Epilepsy

Question 1

What is ictus?

Answer 1

any acute event, refers to the epilepsy attack itself

Question 2

Aetiology of epilepsy?

Answer 2

trauma
hypoxia
pyrexia
mass lesion in skull
drugs
CNS infections
vascular abnormalities

Question 3

what are the main neurotransmitters involved in epilepsy?

Answer 3

GABA (inhibitory) and glutamate (excitatory)

Question 4

in simple partial seizure, does patient remain conscious or lose consciousness?

Answer 4

remains

Question 5

what are deja vu and jamais vu examples of

Answer 5

complex partial seizures

Question 6

treatment of absence seizures?

Answer 6

pals –> sodium valproate and ethosuxamide

Question 7

side effects of sodium valproate?

Answer 7

gerry little side effects
10% will have hair loss
reduces efficacy of COCP

Question 8

Childhood onset
Patient stares
May go pale
may be noticed by teacher in school?

Answer 8

absence seizure

Question 9

what happens during tonic phase of a seixzure?

Answer 9

Rigid
Epileptic cry 
Tongue biting 
Incontinence 
Hypoxia

Question 10

how long does tonic phase last?

Answer 10

10-60 seconds

Question 11

what happens during clonic phase

Answer 11

• Convulsions
• Eye rolling
• Tachycardia
• No breathing

Question 12

status epileptics is a seizure lasting ?

Answer 12

over 30 minutes

Question 13

when would you do a CT scan?

Answer 13

if you think its a stroke
focal signs
head injury with seizure

Question 14

driving - how long can you not drive for after seizure ?

Answer 14

6 months

Question 15

if you have a seizure, how long can you not drive a HGV?

Answer 15

5 years

Question 16

how long seizure free before driving a car?

Answer 16

12 months, or 3 years during sleep

Question 17

how long do you have to be seizure free for and off medication to drive a HGV?

Answer 17

10 years

Question 18

what is encephalitis?

Answer 18

inflammation of the brain parenchyma

Question 19

most common cause of encephalitis?

Answer 19

herpes simplex virus

Question 20

does sodium valproate cause weight gain or weight loss?

Answer 20

weight gain

Question 21

what can they do to the efficacy of the pill?

Answer 21

reduce

Question 22

precipitants of status epilepticus?

Answer 22

Severe metabolic disorders
 hyponatraemia, pyridoxine deficiency
Infection
Head trauma
Sub-arachnoid haemorrhage
Abrupt withdrawl of anti-convulsants Treating absence seizures with CBZ

Question 23

management of status epilepticus?

Answer 23

ABC 
Emergency blood tests +/- CT 
Anti convulsants ( Phenytoin (check levels)
Keppra
valproate
Benzodiazepines)

Question 24

side effects of ethosuxamide?

Answer 24

diziness, nausea, anorexia

Question 25

1st line for focal/partial seizures?

Answer 25

carbamazepine

Question 26

side effects of carbamazepine?

Answer 26

diziness, GI disturbance, water retention, SKIN RASH

Question 27

main side effect of digoxin?

Answer 27

blurred vision

Question 28

which drug causes gum hypertrophy?

Answer 28

phenytoin, which is also teratogenic and causes arrhythmias

Question 29

method of action of lamotrigine?

Answer 29

inhibits sodium channels

Question 30

side effects of lamotrigine?

Answer 30

han (nausea, diziness, ataxia)