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PHA333 > epilepsy 2 > Flashcards

epilepsy 2 Flashcards

1
Q

absence seizure (petit mal)

A
  • begin suddenly, end abruptly
  • 2-20 seconds
  • a few times-100 times daily
  • sudden black staring, daydreaming, switched off
  • brief impairment of consciousness, awareness, responsiveness
  • can get physical symptoms -blinking, lip smacking, fumbling, twitching
  • no memory of episode
  • common in children 4-14yrs
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2
Q

tonic-clonic seizure (grand mal)

A
  • most common, typicsl seizure
  • 30-120 seconds
  • tonic and clonic phases
  • post-ictal/recovery phase
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3
Q

tonic phase of tonic-clonic seizure (grand mal)

A 
muscle contraction - stiffening of limbs
loss of consciousness, fall
cry/moan
shallow breathing - cyanoiss
tongue, cheek, lip biting - bleeding
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4
Q

clonic phase of tonic-clonic seizure (grand mal)

A

after tonic phase
rhythmic contraction and relaxation of muscles - jerking of limbs
can get bladder/bowel incontinence

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5
Q

post-ictal/recovery phase of tonic-clonic seizure

A 
slow return to conscoiusness
muscle relaxation
confusion, grogginess, somnolence
headache
aching limbs
amnesia of event
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6
Q

myoclonic seizures

A 
sudden jerks/twitches
short, few seconds
can affect whole body
commly arma/legs/head/trunk
consciousness not impaired (single jerks) or impaired (cluster of jerks - clonic-tonic-clonic seizure)
usually in morning after waking
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7
Q

tonic seizure

A

tightening of muscles - stiffeing of body
common during sleep
short 20 seconds

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8
Q

atonic seizures

A 
'drop attacks/akinetic seizures'
sudden loss of part or all muscle tone - limpness
sudden head drop or total collapse
forward fall - inc risk of head injury
short lives
rapid recovery - no post-ictal confusion
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9
Q

3 types of partial/focal seizures

A
  1. simple partial/focal seizures
  2. complex partial/focal seizures
  3. secondarily generalised seizures
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10
Q

simple partial/focal seizures

A
  • fully conscious
  • alert, can respond, remembers what happened
  • small part of 1 side of brain
  • no control over seizure
  • symptoms: motor (stiffening, twitching, jerking), sensory (flashing lights, hallucinatons),autonomic (sweating, altered HR/BR, gastric), psychic (fear, anxiety, deja vu)
  • post-ictal weakness
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11
Q

complex partial/focal seizures

A
  • consciousness altered/lost
  • cannot respond
  • anmesia of event
  • few seconds-3mins
  • involves greater part of 1 hemisphere
  • simple partial seizure (aura then impaired consciousness OR impaired conscoiusness at onset
  • 1/both temporal lobes
  • symptoms: autonomic movements
  • recovery: mins-hrs, post ictal confusion and fatigue
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12
Q

secondarily generalised seizures

A
  • partial seizures that spread to become tonic-clonic
  • begin focally (partial seizure) and spreads to become generlised tonic-clonic seizure
  • can get aura before
  • 1-3mins
  • post ictal confusion, somnolence, Todd’s paralysis
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13
Q

classification of seizures ILAE 2017

A

where seizure begins in brain
- focal, generalised, unnkown

level of awareness
- awareness/impaired awareness

nature of first prominent sugns/symptoms
- motor onset/non-motor onset

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14
Q

ILAE 1981 classification of EPILEPSY

A
  • based on whether seizure arises in part of brain/whole brain
  • whether assoaicted with identifiable neurologial abnormality/cause or not
    (idiopathic, symptomatic, cryptogenic)
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15
Q

idiopathic epilepsy

A

no apparent/obvious identifiable cause

preumed genetic

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16
Q

symptomatic epilepsy

A

known/obvious identifiable cause

17
Q

cryptogenic epilepsy

A

no currently known cause, but presumed likely cause

18
Q

investigations for diagnosis of epilepsy

A 
patient medical Hx
seizure description
physical examinaton
lab assessment
EEG/ECG
neuroimagins (CT and MRI)
19
Q

patient Hx for diagnosis

A
  • perinatal and developmental Hx
  • Hx of febrile seizure
  • Hx CNS infection/traume
  • FHx of epilepsy
20
Q

seizure description for epilepsy diagnosis

A

past seizures, episodes, duration, patterns, motor/seosory/behavioural features

  • pre-ictal aura
  • post-ictal state
  • triggers

observer accounts
videos

21
Q

lab assessment for epilepsy diagnosis

A 
FBC
electrolytes
blood glucose
BUN
toxicology screen
22
Q

EEG for epilepsy diagnosis

A
  • most useful
  • recording ictal/inter-ictal spikes
  • do they have epilepsy AND where is the ectopic focus?
    standard/sleep/ambulatory/video-telemetry
23
Q

neuroimaging for epilepsy diagnosis

A

CT/MRI
- to detect exclusion of scructural/organic casue of epilepsy
- detect underlying brain lesions/neurologicalbanormality
- main indication:
adult onset seisures, seizure with focal features. refractory/worsening seizures

PHA333 (27 decks)

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