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MS4 - Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Causes of epilepsy

A
  • Idiopathic
  • Congenital
  • Acquired
  • Non-epileptic/provoked
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2
Q

Non epileptic causes of seizure

A

Withdrawal

Metabolic

Raised ICP

Infection

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3
Q

Prodrome of a seizure

A

Change in mood or behaviour lasting hours/days
Not part of seizure

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4
Q

Aura of a seizure

A

Simple partial seizure (usually temporal) which may precede other manifestations
Epigastric rising, Deja/Jamais vu, Automatisms, Smells, Lights etc

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5
Q

Partial/Focal seizure defintion

A

Only one hemisphere

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6
Q

Primary generalised seizure

A

No aura/warning
Affects whole cortex not one hemisphere

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7
Q

Simple seizure

A

Awareness unimpaired

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8
Q

Complex seizure

A

Awareness impaired

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9
Q

Secondary generalised seizure

A

Focal seizure –> generalised seizure

(aura–>tonic-clonic)

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10
Q

Epilepsy history

A

Aura
Specific trigger (lights)
Lateral tongue biting
Tonic clonic movements
Cyanosis
Post-ictal phase

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11
Q

Simple partial seizure features

A

Focal motor, sensory, autonomic or psychic symptoms

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12
Q

Complex partial seizure features

A

Aura

Awareness lost

Automatisms

Autonomic

Amnesia

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13
Q

Automatisms

A

Lip smacking

Fumbling

Swallowing

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14
Q

Autonomic changes of seizures

A

Change in skin colour

Temp

Palpitations

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15
Q

Absence seizure features

(Petit mal)

A

Abrupt onset/offset
Short <10s
Eyes glazed, blank stare

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16
Q

Trigger for absence seizure

A

Hyperventilation

17
Q

Tonic Clonic seizure definition

(Grand Mal)

A

LOC
Tonic: limbs stiffen
Clonic: rhythmic jerking

18
Q

Other features of tonic clonic seizures

A

Cyanosis

Incontinence

Tongue biting

Post ictal confusion and drowsiness

19
Q

Myoclonic seizure features

A

Sudden jerk of limbs, trunk or face

20
Q

Atonic seizure features

A

Sudden loss of muscle tone –> fall
No LOC

21
Q

West syndrome / infantile spasms

A

Head nodding and arm jerks
EEG hypsarrhythmia

22
Q

Temporal localising seizure features

A

Automatisms
Deja/jamias vu
Delusional behaviour
Abdominal: rising, n/v
Emotional disturbance

23
Q

Emotional disturbance of temporal localising seizure

A

Terror

Panic

Anger

Elation

Tastes, smells

24
Q

Frontal localising seizure features

A

Motor features

25
Q

Parietal localising seizure features

A

Sensory disturbance

26
Q

Occipital localising seizure features

A

Visual phenomena

27
Q

Diagnosis of epilepsy

A

Need more than 1 seizure

28
Q

Ix for epilepsy

A

Raised serum prolactin 10 min after fit
EEG

29
Q

Tonic Clonic seizure treatment

A

1) Valproate
2) Lamotrigine

30
Q

Absence seizure treatment

A

1) Valproate/ethosuximide
2) Lamotrigine

31
Q

Tonic, atonic, myoclonic seizure treatment

A

1) Valproate
2) Levetiracetam

32
Q

Focal +/- secondary generalised seizure treatment

A

1) Lamotrigine
2) Carbamazepine

33
Q

Lamotrigine side effect

A

Skin rash (stephen johnson syndrome)

34
Q

Valproate side effects

(VALPROATE)

A

Appetite ↑ → ↑wt.
Liver failure
Pancreatitis
Reversible hair loss
Oedema
Ataxia
Teratogenicity, Tremor, Thrombocytopaenia
Encephalopathy: due to ↑ ammonia

35
Q

Carbamazepine side effects

A

Leukopenia
Skin reactions
Diplopia
SIADH –> hyponatraemia

36
Q

Phenytoin side effects

A

Gingival hypertrophy
Hirsutism
Cerebellar syndromes
Peripheral sensory neuropathy
Diplopia
Tremor

37
Q

Status epilepticus definition

A

Seizure > 30mins (or 5 mins still don’t know)

or repeated seizures without regain of conciousness

38
Q

Treatment of status epilepticus

A

1) Lorazepam/Midazolam: 2nd dose if don’t respond in 2 mins
2) Phenytoin IV
3) Diazepam infusion
4) Dexamethasone

5) General anaesthetic

39
Q

Pregnancy and epilepsy treatment

A

Don’t give valproate
Give lamotrigine and folic acid

MS4 - Neurology (11 decks)

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