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CCC - LM > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

How prevalent is epilepsy?

What % of epileptics are well controlled with medication?

A

1% of population

70% well controlled

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2
Q

What is an epileptic seizure?

A

Spontaneous uncontrolled abnormal brain activity

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3
Q

What % of epileptics have a 1st degree relative with epilepsy?

A

30%

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4
Q

What conditions are associated with epilepsy?

A

Tuberous sclerosis
SLE
Sarcoidosis

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5
Q

A history of what in childhood increases risk of epilepsy?

A

Atypical febrile seizures

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6
Q

What are common precipitators of an epileptic seizure?

A

Lack of sleep
Alcohol
Flashing lights
TCA use

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7
Q

What is a simple partial seizure?

A

No LOC

Focal motor/sensory/ psychic symptoms

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8
Q

What are the 2 main groups of seizures?

Where do they originate?

A

Partial - Originate in one hemisphere

Generalised - Both hemispheres, LOC immediately

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9
Q

What is meant by tonic?

A

Stiff sustained contractions

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10
Q

What it meant by clonic?

A

Rhythmic jerking of one limb, side of body or whole body

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11
Q

What is meant by Atonic?

A

Myoclonic jerks followed by atony and sudden fall to the floor - no LOC

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12
Q

What is an absence seizure (petit mal)? What seizure category does it fall in to?

A

Abrupt psychomotor arrest & blank staring in to space/upward deviation of eyes
It is a generalised seizure

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13
Q

What is a complex partial seizure?

A

Partial seizure + LOC

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14
Q

When is an EEG performed if suspecting epilepsy?

A

After 2nd seizure

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15
Q

What can be done to elicit a seizure?

A

flashing lights

hyperventilation - can bring on absence seizure

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16
Q

Adults being investigated for epilepsy must have which additional investigations?

A

ECG - determine arrhythmia or long QT

MRI/CT - exclude infective or vascular causes

17
Q

What is first line management of generalised seizures in females?

A

Lamotrigine

18
Q

What is a grand mal seizure?

A

Tonic-clonic

repeated contraction & relaxation of muscles

19
Q

What is the first line treatment for generalised seizures?

Who is this contraindicated in and what is used instead?

A

Sodium valproate - increases GABA
- absence, tonic clonic, atonic etc
Females of reproductive age - lamotrigine

20
Q

What is first line treatment for partial/focal seizure?

A

Carbemazepine - increases GABA

Lamotrigine

21
Q

Following a seizure, what are the rules on driving?

What rules of driving apply to those with epilepsy?

A

Cannot drive for 6 months after a seizure

Those with epilepsy must be seizure free for 12 months

22
Q

What type of diet is advised for epileptics?

A

Ketogenic diet - high fat low carb

23
Q

When can stopping anti epileptic drugs be considered?

A

Seizure free for 2 years

Wean down over 3 months

24
Q

What is SUDEP?

A

sudden unexplained death in epilepsy
commonly occurs with uncontrolled epilepsy
associated with night time seizure + apnea/asystole

25
Q

What are the rules of breastfeeding and anti-epileptics?

A

Safe to use, especially lamotrigine

26
Q

What is defined as status epilepticus?

A

Seizure lasting > 30 minutes or repeated seizures lasting > 30 minutes with no regaining of consciousness inbetween

27
Q

For a tonic-clonic seizure lasting > 5 minutes, what is the preferred treatment in the community?

A

Rectal diazepam - 10mg in adults
Paeds - 0.5mg/kg

Buccal midazolam - 10mg in adults
Paeds - 0.5mg/kg

28
Q

For a tonic-clonic seizure lasting > 5 minutes, what is the preferred treatment in hospital?

A

IV lorazepam - 4mg in adults

Paeds - 0.1mg/kg

29
Q

After administration of 1 drug to terminate a seizure has failed, what is the next step?

A

repeat after 10 minutes

30
Q

After 2 doses of drug have been trailed to terminate a seizure, what is the next step?

A

IV phenytoin

31
Q

If a patient is already on phenytoin, what can be used instead to terminate a persistent seizure?

A

Phenobarbitone

32
Q

What is the end stage attempt at terminating a seizure?

A

RSI with thiopentone - anaesthetist

CCC - LM (14 decks)

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