Epilepsy Flashcards
What is a seizure
Paroxysmal burst of electrical current throwing system out of sync.
Define epilepsy
Repeated pattern of seizures. Cannot prove patient has epilepsy there are, there are investigations, tests etc that pick it up. It is diagnosed clinically.
Describe generalised epilepsy.
Generalized epilepsy- complete loss of consciousness. Commonest- grandmal. Which is associated with family history and starts in childhood. Brain scans are normal. There is a discharge in the lower brain stem sending patient into LOC.
Describe the two stages of a generalised epileptic fit.
Tonic phase- complete contraction of the body and larynx. Lasts 5-6 seconds. Patient is completely unconscious.
Clonic phase- patient drops to the ground. Random contraction of all/any agonist and antagonist muscle(including intercostals, anal and urethral muscles). Body takes on odd postures. Last 2 minutes.
Describe focal/partial epilepsy.
Does not imply LOC. There is a definite part of brain where focus comes from eg, focal motor, sensory, adversive (focus in frontal eye fields, during seizure eyes are driven in one direction), psychomotor which is associated with temporal lobe epilepsy (associated olfactory, gustatory, hallucinations, overwhelming religious ecstasy, déjà vu. As memory, taste, smell banks found in temporal lobe).
Does not necessarily start in childhood therefore can be associated with tumours, abscess, aneurysms.
Describe the three stages of seizures
Pre ictal- before the seizure
Inter ictal- during
Post-ictal- after seizure
What is a petit mal seizure
A genetic condition starting in childhood, teachers often misinterpret this as daydreaming. There is associated loss of consciousness but it is a silent seizure, the body does not shake but eyes have a ‘glazed look’.
What is the management of epilepsy.
Anticonvulsants- carbamazepine, phenytoin, lamatogine. These either increase inhibitory or block excitatory neurons therefore patients have a sedated effect.
What is status epilepticus
A seizure (focal or generalised) that is longer that 30 minutes. Therefore is it one continuous seizure or subsequent seizures where patient does not regain consciousness. Patient can die of this state. Treat with benzodiazopene eg valium, if it does not work intubate patient and sit it out.
