Epilepsy Flashcards

1
Q

What are the risk factors for epilepsy?

A

prematurity; global developmental delay; seizures in the past (incl. febrile fits); head injury; family history; drugs; alcohol

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2
Q

What investigation is mandatory in all those who have fallen/had fit?

A

ECG

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3
Q

When is a CT scan done acutley?

A

clinical/radiological skull #; decreasing GCS; focal neuro signs; head injury with seizure; GCS 12; auggestion of other pathology- eg SAH

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4
Q

What is the ban of driving length after a first seizure for a car?

A

6 months

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5
Q

What is the ban on driving an HGV/ PCV after the first seizure?

A

5 years

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6
Q

What is the driving rules for epilptics and HGV/PCV?

A

been 10 years off medication

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7
Q

What is generalised epilepsy?

A

most genetically prediposed which present in childhood and adolescence, affect both hemispheres and lose consciousness

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8
Q

What is seen on EEG with generalised epilepsy?

A

generalised spike-wave abnormalities on EEG

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9
Q

What is the treatment of choice generally for primary generalised epilpsy?

A

sodium valproate

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10
Q

What is an example of a type of priamry generalised epilepsy?

A

juvenile myoclonic epilepsy

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11
Q

What are the problems with sodium valproate?

A

teratogenic- not suitable for women of child-bearing age; lots of side effects

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12
Q

What are the SE with sodium valproate?

A

weight gain; pancreatitis; hepatitis; oedema; hair loss; ataxia; fatiue; nausea; encephalopathy

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13
Q

What are the risk factors for juvenile myoclonic epilepsy?

A

sleep deprivation and flashing lights

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14
Q

What causes focal onset epilepsy?

A

underlying structural cause- commonly hippocampal sclerosis

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15
Q

What typically causes hippocampal sclerosis?

A

hx of febrile convulsions

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16
Q

What is teh treatmetn for focal epilepsy?

A

carbamazepine or lamotrigine

17
Q

What is phenytoin used for?

A

acute managment only

18
Q

What is a main problem with carbamazepine?

A

can make primary generalised epilepsies worse

19
Q

What is the problem with carbamazepine with females?

A

alters the efficacy of the OCP adn morning after pill

20
Q

What is status epilepticus?

A

recurrent epilpetic seizures without full recovery of consiousness; lasting more than 30 mins

21
Q

What are the types of status epilepticus?

A

generalised convulsive status epilepticus; non convulsive status (consiouc but in altered state); epilepsiea partialis continua- continual focal seizures- consioucenss preserved

22
Q

What are the causes of status?

A

severe metabolic disorders- hyponatraemia; hypoglycaemia; infection; head trauma; SAH; abrupt withdrawal of anti-convulsants; treating absence seizures with CBZ

23
Q

What can convulsive status result in?

A

respiratory insufficiency and hypoxia; hypotension; hyperthermia and rhabdomyolysis

24
Q

What drugs can precipitate epileptic seizures?

A

theophylline; tramadol; anti-emetics; opioids; antibiotics eg penicillins; cephalosproins and quinolones

25
Q

What is the MOA of carbamazepine and lamotrigine?

A

inhibit the actiivity of voltage-gated sodium channels; reducing pre-synaptic excitability and abilityo f APS to spread

26
Q

What is MOA of pregabalin and gabapentin?

A

inhibt voltage-gated calcium cannels with drives neurotrasmitter release