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Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Definition of epilepsy

A

Seizures occurring as a result of spontaneous abnormal electrical discharge in brain

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2
Q

Prodrome vs aura

A

Prodrome - precedes fit, usually behavioural changes

Aura - part of seizure that precedes other manifestations eg odd sensations

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3
Q

Investigations for epilepsy

A

EEG, drugs screen, CT/MRI/LP if thinking structural or infective

Bloods + ECG

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4
Q

What is a partial seizure?

A

Limited to one area of brain

Simple = no impairment of consciousness

Complex = consciousness impaired

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5
Q

What is a generalised seizure?

A

Whole brain involved

6 types:

tonic-clonic, absence, myoclonic, tonic, clonic + atonic

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6
Q

What is an absence seizure, what would the EEG show + what are the triggers?

A

Brief staring spell, usually in children

EEG shows 3 second spike-wave pattern

Triggers = hyperventilation + flashing lights

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7
Q

What is a tonic-clonic seizure + what does EEG show?

A

Losing consciousness + falling to ground T

onic phase = stiffening, 10-20s

Clonic phase = jerking 30-40s

Causes cyanosis, excessive salivation, tongue biting + incontinence

Bilateral, slow wave, subcortical seizures

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8
Q

What is a tonic seizure?

A

Sudden onset of maintained increase in tone in extensor muscle - will usually fall

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9
Q

What is a clonic seizure?

A

LOC and sudden loss of muscle tone followed by limb jerking

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10
Q

What is an atonic seizure?

A

Drop attack - loss of muscle tone causing person to fall to ground

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11
Q

What are the signs of temporal lobe seizures?

A

Aura

Automatisms = oral movements like lip smacking, plucking at clothing

Abdominal rising sensation of pain +- vomiting

Dysphasia

Memory phenomena eg deja vu

Delusional behaviour/ bizarre stories

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12
Q

What are the signs of a frontal lobe seizure?

A

Motor features = posturing, versive movements

Jacksonian march

Motor arrest

Behavioural disturbances

Dysphasia

Todd’s palsy (post ictal)

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13
Q

What are the signs of a parietal lobe seizure?

A

Sensory disturbances = tingling, numbness, pain

Visual phenomenon eg spots, lines, flashes

Contralateral

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14
Q

What is Todd’s palsy?

A

Focal CNS signs eg hemiplegia

Follows an epileptic seizure

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15
Q

General post-ictal features

A

Headache, confusion, myalgia, sore tongue, temporary weakness, dysphasia

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16
Q

Management post first seizure

A

Urgent assessment (2 weeks) by neurologist

Screen for depression

17
Q

Non pharmacological management of epilepsy

A

Annual GP review Education

18
Q

Driving + epilepsy

A

Stop driving + notify DVLA

For first fit: 6 months off driving (group 1), group 2 = 5 years off driving

For diagnosed epilsepy: licensed revoked for 1 year after last attack.

For group 2, license revoked for 20 years

19
Q

When to give drugs for epilepsy

A

Drug treatment after 2nd seizure

Consider withdrawal if fit free for 2-3 years

20
Q

Management of absence seizures

A

Sodium valproate

Lamotrigine

21
Q

Management of myoclonic seizures

A

Sodium valproate

Clonazepam

22
Q

Management of tonic clonic seizures

A

Sodium valproate

Carbamazepine

Lamotrigine

23
Q

What other treatments are available for epilepsy?

A

Surgery = for intractable partial seizures

Vagus nerve stimulation = useful for those refractory to meds

Ketogenic diet = used for refractory epilepsy

24
Q

What is SUDEP?

A

Sudden unexplained death in epilepsy

Usually due to respiratory arrest during seizure

25
Q

Management of seizure (undiagnosed epileptic)

A

Wait 5 mins then give lorazepam to terminate seizure

IV phenytoin if not successful

Phenobarbital if not terminating >60 mins

Treat with thiamine or glucose if related to alcohol or diabetes

26
Q

What is status epilepticus?

A

>30 mins

Neurology (7 decks)

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