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Neuro AM > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What are the common causes of blackout?

A 
Syncope
First seizure
Hypoxic seizure
Concussive seizure
Cardiac arrhythmia
Non epileptic attack
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2
Q

What are some causes of a non epileptic attack?

A

Narcolepsy
Movement disorder
Migraine

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3
Q

What history must be taken from the patient post blackout?

A

What were they doing at the time?
Warning symptoms
What were they doing the night before?
If anything similar has happened in the past
How did they feel afterwards?
Any injury, tongue biting or incontinence?

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4
Q

What information from what they were doing the night before would be relevant?

A

Alcohol intake

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5
Q

What history should be taken from witnesses after a blackout?

A 
Level of responsiveness
Motor phenomena
Pulse
Colour
Breathing
Vocalisation
Behaviour before and after attack
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6
Q

What additional information may be relevant after a blackout?

A 
Age
Sex
PMH, including psych
Alhohol and drug abuse
Family history
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7
Q

What PMH may be relevant for someone who has blacked out?

A

Head injury
Birth trauma
Febrile convulsions
Diabetes

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8
Q

What is the most common type of syncope?

A

Vasovagal

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9
Q

What is the prodrome to syncope?

A

Light headed, nausea
Hot, sweating
Tinnitus
Tunnel vision

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10
Q

What are triggers for syncope?

A 
Prolonged standing
Standing up quickly
Trauma
Venepuncture
Watching/expeiencing medial procedures
Mictrurition
Coughing
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11
Q

What ar the features of syncope?

A 
Upright posture
Pallor common
Gradual onset
Injury rare
Incontinence rare
Rapid recovery
Prcipitants common
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12
Q

What are the features of a seizure?

A 
Any position
Pallor uncommon
Sudden onset
Injury and incontinence quite common
Slow recovery
Precipitants rare
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13
Q

What are hypoxic seizures?

A

Seizures caused by individuals being kept upright when they faint

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14
Q

What are the types of non epileptic seizure?

A

Hypoxic seizure
Concussive seizure
Cardiac arrhythmia
Hypoglycaemic fit

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15
Q

What heart problems can cause seizures?

A

Structural or functional

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16
Q

When should heart conditions particularly be taken into account after a seizure?

A

With family history of sudden death
Cardiac history
Collapse occurs during exercise

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17
Q

What investigations should be done for a possible;e first seizure?

A

Always blood sugar, ECG

Consider CT head and alcohol and drug screen

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18
Q

When is epilepsy diagnosed?

A

After a 2nd unprovoked attack or after taking history or first presenting seizure

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19
Q

What are the features suggestive of epilepsy?

A 
Myoclonic jerks
Absences or feeling strange around flickering lights
Deja vu
Rising sensation in abdomen
Look blank
Lip smacking
Fiddling with clothes
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20
Q

What is an epileptic seizure?

A

Intermittent stereotyped disturbance or consciousness, behaviour, emotion, motor function or sensation which, on clinical grounds, is believed to result from abnormal neuronal discharges

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21
Q

What is epilepsy?

A

Condition in which seizures recur, usually spontaneously

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22
Q

What are the 2 main classifications of epilepsy?

A

Generalised

Focal

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23
Q

What ar the types of generalised seizures

A 
Tonic clonic seizures
Myoclonic seizures
Clonic seizures
Tonic seizures
Atonic seizures
Absence seizures
24
Q

What are clonic seizures?

A

Jerking seizures

25
Q

What are tonic seizures?

A

Stiff seizure

26
Q

What often happens in atonic seizures?

A

Rapid collapse to floor, often causing face and head injuries

27
Q

Who are absence seizures normally in?

A

Children, tend to grow out of it by age 12

28
Q

What are characteristics of focal seizures?

A

Aura, moor features, autonomic features, degree of awareness or responsiveness

29
Q

What can focal seizures develop to?

A

Generalised convulsive seizures

30
Q

What is the difference in onset between primary generalised and focal seizures?

A 
generalised= no warning
Focal= aura
31
Q

What is the difference in diagnosis between primary generalised and focal seizures?

A 
Generalised= diagnosed <25 years
FOcal= any age, MRI may show cause
32
Q

What is the difference on EEG between primary generalised and focal seizures?

A 
Generalised= generalised abnormality
Focal= focal abnormality
33
Q

What investigations should be done for epilepsy?

A

EEG
MRI for patients under 50
CT for over 50s
Video telemetry if uncertain

34
Q

What is the first line treatment of primary generalised epilepsy?

A

sodium valproate, lamotrigine, levetiracetam

35
Q

What is the first line treatment of partial and secondary generalised seizures?

A

Lamotrigine

Carbamazepine

36
Q

What is the first line of treatment for absence seizure?

A

Ethosuximide

37
Q

What is the secondary treatment of generalised epilepsy?

A

Topiramate
Zonisamide
Carbamazepine

38
Q

What is the second line treatment of partial seizures?

A 
Sodium valproate
Topiramate
Leviteracetam
Gabapentin
Pregabilin
Zonisamide
Lacosamide
Lerampanel
Benzodiazepines
39
Q

What are the side effects pf sodium valproate?

A 
Tremor
Weight gain
Ataxia
Drowsiness
Transient hair loss
Pancreatitis
Hepatitis
40
Q

What are the side effects of carbamazepine?

A 
Ataxia
Drowsiness
Nystagmus
Blurred vision
Low serum sodium
Skin rash
41
Q

What are the side effects of lamotrigine?

A

Skin rash

Difficulty sleeping

42
Q

What are the side effects of levetiracetam?

A

Irritability, depression

43
Q

What are the side effects of topiramate?

A

Weight loss
Word finding difficulties
Tingling hands and feet

44
Q

What are the side effects pf zonisamide?

A

Bowel upset

Cognitive problems

45
Q

What are the side effects of lacosamide?

A

Dizziness

46
Q

What are the side effects of pregabilin?

A

Weight gain

47
Q

What are the side effects of vigabatrin?

A

Behavioural problems

Visual field defects

48
Q

What is status epilepticus?

A

Prolonged or recurrent tonic clonic seizures persisting for more than 30 minutes with no period of recovery in between

49
Q

Who does status epilepticus normally occur in?

A

Those with no history of epilepsy

50
Q

What is the mortality of status epilepticus?

A

5-10%

51
Q

What is the first line treatment of status epilepticus?

A

Midazolam
Lorazepam
Diazepam

52
Q

What is the second line treatment of status epilepticus?

A

Phenytoin

Valproate

53
Q

What is the third line treatment of status epilepticus?

A

Anaesthesia

54
Q

What are the features of non epileptic attacks?

A

May be more frequent than epileptic seizures

May look bizarreMay be prolonged

55
Q

What may a patient presenting with non epileptic attacks have?

A

History of other medially unexplained symptoms or history of abuse

56
Q

What are the movements of non epileptic attacks like>

A

May superficially resemble tonic clonic seizures
May resemble a swoon
May have bizarre movements e.g. alternating

Neuro AM (38 decks)

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