Epilepsy Flashcards
What are the two main categories of epilepsy and their subtypes?
- Generalised seizures - involve the whole brain
- Tonic-clonic
-
Rarer
- Myoclonic
- Abscence (Petit Mal)
- Atonic - drop attack.
- Tonic Seizures
-
Rarer
- Tonic-clonic
- Focal/Partial seizures - involve a certain part of the brain.
Which seizures are seen more commonly in childhood?
The rarer causes (myoclonic, atypical abscence, atonic and tonic)
Describe the main feature (conciousness or no consciousness) of Generalised seizures and then describe there subtypes..
- Generalised - no focal features, consciousness lost immediately
- Grand mal (tonic-clonic)
- Petit mal (absence seizures)
- Myoclonic: brief, rapid muscle jerks
- Partial seizures progressing to generalised seizures
What is the difference between simple partial and complex partial seizures?
- Complex Partial (consciousness is disturbed)
- Simple partial (consciousness is preserved)
Describe the subtypes of partial seizures
- Partial - focal features depending on location
- Simple (no disturbance of consciousness or awareness)
- Complex (consciousness is disturbed)
-
Temporal lobe - simple partial seizures in temporal lobe epilepsy will usually only cause abnormal sensations.
- Sensations include aura, deja vu, jamais vu; motor → Jacksonian march.
In Temporal Lobe seizures, what do, aura, deja vu, jamais vu and Jacksonian march mean?
- 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.
Roughly speaking what are the first line drug for generalised seizures vs partial seizures?
Generalized seizures = sodium valproate
Partial seizures = Carbamazepine.
What anti-epileptic is used to treat absence seizures?
Sodium valproate
What anti-epileptics are used to treat Generalised seizures?
1st line = sodium valproate
2nd line = lamotrigine or carbamazepine
What drugs are used to treat Partial Seizures?
1st line Carbamazepine
2nd line - lamotrigine or sodium valproate
What anti-epileptics are used to treat myoclonic seizures?
1st line - sodium valproate
2nd line - clonazepam or lamotrigine.
What are some side effects of sodium valproate?
- Gastrointestinal: nausea
- Increased appetite and weight gain
- Alopecia: regrowth may be curly
- Ataxia
- Tremor
- Hepatitis
- Pancreatitis
- Thromobcytopaenia
- Teratogenic
- Hyponatraemia
What are some side effects of carbamazepine?
- P450 enzyme inducer
- Dizziness and ataxia
- Drowsiness
- Headache
- Visual disturbances (especially diplopia)
- Steven-Johnson syndrome
- Leucopenia and agranulocytosis
- Syndrome of inappropriate ADH secretion