Epilepsy Flashcards
ED Status Epilepticus Mx algorithm
Airway: High flow O2 15L non-breathable mask
- Large bore IV
1. 5mins: Midozolam 10mg IV, Lorazepam 2/4mg IV, Diazepam 5-10mg IV
2. 10mins: Loarazepanm 4mg IV
3. 20mins: Phenytoin 20mg/kg IV (max. 2g)
4. 40mins Rapid Sequence intubation
Focal seizure Mx
1st line: Leviteracetam or Lamotrigine
Abscence seizure Mx
Ethosuximide
Tonic-clonic seizure Mx
1st line: Sodium Valporate
2nd: : Lamotrigine / Leviteracetam
Satus epilepticus Mx
1st line: Benzos - Midazolam (buccal), Loprazepam (IV), Diazepam (rectal)
2nd line: Anti epileptics - Phenytoin, Leviteracetam, Sod valporate
Define Focal Seizures
Seizures orginate from a specific area(s) of the brain
2 subtypes
Focal seizure subtypes
- Simple partial seizures (remain conscious)
- Complex partial seizures (loss of awareness)
Simple partial seizure Sx
- Deja vu
- Tingling
- sense of tear
- may have twitching
Complex partial seizure Sx
- Dazed / confused
- Lip smacking
- Hand rubbing
Simple partial seizure duration
few secs - few mins
Complex partial seizure duration
1-2 mins
Define Generalised seizures
Seizures involves both sides the brain
Generalised seizure subtypes
- Abscence seizure
- Atonic seizure
- Tonic-clonic seizure
- Myoclonic seizure
Define abscence seizure
Brief pauses < 10s with sudden loss of awareness
Tonic-Clonic seizure Sx
- muscle stiffness
- rhtymic jerking
- tongue biting
- incontinence
- Post-ictal confusion
Myoclonic seizure Sx
Sudden muscle twitching or jerking lasting for secs
Atonic seizure Sx
Sudden loss of muscle tone - leading to fall / drop
DVLA guidelines on Epilepsy
- One-off seizure: 6 months
- > 1 seizure: 12 months
Define Status Epilepticus
- A single seizure persisting for more than 30 minutes (5mins or >)
- Multiple seizures of shorter duration without a full neurological recovery in between seizures
