Epilepsy

Question 1

What is the leading cause of epilepsy?

Answer 1

Idiopathic

Question 2

If a seizure begins with focal features, what is it called?

Answer 2

Partial seizure (regardless of how quickly it generalises)

Question 3

Primary generalised seizures are commonest amongst which age group?

Answer 3

Childhood - teens

Question 4

What are the 4 indications for an EEG to be carried out?

Answer 4

1) Classification of epilepsy
2) Confirmation of non-epileptic attack
3) Surgical evaluatin
4) Confirmation of non-convulsive attack

Question 5

What medications are advised in focal onset seizures?

Answer 5

Carbamazepine or lamotrigine

Question 6

In women taking anticonvulsant medication, what 3 points should be discussed with them particularly?

Answer 6

1) Teratogenicity risk
2) Reduced efficacy of OCP; requires higher dose of oestrogen (POP deemed not effective)
3) Morning after pill; require higher dose

Question 7

If epileptic attacks occur whilst the person is awake and there is an associated loss of consciousness, what implications does this have for their driving licence?

Answer 7

Taken away; reapply if seizure free for 1yr.

Question 8

If a one-off seizure occurs whilst awake and there is an associated loss of consciousness, what implications does this have for their driving licence?

Answer 8

Taken away; reapply in 6mths if no seizures in that time AND DVLA’s medical advisors decide there is not a high risk you will have another seizure.

Question 9

If epileptic attacks while asleep coincide with awake attack, what affect does this have on the individuals driving licence?

Answer 9

3yrs seizure free before they can reapply for their licence

Question 10

What is status epilepticus?

Answer 10

Recurrent epileptic seizures without full recovery of consciousness.

Question 11

What is the initial management of status epilepticus?

Answer 11

Midazolam 10 mg IM, if >40kg; if <40kg, 5mg