Epilepsy Flashcards
Give some examples of non epileptic attacks
narcolepsy and migraine
What would cause a concussive seizure?
blow to the head
What are some important things in the history from the patient?
What were they doing at the time warning feelings what were they doing the night before Had anything similar before how did they feel after Any injuries eg bit tongue, incontinence
What would you ask the witness?
what were the movements like, colour in the face, frothing at the mouth, pulse, level of consciousness, vocalisation
What is additional potentially important information?
age, sex, family history, past medical history, drugs, alcohol, abuse, past psychiatric history
Causes of syncope
long time standing, watching medical procedures, warmth, trauma
What is the most common cause of fainting?
Vasovagal syncope
Symptoms of syncope
nausea, tunnel vision, tinnitus, hot, light headed
Differences between syncope and seizures
position - syncope standing
pallor, onset, recovery, injury, incontinence and precipitants
When do hypoxic seizures most likely occur?
Kept upright in a faint
Is long QT syndrome structural or functional problem?
functional
Long QT syndrome symptoms
family history, collapse after exercise and a cardiac history
Why can seizures cause arrhythmias?
outpouring of adrenaline
Non-epileptic attacks - risk factors
female, history of abuse, history of medically unexplained symptoms
What do non-epileptic attacks look like?
very bizarre movements with jerks and swooning, frequent and prolonged
Investigations of first possible seizures
Blood glucose - hypoglycaemic
ECG
consider alcohol and drugs
CT head
What advice do you give to patients after their first possible seizure?
contact their work
safety information sheets and first seizure clinic
potentially dangerous leisure
driving regulations
What are the driving regulations after the first seizure?
allowed to drive 6 months after if there has been no other events and their investigations are normal
If you drive a HGV or PSV what are the regulations?
After 5 years, same criteria as driving a car but also must not be on anti epileptic medication
When is epilepsy usually diagnosed?
After a second event or if the history of the first seizure points to epilepsy
Features of primary generalised epilepsy
Myoclonic jerks first thing in the morning
Absences, feeling strange with flickering lights
What are features of focal onset epilepsy?
deja vu rising from abdomen
look blank, lip smack, fiddle with clothes
Epilepsy
A condition in which seizures recur, usually spontaneously
Epileptic seizure
An intermittent stereotyped disturbance of consciousness, behaviour, emotion, motor function or sensation which on clinical grounds is believed to result from abnormal neuronal discharges
What group of people are highly affected by epilepsy?
Those with learning difficulties
J shaped curve - young babies and increasing likelihood with age
What 2 ways did ILAE classify epileptic seizures?
clinical data and EEG
Which of generalised seizures and focal seizures are functional and which is structural?
Focal - structure
generalised - funciton
List some generalised seizures
tonic-clonic, myoclonic, clonic, tonic, atonic, absence
Which type of seizures are at any age and which are more likely <25?
<25 is generalised which can have a family history
Focal seizures symptoms
ANS, aura, motor features, degree of awareness
Investigations of epilepsy
EEG and MRI
Name some treatments of epilepsy
sodium valproate, carbamezapime, lamotrigine, phenytoin
What is status elipticus?
Prolonged or recurrent tonic-clonic seizures lasting over 30 minutes with no recovery
Contraindication of sodium valproate
do not give to women of child bearing age
