Epilepsy Flashcards
What factors should be considered when making a possible diagnosis of epilepsy
history from patient and witness aura/ warning abnormal movements colour position when after effects
what are the signs? what is the type of seizure?
what investigations should be done when making an epilepsy diagnosis
examination will often be normal
EEG, ECG, MRI
what is the difference between a partial and generalised seizure
partial seizure activity originates in one area of the brain and may be simple or complex
generalised seizures affect the whole brain(both hemispheres) and may be absent, myoclonic, tonic clonic, tonic, atonic
what are the features of a myoclonic seizure
a type of generalised seizure
the person is usually awake
brief shock like jerks of muscles
seen in a wide variety of seizures
what are the features of simple partial seizures
focal with minimal spread of abnormal discharge
normal consciousness
what are the features of complex partial seizures
local onset then spreads impaired consciousness often an aura automatisms motor activity
most commonly temporal lobe epilepsy
what are secondary generalised seizures
begin focally, with or without focal neurological symptoms
variable symmetry, intensity and duration of tonic-clonic phases
usually 1-2 minutes
postictal confusion and somnolence
what are the features of absence seizures
a type of generalised seizures sudden onset and abrupt cessation brief duration altered consciousness may be mild clonic jerking postural tone change autonomic features and automatisms
what is an atonic seizure
sudden loss of postural tone
often in children
what are the features of tonic clonic seizures
major convulsions with rigidity (tonic) and jerking (clonic)
followed by stuporous state- post ictal depression
what are the phases of generalised tonic clonic seizures
1) tonic phase, muscles tense up causing the person to fall to the ground
2) Muscles start to contract and relax rapidly- clonic phase
may also occur in partial seizures involving motor centres
what factors increase seizure risk
lack of sleep tiredness alcohol/ hangover certain drugs e.g. antidepressants fever structural brain abnormalities
what is status epilepticus
more than 30 minutes of seizure activity or multiple seizures in 30 minutes without full recovery in between
medical emergency
In what proportion of epileptics are medications effective at reducing seizure
60% become seizure free
20% are drastically reduced
what AEDs act primarily on sodium channels
phenytoin, carbamazepine, oxcarbazepine, zonisamide, lamotrigine
what is a partial seizure
confined to one lobe or hemisphere of the brain
what is a simple partial seizure
person remains conscious
may involve strange sensations or abnormal movements
what is a complex partial seizure
local onset, then spreads
impaired consciousness
aura
automatisms
person looses consciousness or regains consciousness slowly
what are the types of generalized seizures
absence myoclonic tonic clonic tonic clonic atonic
what are the types of partial seizure
simple partial
complex partial
what are the features of absence seizures
sudden onset and abrupt
cessation; brief duration, consciousness is altered; attack
may be associated with mild clonic jerking of the eyelids or
extremities, postural tone changes, autonomic phenomena
and automatisms (difficult diagnosis from partial);
characteristic 2.5-3.5 Hz spike-and wave pattern
