Epilepsy

Question 1

Aetiologies?

Answer 1

Focal lesions
Infections
Hypoxia
Idiopathic 
Trauma

Question 2

Pathology?

Answer 2

Generalised - bilateral abnormal brain neuron firing showing general manifestations
Focal - as above but only focal signs

Question 3

Signs and symptoms of absence seizures?

Answer 3

Patient will cease activity randomly and stare blankly
Skin pallor, twitching
Activity begins where it left off

Question 4

Signs and symptoms of tonic-clonic seizures?

Answer 4

Tonic phase = rigidity, falls, bitten tongue, incontinence

Clonic phase = convulsions, frothing of mouth, rhythmic jerking

Question 5

Investigations and Findings?

Answer 5

EEG
ECG
CT scan
Serum calcium 
Glucose
Can exclude epilepsy in many cases

Question 6

Management for absence seizure?

Answer 6

Sodium valproate

Lomotrigine

Question 7

Management for tonic - clonic seizures?

Answer 7

Sodium valproate

Carbemazepine

Question 8

Complications of absence seizures?

Answer 8

Can progress into tonic clonic epilepsy

Question 9

Complications of tonic-clonic epilepsy?

Answer 9

Trauma
Road traffic accidents
loss of driving licence
Status epilepticus

Question 10

Aetiologies of status epilepticus?

Answer 10

Anyone with epilepsy can have this type of seizure

First presentation as SE is almost unheard of

Question 11

Pathology of status epilepticus?

Answer 11

a seizure which lasts more than 30 mins or 2+ seizures in a row without recovery

Question 12

Investigations for status epilepticus?

Answer 12

ABG
Blood glucose
ECG

Question 13

Management of status epilepticus?

Answer 13

Secure airway
IV/IR diazepam +/- phenytoin if symptoms persist
Treat after 5 mins

Question 14

Complications of status epilepticus?

Answer 14

10% mortality