Epilepsy Flashcards
What visible things are important to note in a patient with a fall?
Pallor, breathing
posturing of limbs
Head turning
What are the different types of movements?
Tonic phase
Clonic movements
Corpopedal spasms
Rigor
What type of seizure is this: In bed, staring at onset of attack, unresponsive, had movements of upper limbs, some kicking of lower limbs
Generalised tonic-clonic seizure
What are important questions to ask regarding epilepsy?
Birth and development
Past seizures icluding febrile C
Head injuries
FHx, drugs, alcohol
What should always be taken with a first seizure?
ECG - look for abnormality such as Prolonged QT syndrome
Who gets an acute CT scan?
Clinical/Radiological skull fracture Deteriorating GCS Focal signs Head injury with seizure Suggestion of other pathology Failure to be GCS 15/15 4 hours after arrival
How long can’t you drive for if you’ve had a first seizure?
Car = 6 months HGV/PCV = 5 years
How long can’t you drive for if you are diagnosed with epilepsy?
Car = 1 year/3 years during sleep HGV/PCV = 10 years off all medication
Do most epilepsies have a genetic predisposition about them?
Yes
What is seen with epilepsy on an EEG?
Generalsied spike-wave abnormalities, usually in a child or adolescence
When does primary generalized epilepsy present?
Childhood or teens
What is the treatment of choice for primary generalized epilepsy?
Sodium Valporate or Lamitrigine
Give and describe an example of a primary generalized epilepsy
Juvenile Myoclonic Epilepsy - early morning jerks
generalized seizures
Risk factors include sleep deprivation and flashing lights
When can focal onset epilepsy present?
Any age
What are possible treatments for focal onset epilepsy?
1st line = Carbamazepine or Lamotrigine
2nd line = Sodium valporate
Give 3 examples of old anticonvulsants?
Phenytoin - enzyme inducer, acute management
Sodium Valporate - many side effects
Carbamazepine = focal onset seizures, can worsen primary generalzied epilepsies worse
Give some examples of new anticonvulsants
Lamotrigine - generalized and focal epilepsies
Levetiracetam - can cause mood swings
Topiramate - Sedation and dysphasia are caused
Gabapentin/Pregabalin - more for neuropathic pain
What should women on anti-convulsants be warned about?
Alter the efficacy of combined oral contraceptive pill
Should use progesterone only pill
What isn’t effective if on Enzyme Inducing AEDs?
Morning after pill
What is non-convulsive status?
Conscious but in altered state
What is Epilepsia partialis continua?
Continual focal seizures, consciousness preserved
What are other causes of a seizure?
Severe metabolic disorders - hyponatraemia, pyridoxine deficiency Infection Head trauma Sub-arachnoid haemorrhage Abrupt withdrawl of anti-convulsants
How long does syncope take to recover?
Seconds
How long does a seizure take to recover?
Minutes to hours
What seizures can a focal epilepsy cause?
Focal or generalised seizures
What seizures can generalised epilepsy cause?
Generalised seizure
How does an epilepsy be generalised?
The electrical signals hit a pathway and spread to a different part of the brain affecting that as well
What is sudden death caused by epilepsy called?
SUDEP
