Epilepsy Flashcards
What is epilepsy?
A condition that affects the brain, when someone has epilepsy it means they have a tendency to have epileptic seizures
Does it start at a particular age?
It can happen at any age
Will I have it forever
Some types of epilepsy last for a limited time and the person eventually stops having seizures but for many people it is a life long condition
What are epileptic seizures?
Electrical activity is happening in our brain all the time as the cells send messages to each other but a seizure is when there is a sudden burst of intense electrical activity in the brain
Why are there different types of seizures?
What happens to someone during a seizure depends on which part of their brain is affected
How common is epilepsy?
1 in every 100 people in the U.K. Have it
What causes epilepsy?
Mainly we don’t know but it could be caused by a stroke, a brain infection (meningitis), a severe head injury or problems during birth which caused the baby to get less oxygen
Does the medicine cure epilepsy?
No, but it helps to stop or reduce the number of seizures
Can I have children?
Yes, but speak to your doctor because there is a small risk that having seizures or taking medications during pregnancy can affect the health of you or your baby
Can I still take part in sport and leisure activities?
Yes, it shouldn’t stop you but if you enjoy certain activities like swimming take someone with you who knows what to do if you have seizure in the water
Can I have baths?
It would be better to have showers unless someone is with you in case you have a seizure
Can I die because of my epilepsy?
It is possible, but most people don’t die because of it. Taking your medication regularly, taking steps to stay safe and talking to your doctors lowers the risk
Can I drive?
The law says if you have a seizure you must stop driving and inform the driving agency. You usually have to be seizure free for 12 months before you can drive again but it varies with different types of seizures
Will having epilepsy stop me doing certain jobs?
All jobs, except the armed forces are open to people with epilepsy. Legally they can’t fire or not hire you because of it unless it would put you or others at risk (working at heights)
Am I entitled to any benefits because of it?
Free prescriptions and free or reduced price bus and rail travel
How can I take control of my epilepsy?
Take your medication regularly, attend your treatment reviews, know your triggers, keep a seizure diary
How often are my treatment reviews?
At lest once a year. If your doctor doesn’t invite you for a review, ask for one
What are common triggers?
Stress, not sleeping well, drinking too much alcohol, flashing lights
Why should I keep a seizure diary?
To help you and your doctor see if there is a pattern to your seizures
How long do seizures normally last?
Between a few seconds and several minutes
Will it happen while I sleep?
Some people have them awake, some have them asleep, some both
Are there any conditions linked to epilepsy?
Tuberous sclerosis and cerebral palsy
How will I know if my epilepsy has gone away?
If you have not had a seizure for 10 years and had no epileptic medication for five years
What are febrile seizures?
Seizure that occur when children under 6 have a seizure that is triggered by a high temperature
What should I do if someone is having a tonic clonic seizure?
Remove harmful objects nearby, cushion their head, look for an epilepsy identity card, time how long the jerking lasts, put in recovery position once finished, stay with them and reassure
What should I not do during a tonic clonic seizure?
Restrain their movements, put anything in their mouth, try to move them unless they are in danger, give them anything to eat or drink until they are fully recovered, try to bring them round
When should I call for an ambulance after a tonic clonic seizure
If it is the first seizure, the jerking continues for more then five minutes, they have more than one seizure without regaining consciousness, they are injured,
Will family all have the same type of epilepsy?
No, it’s more common for families to have different types of epilepsy in them
What is SUDEP
Sudden unexpected death in epilepsy. The cause is not known, it is thought the seizure activity causes changed in the persons heartbeat or breathing
What is my risk of SUDEP
1 in 1000, increases if you have tonic clonic seizures in your sleep or if you have lots of seizures or if you have an alcohol or drug problem
What should I do during pregnancy?
Have pre-conception counselling to get special advice about medications. If you change medication during the pregnancy, have an appointment about changing back afterwards
ACTION - explain
A - assess situation (harmful objects) C-cushion head T-time the seizure I- identify the person O- once it's over, recovery position N-never put anything in their mouth
What is status epilepticus?
Seizure that lasts longer than 30 minutes. Can cause damage to the brain or even death
How many medications will I need to take?
Usually one at a time to lower the risk of side effects
Why do I need to take my tablets regularly?
To keep a steady a level of the medicine in your blood as possible
Why do I start on a low dose of medications not the maintenance dose?
It allows your body to slowly get used to the medicine, this reduces side-effects
How likely is it that the medication won’t work?
About 30 in every 100 people have seizures that do not respond to medication
What are the most common side effects?
Headaches, nausea, dizziness, drowsiness and mood changed
Will the side effects go away?
They are worse in the early days of taking the medicine, after a few days or weeks your body may get used to it and they may lessen or completely disappear
Why can’t I take more than one medicine?
One of them may raise or lower the amount of another in your blood
When can I stop taking medications
If you have been seizure free for at least two years, your epilepsy specialist might discuss the risks and benefits of stopping the medications
Will I have to stop driving if I stop taking my medications?
Yes, even if you are seizure free it has to be six months after you stop taking the medication
How does epilepsy affect other medications?
It can make the pill less effective, use other forms of contraception!!!
What are the other options other than medications?
Brain surgery, vagus nerve stimulation, deep brain stimulation and epilepsy, ketogenic diet
When would I have brain surgery?
If there is an obvious cause like scar tissue or no medications work
What is vagus nerve stimulation
A small device is implanted under the skin below the left collar bone, which is connected to a thin wire that stimulates the vagus nerve in the persons neck
How long does the VNS take to work?
From a couple of months to two years, sometimes it doesn’t work at all
What are the benefits of VNS ?
Fewer seizures, less severe seizures and improved quality of life
What daily living aids are available for me?
ID cards, jewellery and apps, pull organisers (dosette box), protective head gear, safety pillows , seizure alarms, monitors and fall call alarms
How do I reduce my risk of accidents?
No loose wires, use guards on heaters, radiators and fires. Use a sensor hairdryer that stops when put down, switch off heated appliances. Avoid hard floors, use toughened safety glass. Don’t lock your bathroom door
What is Todd’s paralysis?
Paralysis of the involved limbs several hours after the seizure
What’s the hereditary link?
About 30% of patients have a first degree relative with epilepsy although the exact mode of inheritance is unknown
How do I treat a prolonged seizure (longer than 3 minutes)
Rectal or i.v. diazepam or lorazepam. It is repeated after 10 minutes if no response. Give phenytoin if seizures continue
What drugs are used to treat generalised tonic-clonic seizures
sodium valproate or lamotrigine or carbamazepine.
What are the side effects of sodium valproate
nausea is very common (take with food) weight gain, hair loss, liver damage, blood dyscrasias,
what are the side effects of lamotrigine?
toxic epidermal necrolyis, rash, diplopia, blurred vision, tremor, vomiting, agitation, tremor
What are the side effects of carbamazepine?
Rashes, leucopenia, toxic epidermal necrolyis, blurred vision, impaired balance, drowsiness, diplopia
What are the side effects of phenytoin?
Rashes, blood dycrasias, lymphadenopathy, SLE, TEN, gum hypertrophy, hirsuitism, nystagmus, diplopia, tremor, ataxia
What medication would you use for petit mal seizure?
Sodium valproate
What medications would you use for partial seizures?
Lamotrigine, carbamazepine, sodium valproate
How successful is drug withdrawal?
In less than 50%
Can I tell when I’m going to get a seizure?
Some people get a prodrome/aura, such as a strange feeling/smell/experience such as de ja vu.
What happens after a seizure?
Post-ictally there may be a headache, confusion, myalgia and a sore tongue or temporary weakness after a focal seizure in motor cortex.
What can the epilepsy nurse specialist do?
provide telephone advice and annual reviews to monitor drug efficacy and side effects, to address employment, leisure and reproductive issues.
Which medication is best for pregnant ladies?
Lamotrigine, not sodium valproate. Lamotrigine is not in breast milk.
