Epilepsy Flashcards

0
Q

What are types of generalised seizure?

A
Tonic clinic
Isolated tonic click
Absence seizure
Myoclonic - sudden jerk of limb/face
Atonic - no loc, sudden loss of muscle tone
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1
Q

What is a generalised seizure?

A

A seizure in which consciousness is impaired and there is distortion of activity of whole or a large part of the brain

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2
Q

What is a partial seizure?

A

Limited to one hemisphere, discretely localised or more widely distributed

Awareness may be retained (simple) or impaired (complex)

May progress to generalised seizures

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3
Q

What occurs with temporal lobe partial seizures?

A

Automatisms - complex movements eg fumbling performed with limited awareness

Abdominal rising sensation or pain

Dysphasia

Memory phenomena - déjà/jamais vu

Hippocampal involvement - emotional disturbance

Hallucinations of taste/smell

Delusional behaviour

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4
Q

What occurs with frontal lobe partial seizures?

A

Motor features - posturing, eye/head movements

Jacksonian March - retained awareness in spreading motor seizure

Motor arrest

Subtle behavioural disturbances

Speech arrest/dysphasia

Subtle behavioral disturbances

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5
Q

What occurs in parietal lobe partial seizures?

A

Sensory disturbances - tingling, numbness and pain

Motor symptoms

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6
Q

What happens in occipital lobe partial seizures?

A

Visual phenomena - spots, lies, flashes

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7
Q

What is the treatment of general seizures?

A

First line usually sodium valproate

Adjunct treatment may include:
Lamotrignine
Clobazam
Levetiracetam
Topiramate
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8
Q

What is the treatment of partial seizures?

A

First line: carbamazepine or Lamotrignine

Second line: levetiracetam, oxcarbazepine, valproate

Adjunct - carbamazepine, clobazam, retigabine (if age >18)

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9
Q

How can patients be supported to self manage in epilepsy?

A

Keep diary to document seizures and know triggers

Regular reviews - 3-12 months depending on control

Maintain hold physical and mental health

Self management programs

Formulate care plan with specialist nurse or gp

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10
Q

What are the side effects of carbamazepine?

A
Drowsiness
Agitation
Diplopia
Blurred vision
Leukopenia
Hepatic failure
SIADH
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11
Q

What are the side effects of valproate?

A
Weight gain
Hepatotoxicity
Pancreatitis
Mild GI disturbances
Alopecia
Tremor
Rash
Thrombocytopenia
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12
Q

What are the side effects of Lamotrignine?

A

Hyponatraemia
Nausea
Rash

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13
Q

What drugs does valproate interact with?

A
May reduce valproate levels:
Phenytoin
Phenobarbital
Topiramate
Carbamazepine

May increase valproate levels:
Amitriptyline
Nortriptyline

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