Epilepsy Flashcards
What is a seiure?
excessive synchronous neuronal activity
What is given for status epileptics?
midazolam
diazepam if <3 months
Why is midazolam used?
easier, short half life, quick onset
How to give midazolam?
tilt head back, aim it towards ear in nose, squirt half and do other nostril
Can the atomizer be reused?
yes
Difference between Childhood and juvenile absence epilepsy?
Childhood happens earlier and remits in teens
Juvenile= later and may persist
First line for absence seizures?
ethosuxamide
Can ethosuxamide be used for generalized?
NO
Advantages of ethosuxamide?
fast onset, well tolerated, few DI
Side effects of ethosuxamide?
drowsy, behaviour, gi, skin rashes
How can we help with gi side effects of ethosuxamide?
split doses
What diagnostic shows us infantile epileptic spasms?
hypsarrythmia
What is infantile epileptic spasm?
cluster usually on awakening with limb movement every 5-10 seconds for 15 min
How do we treat infantile spasms?
hormonal (prednisolone, ACTH) or vigabatrin
Consequences of infantile spasms?
intellectual delay and other bad sequelae
How does vigabatrin work?
irreversible inhibition of GABA transaminase= more inhibition
What interactions with vigabatrin?
NONE
s/e of vigabatrin
permanent vision loss, vomit, MRI issues
Consequences of LGS?
drug resisitant, intellectual disability
LGS treatment?
VA, rufinamide
2nd lamotrigine
S/e of rufinamide?
short QT, h/a, drowsy, vomit, tremor, hypersensitivity
What is the shape of rufinamide and what has cross reactivity?
aromatic= phenytoin
Epilepsy syndrome with the worst prognosis?
dravet
What causes dragnet syndrome?
80% loss of SCN1A sodium channel gene
