Epilepsy

Question 1

What are the two main seizure groups?

Answer 1

• Generalised
  
  • Tonic-clonic
  • Absence
• Focal
  
  • Simple partial (local effects)
  • Dyscognitive (simple partial with change in conscious state)
  • Secondarily generalised

Question 2

How is an epilepsy syndrome confirmed?

Answer 2

• History of two seizures
• Epileptiform EEG and MRI lesion

Question 3

What differentials needs to be considered when diagnosing epilepsy?

Answer 3

• Syncope
  
  • Urinary incontinence more common
  • No tonic phase (although clonic phase may occur)
  • No confusion
• TIA
  
  • Sudden, focal deficit
• Psychogenic psuedoseizure
  
  • Fluctuating long course, non-anatomical tremor

Question 4

What pharmacological agents might you consider to:

• Terminate a seizure?
• Prevent a generalised seizure?
• Prevent a focal seizure?
• Prevent seizures over a broad-spectrum?

Answer 4

• Benzodiazepines
• Ethosuximide
• Carbamazepine
• Valproate, levatiracetam