Epilepsy

Question 1

what test must you do when someone comes in with a new 1st seizure?

Answer 1

ECG

Question 2

what type of seizure does aura imply?

Answer 2

partial (focal) seizure from temporal lobe

Question 3

dysphasia may occur after which type?

Answer 3

focal temporal lobe seizure

Question 4

what lobe are complex partial seizures usually originated from?

Answer 4

temporal lobe

Question 5

what age group are absence seizures commonest in

Answer 5

childhood

Question 6

sudden loss of muscle tone then fall, which type?

Answer 6

atonic

Question 7

what are infantile spasms assoc with

Answer 7

tuberose sclerosis

Question 8

what type of abnormalities are seen on EEG in generalised seizures

Answer 8

spike wave abnormalities

Question 9

after how many seizures is tx generally started?

Answer 9

2

Question 10

1st and 2nd line for generalised tonic clonic

Answer 10

1st line - sodium valproate

2nd line - lamotrigine, carbamazepine

Question 11

1st line for absence seizures

Answer 11

sodium valproate, ethosuximide or lamotrigine

Question 12

what drug can exacerbate absence seizures

Answer 12

carbamazepine

Question 13

1st and 2nd line for partial seizures (including secondary generalisation)

Answer 13

1st: carbamazepine
2nd: sodium valproate

Question 14

Myoclonic seizures - 1st and 2nd line

Answer 14

1st: sod valproate
2nd: clonazepam, lamotrigine

Question 15

alternatives if drug tx doesn’t work

Answer 15

neurosurgical resection - but risk of memory impairment

vagal n stimulation

Question 16

features of tuberose sclerosis

Answer 16

aut dom 
shagreen patches (roughened skin over lumbar spine)
depigmented ash leaf spots 
butterfly distribution over nose 
epilepsy