Epilepsy Flashcards
What is Epilepsy?
The most common neurological condition in children, affecting approximately 1 in 200 children. 50-60% of children outgrow epilepsy by adulthood. Causes include genetic disorders, structural lesions, previous brain injury, and epilepsy syndromes.
What is the definition of epilepsy?
The tendency to have recurrent unprovoked seizures
What is a seizure?
A physical manifestation of abnormal electrical activity in the brain. Seizures can be:
Focal (affecting one part of the brain)
Generalised (affecting the whole brain)
What can cause seizures?
Febrile seizures (due to fever)
Hypoglycaemia (low blood sugar)
Trauma (head injury)
Symptomatic (caused by underlying conditions)
Epileptic (due to epilepsy)
How long do seizures usually last?
Most stop by themselves within 5 minutes. Under 30 minutes is usually okay, but over 30 minutes may cause brain damage.
How does seizure location in the brain affect symptoms?
The physical manifestations depend on the location in the brain.
What are signs of a focal seizure?
Wandering aimlessly, fidgeting with clothing, chewing/smacking lips, confusion, trance-like staring.
What is an EEG?
An Electroencephalogram (EEG) tests electrical activity of the brain. It’s painless and involves placing electrodes on the scalp. Activation procedures may include:
Hyperventilation (blowing for 2 minutes)
Photic stimulation (light flashes)
What is an MRI brain scan used for?
To identify structural abnormalities in the brain (e.g., improper development, tumors).
How does genetic testing help in epilepsy?
It may identify underlying causes using:
Karyotype (whole chromosome analysis)
Microarray (detects small genetic changes)
Single gene testing (examines specific genes)
Gene panel (tests multiple genes at once)
Whole exome/genome sequencing (comprehensive analysis)
What are the main types of seizures?
Tonic-Clonic: Cry, sudden fall, stiffening, jerking, possible tongue biting/incontinence
Absence: Staring, eye blinking, lip smacking (5-10 sec)
Myoclonic: Sudden brief muscle jerks
Tonic: Body stiffening
Atonic: Sudden loss of muscle tone (falls)
What are epilepsy syndromes?
Conditions with characteristic seizure patterns, often linked to genetics.
What is SeLECTS?
Self-limited epilepsy with centro-temporal spikes. Occurs in ages 4-10, often nocturnal, with focal seizures affecting the face and tongue.
What is SeLEAS?
Self-limited epilepsy with autonomic seizures, often prolonged.
What are key generalised epilepsy syndromes?
CAE (Childhood Absence Epilepsy): Onset 4-10 years, frequent absence seizures (>40/day), 3Hz spike-wave EEG, triggered by hyperventilation, treated with ethosuximide.
JME (Juvenile Myoclonic Epilepsy): Onset 10-24 years, myoclonic seizures on waking, worsened by sleep deprivation.
What is Lennox-Gastaut Syndrome?
Severe childhood epilepsy with tonic seizures (often at night), atypical absence seizures, drop attacks, severe intellectual disability, and drug resistance.
What are Infantile Spasms?
Seizures in infants (1-24 months) with brief head/arm jerks, linked to poor development. EEG shows hypsarrhythmia. Treated with steroids/Vigabatrin.
What is Landau-Kleffner Syndrome?
Childhood epilepsy causing language regression, misdiagnosed as autism. Seizures are rare, but continuous epileptic activity disrupts language processing.
How do Anti-Seizure Medications (ASM) work?
They decrease neuron excitation or enhance inhibition
When is medication started?
After two unprovoked seizures or one if another is highly likely.
How long does treatment last?
Aim for two years of seizure freedom before considering stopping.
What emergency medication is used for prolonged seizures (>5 minutes)?
Buccal midazolam.
What are non-pharmacological treatments?
Ketogenic diet (high fat, low carb)
Vagus nerve stimulation (VNS) (for daily seizures, improves quality of life)
Epilepsy surgery (for structural causes)
What co-morbidities are common in epilepsy?
Anxiety, depression, ADHD, ASD, intellectual disabilities (21.6%), sleep disturbances, and bone health issues.
