Epilepsy

Question 1

Genotype associated with Stevon Johnson syndrome with CBZ

Answer 1

HLA-B1502

Question 2

Driving restrictions with seizure

Answer 2

Drive once seizure free for 6 months

If commercial driver -more restriction

Question 3

Stimulation of following receptors in brain lead to increased seizure activity

Answer 3

NMDA, sodium,calcium, AMPA

Influx of chloride in post synaptic neurons -inhibitory(GABA receptors)

Question 4

Epilepsy mimickers

Answer 4

Syncope, migraine,sleep disorders(parasomnias),movement disorders, vertigo, CVA, psychogenic non epileptic seizures(PNES)

Question 5

Diagnostic tests in epilepsy

Answer 5

EEG -done in 24-48 hrs of seizure- abnormal in 70%
Sleep deprived EEG picks up additional 13-30%
In patient video EEG
High resolution Brain MRI

Question 6

Agents effective for most seizure types

Answer 6

Valproate, phenobarbitone,BZD, levetiracetam,lamotrigine, topiramate, primidone

Question 7

Agents effective against focal seizures

Answer 7

CBZ, Oxcarbamazepine, phenytoin, pregabalin, gabapentin, lacosamide, perampanel

Question 8

DOC in absence seizure

Answer 8

Ethosuximide

Question 9

Surgical treatment for epilepsy

Answer 9

Anterior temporal lobectomy
Palliative Sx- corpus callosectomy
Multiple subpial transections
Hemispherectomy/ functional hemispherotomy

Question 10

Vagus nerve stimulation in epilepsy

Answer 10

Effective, can control seizure

Exact mech unclear

Question 11

DBS in epilepsy

Answer 11

Target -anterior thalamus

Question 12

Ketogenic diet in epilepsy

Answer 12

First line Rx for GLUT 1 syndrome, pyruvate dehydrogenase deficiency syndrome

Question 13

Vigabatrin side effects

Answer 13

GABA uptake inhibitor

Associated with Bilateral concentric visual field loss

Question 14

Major concerning side effect of Leveteracetam

Answer 14

Mood disorder, suicidality

Question 15

AED that causes weight loss

Answer 15

Topiramate