Epilepsy

Question 1

What does “simple” and “partial” means in epilepsy?

Answer 1

Simple - patients do not lose awareness

Partial - abnormal neuronal firing is limited to only one part of the brain

Question 2

For partial seizures, what is the clinical presentation when the focus is in the temporal lobe? How about in the motor cortex?

Answer 2

Focus in the temporal lobe: hallucinations

Focus in the motor cortex: bizarre movements

Question 3

What is another name for petit mal seizures?

Answer 3

Absence seizures

Question 4

What is the frequency of discharge of the neurons in petit mal seizures?

Answer 4

3Hz (3cycles/sec)

Question 5

Name the anti-convulsant that blocks T-type calcium channels specifically

Answer 5

Ethosuximide

Question 6

What is the action of Lamotrigine?

Answer 6

Blocks Voltage-gated sodium channels

Question 7

What type of seizure/epilepsy is Ethosuximide mostly used for?

Answer 7

Petit Mal/Absence seizures

Question 8

What are myoclonic seizures?

Answer 8

They are brief shock-like jerks of a muscle or a group of muscles. The person is usually awake and able to think clearly during a myoclonic seizure.

Question 9

Which medication is for Generalised tonic-clonic seizures?

Answer 9

Sodium valproate or Lamotrigine

Question 10

What is the difference between simple partial seizures and complex partial seizures?

Answer 10

Simple partial seizures: awareness is unimpaired. No post-ictal symptoms.

Complex partial seizures: Awareness is impaired. Post-ictal confusion is common in temporal lobe seizures.

Question 11

What is the medication for absence seizures?

Answer 11

Sodium valproate, Lamotrigine or Ethosuximide

Question 12

What are automatisms? In which type of seizure is automatism a symptom?

Answer 12

Automatisms is a complex motor phenomenon, but with impaired awareness and no recollection afterwards. It involves lip smacking or chewing, to fumbling movements or singing.

Focal seizures of the temporal lobe involvement can cause automatisms

Question 13

Uncal involvementin focal seizures can cause which symptoms?

Answer 13

Hallucinations of smell or taste and a dreamlike state.

Question 14

What are the treatments for partial seizures?

Answer 14

Carbamazepine

Question 15

Which anti-epileptic drug should be avoided in women of childbearing age? Why?

Answer 15

Valproate should be avoided due to teratogenicity - congenital malformations and neurodevelopment disorders

Question 16

Can anti-epileptic drugs enter breast milk? Which drugs are an exception?

Answer 16

Most AEDs should be avoided when breastfeeding. Valproate and Carbamazepine are not present in breast milk.