epilepsy Flashcards
What is necessary in the assessment of syncope
Must have an ECG to look for heart block
What is the presentation of cardiogenic syncope
- On exertion
- Chest pain
- SOB
- palpitations
- Came around quickly
- clammy and sweaty
- Grey ashen white colour and stopping of breathing
What is epilepsy
Tendency to recurrent unprovoked seizures
How do epilepsy drugs work
They dampen the excitation of the post synaptic neuron by inhibiting neurotransmitter release or increasing reuptake or blocking the postsynaptic receptors
What is a generalised seizure
Affects the whole brain at once
What is an absent seizure
Appears to stare into space for a few seconds
What is a tonic clonic seizure
A tonic-clonic seizure (formerly called a grand mal seizure) is a type of generalized seizure that affects the entire brain, causing loss of consciousness, muscle stiffness, and jerking movements.
What is a myoclonic seizure
Brief sudden jerks
What is a focal siezure
Affecting one area of the brain
What is the difference in presentation between primary generalised and focal epilepsies
primary general:
- No warning
- Less than 25 years old
- generalised EEG abnormality
Focal :
- May get an aura
- Any age
- focal abnormality on EEG
What is the presentation of a focal temporal lobe seizure
- Rising feeling in stomach
- Funny smell/taste
- Dejavu - characteristic of temporal lobe
- Sudden arrest in activity
- Staring blankly into space
- Lip smacking
What is the presentation of a focal frontal lobe seizure
Alert with continous facial and limb jerking
What investigations for seizures
- EEG
- Bloods
- possibly a MRI
What is the first line treatment for epilepsy
- Lorazepam, midazolam
- Valproate, levetiracetam or phenytoin
What is status epilepticus
Prolonged or recurrent tonic-clonic seizures persisting for more than 30 minutes with no recovery inbtwetween
What is the specific treatments for primary generalised epilepsies - not including lorazepam
Sodium valproate, levetiracetam and lamotrigine
What is the treatment for focal epilepsy - not including lorazepam
Lamotrigine, carbamazepine or levetiracetam
What is the treatment for status epilepticus
IV lorazepam - 4mg bolus
