic
reflex synpe
due to cough
or meidcal situation such as taking blood
orthostatic syncope
due to dehydraiont, medicaito related
endocrine, autonomic nervous system
cardiogenic related syncope
arrhythrmia, aortic stenosis
why can syncope look like a seizure
as there can be jerks
what assemsnt shoul dbe done for syncpe
heart souns, pulse
postula bp, ecg for heart block adn qt ratio
bloods
24 hour ecg may be needed
what are after a cardiogne syncpe
chest pai, palpitations, sob, thye feel clammy and seaty
epilepsy
recurrent unprovoked seizures
cardiac cuase of syncpe
Arrhythmias
Valvular heart disease
Hypertrophic obstructive cardiomyopathy
signs of syncpe
Hot or clammy
Sweaty
Heavy
Dizzy or lightheaded
Vision going blurry or dark
Headache
pathophysiology of epilepsy
syncrondous disrcharge in the cortical neurons
what happesns if ther is to much excitement in epilepsy
this happens as a reuslt of glutamate recptors
and ion channels across it
with exiteror amino acids release
what stucure is responsible for too little inhibition in epilepsy
gaba
what are the types of things that can cause damage neruons leading to epilepsy
stroke/ tumour/ trama
what factors can make seizures more likel
missing medications
sleep distubances
fatique
hormonal changes
drug/ alchol use
stress / anxiety
photosensitive in small groups of patients
what are the the types of sezireuse
generaliezed or focal seizures
what are the types of pimary genilaed seizuers
absence seizue
generalised tonic clonic seizures
myoclonic seizures
juvenile myoclonic epilepsy
atonic seizures
what happens in the first stage of a tonic clinic seizure
All the muscles stiffen.
Air being forced past the vocal cords causes a cry or groan.
The person loses consciousness and falls to the floor.
A person may bite their tongue or inside of their cheek. If this happens, saliva may look a bit bloody.
second stage of a tonic clonic seizure
The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees.
After a few minutes, the jerking slows and stops.
when to go to hospital for seizures
first one
if seizure lasts more than 5 min
if more than 3 seizures in a row without the person coming round
what are myotonic seizures
breif jerking of a musles in the hand or legs
what is juvenile myoclonic epilepsy
genetic assoicated khave mulitple myochonc jerks
what are atomic seizures
sudden loss of musle control and temporly los of conciousness
types of focal seizures
focla seizures with retained awareness, losss of awareness, focal seizrues to bilater ocnsulve seizures - this is secondary general , localisation of onset seizures
what are some key chartericses of primary generalised seizuers
have no warning prior to onset
the person may have a history of absence or myolocic jerks
there is a generalised abnormality on eegs
may have a family histy
what are some symtoms after a geneerlaisd tonic seizuers
lateal tonge bites
irratibly afterwords
may hae had a vague warning
muscle pain
may first remember where they are when they are in the ambulance
causes of toniccolic seizures
meningitis, complications at birth, feb convultion, trauma, brain injuries
what happens to eyes during tonic clonic seizures
staring/ roll back
what are the general things in a focal/ partial seizure
may get aura
they can happen at any age
can lead to a secondary generalised seizure
may be a focal abnormality on the eeg
MRI may show the cuase
what is a temporal lobe seizure
a focal sezirue with loss of awarnes
what often precedes a temporal lobe seizure
a rising feeling in stomach
funny smell / taste
deja vu
what is seen for a winess fo a tmperal siezures
arrests in actiivty
stares blankley into space
lip smacking
repetive picking at clothes
what is a frontal lobe seizure
a focal seziures
what do witnesses see in frontal lobe seizures
the person is alert, with facial/ limb jerking
when do frontal lobe seizures normally occur
nocturnally
how long do fronal lobe seizure last
about 30 s
what is the clincal assesment for a seizure
ecg, bloods and ct and mri maybere for nero glicn
also eeg
how long are epilepts preventsed from driving
6 - months is just 1 seizure
12 months if they are diagnosed with epilepsy
what speciale investgion for seizures
video telemetry - if uncertain about diagnoiss
eeg
mri
first line tremat for epilepsy that last more than 5 min
lorazepan, midaloam
second line treatme for status elipeicus - seizrues that last more than 5 min
valproate, levetiracetam, phenytoin
first line treatemet for piramy genalsisd sizures
sodium valproate, levetiracetam, lamotrigine
first line treatemt for focal seizures
lamotrigine, cabamazepine, leeticamet,
side effects of sodum valproate
tremor, weight gain, ataxia, nausea, drowesies, hepatisi, bone marrow sprpesion, drug induced parkinsons
side effects for carbamezpine
ataxia, drowsinses, nystagmsu, blurred vision, low serum sodium lelves, skin rash
side effects of levetiracetam
irratibilty, depression
what is status epilepticus
prolonged seizures that last 10 min or more with no recovery period between seizures
where does status epilepsy norlly occr in
those people who have not had epilepsy before
treatmet for statu epilpes
protect air way and give 10% glucose via iv, and then lorapan
if failure - iv levetriacetam or iv valproate
what difertns pseudoseures and seizues
they can recall waht happens udring event and what people siad
what do witnes see in spudeo seiur
pelviec thrus, astycogous movemts such as tremoturs
what is best tests or pseudoseizuer
eeg
