Epilepsy Flashcards

1
Q

What are the two main categories of epilepsy and their subtypes?

A
  1. Generalised seizures - involve the whole brain
    1. Tonic-clonic
      • Rarer
        • Myoclonic
        • Abscence (Petit Mal)
        • Atonic - drop attack.
        • Tonic Seizures
  2. Focal/Partial seizures - involve a certain part of the brain.
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2
Q

Which seizures are seen more commonly in childhood?

A

The rarer causes (myoclonic, atypical abscence, atonic and tonic)

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3
Q

Describe the main feature (conciousness or no consciousness) of Generalised seizures and then describe there subtypes..

A
  • Generalised - no focal features, consciousness lost immediately
    1. Grand mal (tonic-clonic)
    2. Petit mal (absence seizures)
    3. Myoclonic: brief, rapid muscle jerks
    4. Partial seizures progressing to generalised seizures
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4
Q

What is the difference between simple partial and complex partial seizures?

A
  • Complex Partial (consciousness is disturbed)
  • Simple partial (consciousness is preserved)
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5
Q

Describe the subtypes of partial seizures

A
  • Partial - focal features depending on location
  1. Simple (no disturbance of consciousness or awareness)
  2. Complex (consciousness is disturbed)
  3. Temporal lobe - simple partial seizures in temporal lobe epilepsy will usually only cause abnormal sensations.
    1. Sensations include aura, deja vu, jamais vu; motor → Jacksonian march.
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6
Q

In Temporal Lobe seizures, what do, aura, deja vu, jamais vu and Jacksonian march mean?

A
  • Aura
    • Auditory, olfactory, gustatory, visual or sensory (skin or organs)
  • Deja Uv - a feeling of familiarity
  • Jamais vu - a feeling of unfamiliarity
  • Amnesia
  • Jacksonian march - unilateral motor cortex activity that advances to affect different parts of the motor cortex and thus different parts of the contralateral body seize at different times.
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7
Q

Roughly speaking what are the first line drug for generalised seizures vs partial seizures?

A

Generalized seizures = sodium valproate

Partial seizures = Carbamazepine.

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8
Q

What anti-epileptic is used to treat absence seizures?

A

Sodium valproate

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9
Q

What anti-epileptics are used to treat Generalised seizures?

A

1st line = sodium valproate

2nd line = lamotrigine or carbamazepine

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10
Q

What drugs are used to treat Partial Seizures?

A

1st line Carbamazepine

2nd line - lamotrigine or sodium valproate

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11
Q

What anti-epileptics are used to treat myoclonic seizures?

A

1st line - sodium valproate

2nd line - clonazepam or lamotrigine.

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12
Q

What are some side effects of sodium valproate?

A
  • Gastrointestinal: nausea
  • Increased appetite and weight gain
  • Alopecia: regrowth may be curly
  • Ataxia
  • Tremor
  • Hepatitis
  • Pancreatitis
  • Thromobcytopaenia
  • Teratogenic
  • Hyponatraemia
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13
Q

What are some side effects of carbamazepine?

A
  • P450 enzyme inducer
  • Dizziness and ataxia
  • Drowsiness
  • Headache
  • Visual disturbances (especially diplopia)
  • Steven-Johnson syndrome
  • Leucopenia and agranulocytosis
  • Syndrome of inappropriate ADH secretion
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