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ESA 5 - Nervous System > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is a seizure?

A

A sudden, irregular discharge of electrical activity in the brain, causing a physical manifestation such as sensory disturbance, unconsciousness, or convulsions

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2
Q

What is a convulsion?

A

Uncontrolled shaking molecules of the body due to rapid and repeated contraction and relaxation of muscles

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3
Q

What is an aura?

A

A perceptual disturbance experienced by some prior to a seizure, e.g. a strange light, unpleasant smell, confusing thoughts

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4
Q

What is epilepsy?

A

A neurological disorder marked by sudden recurrent episodes of sensory disturbance, LOC, or convulsions, associated with abnormal electrical activity in the brain

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5
Q

When can epilepsy be diagnosed when there is only a single episode?

A

If high underlying risk through past medical history or family history

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6
Q

What is status epilepticus?

A

Epileptic seizures occuring continuously without recovery of consciousness in between

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7
Q

What broad categories are seizures categorised into?

A
  • Partial, or focal
  • Generalised
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8
Q

What are focal seizures categorised into?

A
  • Simple
  • Complex
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9
Q

What are generalised seizures classified into?

A
  • Absense
  • Myoclonic
  • Tonic-clonic
  • Tonic
  • Atonic
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10
Q

What is the difference between focal and generalised seizures?

A

In focal, a small area of the brain is involved. In generalised, the whole brain is involved

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11
Q

What is meant by a simple partial seizure?

A

One where there is no loss of consciousness

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12
Q

What is meant by a complex partial seizure?

A

One where consciousness is impaired

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13
Q

What are the types of epilepsies causing partial seizures?

A
  • Temporal lobe epilepsy
  • Frontal lobe epilepsy
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14
Q

When does temporal lobe epilepsy present?

A

In the 1st/2nd decade in most people

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15
Q

What does temporal lobe epilepsy follow?

A

Seizure with fever, or early injury to the brain

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16
Q

What auras might you get with temporal lobe epilepsy?

A
  • Auditory hallucinations
  • Rush of memories
17
Q

What are the stages of tonic clonic seizures?

A
  • 1st part is tonic
  • 2nd part is clonic
18
Q

What happens in myoclonic seizures?

A

Brief, shock-like muscle jerks

19
Q

What happens in atonic seizures?

A

Drop attacks

20
Q

What investigations are done in epilepsy?

A
  • Clinical history
  • EEG
  • MRI
21
Q

What information is needed about before the seizure in the clinical history?

A
  • PMH
  • Family history
  • Aura
  • First sign/symptom
22
Q

What information about during the seizure is required in the clinical history?

A
  • Description of seizure
  • Duration
  • Abrupt or gradual end
23
Q

What information about after the seizure is required in the clinical history?

A
  • Post-ictal state
  • Tongue biting
  • Incontinence
  • Neurological deficit
24
Q

What are the vascular differential diagnoses for epilepsy?

A
  • Stroke
  • TIA
25
Q

What are the infectious differential diagnoses for epilepsy?

A
  • Abscess
  • Meningitis
26
Q

What are the traumatic different diagnoses for epilepsy?

A

Intracranial haemorrhage

27
Q

What are the autoimmune differential diagnoses for epilepsy?

A

SLE

28
Q

What are the metabolic differential diagnoses for epilepsy?

A
  • Hypoxia
  • Electrolyte imbalance
  • Hypoglycaemia
  • Thyroid dysfunction
29
Q

What are the iatrogenic differential diagnoses for epilepsy?

A
  • Drugs
  • Alcohol withdrawal
30
Q

What are the neoplastic differential diagnoses for epilepsy?

A

Intracerebral mass

31
Q

What is the use of the EEG in epilepsy?

A

It is not diagnostic, but supports the diagnosis

32
Q

What should be assessed using EEG after the first unprovoked seizure?

A

The risk of seizure recurrence

33
Q

How is the risk of seizure reoccurence assessed on the EEG?

A

Looking for unequivocal epileptiform activity

34
Q

What does the standard EEG assessment involve?

A

Photic stimulation and hyperventilation

35
Q

When should an EEG not be used?

A
  • Probably syncope
  • Clinical presentation supports diagnostic of non-epileptic event
36
Q

Why should EEGs not be used if there is probably syncope?

A

Risk of false positive result

37
Q

Can EEG be used in isolation to diagnose epilepsy?

A

No

38
Q

What actions should you consider taking if the EEG is unclear?

A
  • Repeated standard EEGs
  • Sleep EEGs
  • Long-term video or ambulatory EEG

ESA 5 - Nervous System (18 decks)

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