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Medicine Phase 2a Neuro > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is it

A

Condition where brain is affected by recurrent seizures

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2
Q

Types of seizures

A

Partial

Generalised

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3
Q

Describe partial seizure

A

Seizure that occurs in one discrete part of the brain

These seizures may be simple or complex

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4
Q

What is meant by a partial seizure being simple or complex

A

Simple - Without alteration in consciousness

Complex - With alteration in consciousness

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5
Q

Describe generalised seizure

A

Seizures that affect the brain globally

Consciousness is always altered

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6
Q

Examples of generalised seizures

A 
Absence seizure
Tonic-clonic seizure
Atonic seizure
Myotonic
Secondary generalised
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7
Q

Describe Absence seizure

A

Often picked up in children who ‘stare into space’

Usually only lasts for afew seconds

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8
Q

Describe Tonic-clonic seizure

A

Involves convulsions and muscle rigidity

Usually lasts minutes

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9
Q

Describe Atonic seizure

A

Involves a loss of muscle tone

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10
Q

Describe myotonic seizure

A

Involves jerky muscle movement

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11
Q

Describe secondary generalised seizure

A

Generalised seizure that originates from a partial seizure

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12
Q

Cause of seizures

A

Abnormal paroxysmal neuronal discharges in the brain, which result from some form of traumatic brain injury.
These discharges display hypersynchronisation.

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13
Q

3 types of causes of epilepsy

A

Idiopathic
Cryptogenic
Symptomatic

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14
Q

What is meant by idiopathic cause

A

Cause is unknown

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15
Q

What is meant by cryptogenic cause

A

Cause is unknown

Signs suggesting it may be linked to brain injury e.g. patient has autism or learning difficulties

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16
Q

What is meant by symptomatic cause

A

Cause known

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17
Q

Symptomatic causes of epilepsy

A 
VINDICATE
Vascular - history of stroke
Infection - history of meningitis or malaria
Neoplasms - brain tumour
Drugs - alcohol and illicit drug use
Iatrogenic - drug withdrawal
Congenital - family Hx of epilepsy
Autoimmune - vasculitis
Trauma - history of brain injury
Endocrine - Low Na+, Low Ca2+ or Loe/High Glucose
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18
Q

What do Signs and symptoms of epilepsy depend on

A

The region of the brain affected

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19
Q

Signs and symptoms of seizure affecting frontal lobe

A

JAM
Jacksonian march
pAlsy (postictal Todd’s palsy)
Motor features

20
Q

Signs and symptoms of seizure affecting the temporal lobe

A 
ADD FAT
Aura that the epileptic attack will occur
Deja vu
Delusional behaviour
Fear/panic (hippocampal involvement)
Automatisms
Taste/smell - uncal involvement
21
Q

Signs and symptoms of seizure affecting the temporal lobe - what part of brain is also involved is presentation of Fear/Panic

A

Hippocampus

22
Q

Signs and symptoms of seizure affecting the parietal and occipital lobe

A

Visual and sensory dsturbances

23
Q

Other Signs and symptoms of seizure (not resulting from seizures of particular lobes of brain)

A

Partial or generalised seizure with or without convulsions
Tongue biting
Migraines
Depression

24
Q

Investigations

A

Bloods - FBC, U and Es, LFTs, ESR, glucose, calcium levels
Radiology - CT scan, MRI scan
Other - ECG, LP, EEG

25
Q

Conservative treatment

A 
Patient and family education
Inform DVLA (UK)
26
Q

Medical treatment

A

Anticonvulsant therapy

27
Q

Surgical treatment

A

Anterior temporal lobe resection
Corpus callosotomy
Tumour removal

28
Q

Examples of Anticonvulsants

A 
Carbamazepine
Phenytoin
Sodium valproate
Ethosuximide
Phenobarbital
29
Q

How does carbazepine or phenytoin work

A

Blocks voltage dependent Na+ channels

30
Q

How does ethosuximide work

A

Inhibits T-type Ca2+ channels

31
Q

How does phenobarbital work

A

Acts of GABA receptors - enhancing synaptic inhibition

32
Q

Complications

A 
Injuries whilst having seizure
Depression
Anxiety
Brain damage
Sudden unexplained death in epilepsy (SUDEP)
33
Q

Differential diagnosis

A 
Migraine
Hypoclycaemia
Dystonia
Cardiogenic syncope
Hyperventilation
34
Q

Is it epilepsy?

Causes of blackouts

A

Primary disturbance of brain function

Secondary disturbance of brain function

35
Q

Examples of secondary disturbances of brain function

A

Low blood pressure

Related to heart

36
Q

Examples of primary disturbances of brain function

A

Dissociative/non-epileptic seizures (psychological)

Epileptic seizures

37
Q

Types of epileptic seizures

A

Genetic generalised epilepsy
Unclassifiable epilepsy
Structural/metabolic epilepsy

38
Q

What is an Epileptic seizure

A

Paroxysmal event in which changes of behaviour, sensation or cognitive processes are caused by excessive (too much voltage), hypersynchronous neuronal discharges in the brain

39
Q

Duration of epileptic seizure

A

30-120 seconds

40
Q

Features of epileptic seizures

A

Postictal symptoms (Positive-itcal symptoms)
Stereotypical seizures
May occur from sleep
May be associated with other brain dysfunction

41
Q

What is meant by postictal symptoms

A

“positive” of something (feeling touch when not being touched; hearing something thats not there etc) - opposite of negative symptoms

42
Q

Examples of typical seizure phenomena

A

Lateral tongue bite

Deja vu

43
Q

Differences between an epileptic and non-epileptic seizure

A

Non-epileptic tends to last longer
Eyes open in Epileptic
Non-epileptic involved hip thrusting
Incontinence associated with Epileptic

44
Q

Pathophysiology of an epileptic seizure

A

Excessive, unsynchronised neuronal discharges

Causes paroxysmal changes in behaviour, sensation and cognitive processes

45
Q

Example of antiepileptic and side effect

A

Carbamazepine

Heart problems

Medicine Phase 2a Neuro (28 decks)

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