Epilepsy Flashcards
What is epilepsy?
Neurological disorder
Characterised by seizures
What is a seizure?
Signs or symptoms due to abnormal excessive electrical activity in the brain
What are the signs and symptoms of a seizure?
Sensory disturbance
Convulsions
Loss of consciousness
What is an aura?
Sensory disturbance
When do auras occur?
Before a seizure begins, for some patients only
What are some examples of an aura?
Strange light
Unpleasant smell
Confusing thoughts
Depending on which part of the brain is affected
What are the types of seizures?
Partial
Generalised
What is a partial seizure?
Source of seizure is localised in the brain
What is a generalised seizure?
Source of seizure is distributed throughout the brain
What are the types of partial seizures?
Simple
Complex
What is a simple partial seizure?
Consciousness is maintained throughout the seizure
What is a complex partial seizure?
Consciousness is impaired throughout the seizure
What are some examples of partial seizures?
Temporal lobe epilepsy
What is temporal lobe epilepsy?
Focal seizures that originate in the temporal lobe
What age group does temporal lobe epilepsy occur in?
Young age e.g. children, adolescents
What are the causes of temporal lobe epilepsy?
Head injury
Brain infections
What are the signs and symptoms of temporal lobe epilepsy?
Auditory or olfactory hallucinations
Rush of memories
How is consciousness affected in generalised seizures?
Loss of consciousness
What are the types of generalised seizures?
Tonic-clinic
Absence
Myoclonic
Atonic
Tonic
What is a tonic-clonic seizure?
Increased muscle tone followed by convulsions
What is an absence seizure?
Patient stops what they’re doing for a short while and then carries on as normal
What is a myoclonic seizure?
Muscle spasms with breaks in between
What is an atonic seizure?
Lack of muscle tone
What do atonic seizures look like?
Drop attacks e.g. if standing up then fall down, if sitting down then neck drops backwards
What is a tonic seizure?
Increased muscle tone
What is status epilepticus?
Epileptic seizures occurring continuously without recovery of consciousness in between
How is status epilepticus managed?
As a medical emergency
What is a convulsion?
Uncontrolled shaking movement due to rapid repeated contraction and relaxation of muscles
How is epilepsy diagnosed?
History
EEG
MRI head
ECG
What are the parts of a history for a patient who’s had a seizure?
Before the seizure e.g. past medical history, family history, triggers, aura, first sign or symptom
During the seizure e.g. description of seizure, duration, abrupt or gradual end, maybe by a collateral history
After the seizure e.g. post-ictal state, tongue biting, incontinence, neurological deficit
Why is an MRI head done for a patient who’s had a seizure?
To look for structural changes in the brain to rule out other causes
Why is an EEG done for a patient who’s had a seizure?
To support the diagnosis
The assess the risk of seizure recurrence
How is an EEG done for a patient who’s had a seizure?
Use photic stimulation e.g. flashing lights, hyperventilation to induce a seizure
If an EEG of a patient who’s had a seizure gives unclear results, what is done?
Repeat standard EEGs
Do sleep EEGs or when the patient is sleep-deprived
Ambulatory EEG, done when patient is at home
What are some other conditions that may also cause seizures?
Vascular - stroke, transient ischaemic attack
Infection - abscess, meningitis, febrile seizure
Trauma - intracerebral haemorrhage
Metabolic - hypoxia, hypoglycaemia, electrolyte imbalance
Iatrogenic - drugs
Neoplastic - intracerebral tumour
Why is an ECG done for a patient who’s had a seizure?
To look for any cardiac abnormalities causing syncope to rule it out
How are seizures managed?
ABCDE approach for emergencies
Benzodiazepines
What are some examples of benzodiazepines given to patients with seizures?
Lorazepam
Midazolam
How are benzodiazepines given to patients with seizures?
If pre-hospital, give through cheek or rectally
If in hospital, give intravenously
