Epilepsy Flashcards
What is epilepsy?
intermittent abnormal electrical activity in the brain
results in seizures
What is a partial/focal seizure?
focal onset, with features referable to part of 1 hemisphere
What are the two types of partial/focal seizures?
simple - awareness unimpaired
complex - awareness impaired
What symptoms would you get in a temporal lobe partial seizure?
- automatisms (motor phenomena with no awareness/recollection after): lip smacking, chewing, fumbling, grabbing, singing etc.)
- epigastric sensation
- dysphasia
- memory stuff e.g. deja vu
- hippocampal involvement - emotional symptoms e.g. sudden terror, panic, elation
- uncal involvement - hallucinations
- delusional behaviour
What symptoms would you get with a frontal lobe partial seizure?
motor features: posturing, peddling movement of legs, versive head and eye movements
What symptoms would you get with a parietal lobe partial seizure?
sensory disturbances - tingling, numbness, pain
What symptoms would you get with an occipital lobe seizure?
visual - spots, lines, flashes
What is the treatment of partial/focal seizures?
carbamazepine
lamotrigine
What is a generalised seizure?
simultaneous onset of electrical discharge throughout cortex - no localising features
Describe a tonic clonic seizure.
loss of consciousness
limbs stiffen (tonic)
then jerks and convulsions (clonic)
What are the types of generalised seizure?
absence
tonic clonic
myoclonic
What is an absence seizure?
brief (<10s) pauses e.g. suddenly stops talking mid sentence then carries on
What are myoclonic seizures?
sudden jerk or limb, face, trunk e.g. patient may be thrown suddenly to the ground or have violently disobedient limb
What is the treatment of atonic, tonic, generalised tonic clonic seizures?
1st line: sodium valproate, lamotrigine
then: carbamazepine, topiramate
What is the treatment of absence seizures?
sodium valproate
ethosuximide
