Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Light headedness before a collapse is suggestive of what cause

A

Cardiac cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vertigo before a collapse is suggestive of what cause

A

ENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Unsteadiness before a collapse is suggestive of what cause

A

Neurological issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What features need to be covered in the history of a collapse

A 
Any symptoms before hand 
Environmental factors 
What did they look like - pallor, breathing 
Type of movement 
Responsiveness throughout 
Speed of recovery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

People will usually lose awareness in a tonic clonic seizure - true or false

A

True

Therefore need a collateral history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

After syncope recovery is usually fast - true or false

A

True

Will come round quickly and wont be too disorientated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe recovery after a seizure

A

Takes a while to fully recovery

Will be drowsy or disorientated for a significant time after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the risk factors for epilepsy

A 
Difficult birth 
Time in the ICU as a baby 
Past seizures including febrile 
Head injury 
Family history 
Drug and alcohol use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Febrile seizures increase your risk of epilepsy - true or false

A

True

2 or more febrile seizures leads to an increased risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the rules for driving with epilepsy

A

Can’t drive for 6 months after 1 seizure and 1 year if you’ve had 2
If you’ve only had nocturnal seizures for 3 years you can return to driving
HGV drivers are more restricted even if well controlled - cant drive for 5 years after 1st one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which common drugs can precipitate epileptic seizures

A 
Antibiotics – penicillin, cephalosporins, quinolones 
Painkillers – tramadol 
Anti-emetics 
Opioids – diamorphine  
Aminophylline/theophylline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What investigation must always be carried out when someone collapses

A

ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who need an acute CT scan

A

If there are clinical or radiological signs of a skull fracture
Deteriorating GCS
Focal signs
Head injury with a seizure
Failure to be at GCS 15/15 after 4hrs in hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is EEG used

A

Classify epilepsy
Confirms non-epileptic attacks and non-convulsive states
Can be used for surgical evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is an EEG diagnostic for epilepsy

A

Not really
Can have positive result but not be epileptic
Some epileptics will have a normal EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which other common conditions can present like epilepsy/seizures

A 
Syncope 
Non-epileptic disorders - pseudo seizures 
Panic attacks 
Sleep phenomena 
TIAs 
Migraines 
Hypoglycaemia 
Paroxysmal movement disorders 
etc etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the risk of having a further seizure in the year after your 1st

A

Around 1 in 5 chance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Does a seizure always mean its epilepsy

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is epilepsy

A

A tendency to recurrent, usually spontaneous, epileptic seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is an epileptic seizure

A

Abnormal discharge of electrical activity in the brain
It interrupts normal brain activity
Usually excitatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What causes an epileptic seizure

A

Too much excitation or too little inhibition of electrical activity
Changes in synaptic function or the channels
Genetics - in kids
Electrolyte abnormalities - metabolic
Toxins
Some environmental factors
Acquired brain injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which age groups tend to get epilepsy

A

Seen in infants

Also peaks in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is SUDEP

A

Sudden unexplained death in epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the normal underlying reason for death in older epileptics (over 60s)

A

Usually due to the underlying cause of the epilepsy – e.g. brain tumour or injury

25
Q

Suicide is a big killer in those with epilepsy - true or false

A

TRUE
Slightly higher than population average
Seen in the younger patients

26
Q

Focal seizures can lead onto a generalised one - true or false

A

TRUE

Some seizures will start in a certain area but can trigger a specific pathway that triggers a secondary generalised one

27
Q

How are seizures classified by location

A

Generalised - affects whole brain

Focal/partial - specific site of origin

28
Q

How can you determine the location of origin of a seizure

A

EEG

Will tell you if its generalised or focal

29
Q

What are the further classifications of partial epilepsy

A

Simple: without impaired consciousness
Complex: with impaired consciousness

30
Q

What are the further classifications of generalised epilepsy

A 
Absence
Myoclonic
Atonic
Tonic
Tonic clonic

These are all generalised seizure types

31
Q

What are the motor signs of epileptic seizures

A 
Rhythmic jerking 
Other involuntary movement - cycling 
Posturing 
Head and eye deviation 
Vocalisations
32
Q

What are the sensory/psychological signs of a seizure

A 
Altered memory 
Depersonalisation 
Aphasia 
Complex visual hallucinations 
Somatosensory disturbance
Olfactory and gustatory changes
33
Q

Who gets generalised epilepsy

A

Those with a genetic predisposition

Presents in childhood and adolescence

34
Q

How do you treat generalised epilepsy

A

Sodium valproate is the first choice

Lamotrigine as an alternative

35
Q

What are the potential triggers/risk factors for a seizure in generalised epilepsy

A

Sleep deprivation

Flashing lights

36
Q

What are the side effects of sodium valproate

A

Extremely teratogenic
Makes you gain weight
Hair loss
Fatigue

37
Q

What are the drawbacks of using lamotrigine

A

It takes about 2/3 months of treatment before it reaches the target dose

38
Q

How do you treat focal/partial seizures

A

Carbamazepine or lamotrigine first line

Sodium valproate works but isn’t as used due to side effects

39
Q

What are the adverse effects of carbamazepine

A

It reduces the efficacy of all types of contraception
Including the morning after pill
Can make generalised epilepsy worse

40
Q

What causes focal onset epilepsy

A

Usually an underlying structural cause - e.g. following a stroke or injury
Therefore can affect any age

41
Q

Which drugs reduce pre-synaptic excitability

A

Carbamazepine
Lamotrigine

These reduce the ability of AP’s to spread

42
Q

What is the mechanism of action of sodium valproate

A

It enhances GABA synthesis

As this is an inhibitory NTT it reduces excitation

43
Q

How do you treat absence seizures

A

sodium valproate

ethosuximide

44
Q

How do you treat myoclonic seizures

A

sodium valproate
levetiracetam
clonazepam

45
Q

How do you treat atonic, clonic and tonic clonic seizures

A

sodium valproate
levetiracetam
topiramate
lamotrigine

46
Q

How is phenytoin used in the treatment of epilepsy

A

For acute management only

6 weeks to 3 months as it causes significant cosmetic changes if taken long term

47
Q

How is levetiracetam used in the treatment of epilepsy

A

Very popular - used in certain types of generalised seizures
Few interactions
Well tolerated
Can cause mood swings

48
Q

How is topiramate used in the treatment of epilepsy

A

Used for tonic clonic, clonic and atonic
Quite effective
Not well tolerated - sedation, dysphasia and weight loss

49
Q

When is someone given anti-epileptics

A

If they have a confirmed diagnosis of epilepsy

If they have had one seizure but a high chance of recurrence - brain tumour

50
Q

Why do some anti-epileptics affect contraception

A

They induce hepatic enzymes so the efficacy of contraceptive drugs is reduced
Will need higher dose

51
Q

What must you consider in an epileptic female who wants to get pregnant

A

Many of the drugs are teratogenic - need to alter
Uncontrolled seizures are also very risky for pregnancy – damage to placenta or foetus themselves - so must balance this with drugs side effecst
Must put them on high dose folic acid for at least 3 months prior to conception

52
Q

What is status epilepticus

A

Continuous seizure activity lasting more than 30mins
Recurrent seizures without full recovery of consciousness
Can occur with generalised or focal seizures

53
Q

At what point would you start treating status epilepticus

A

Treat after 10 mins of seizure activity as they wont stop by themselves after that point
Early treatment is key - ABCDE

54
Q

What can precipitate status epilepticus

A 
Severe metabolic disorders 
Infection - CNS particularly 
Head trauma 
SAH 
Abrupt withdrawal of anti-epileptics 
Treating an absence seizure with carbamazepine
55
Q

What is a convulsive status

A

Ongoing tonic-clonic activity without stopping - generalised convulsions
This puts a huge metabolic demand on the body

56
Q

What are the outcomes of convulsive status epilepticus

A

Huge metabolic and fluid shifts - massive energy demand
Use up all glycogen, hyperthermia, can lead to rhabdomyolysis etc within 30-60mins
Can go onto organ failure after 60mins
Cerebral oedema and brain exhaustion can occur after hours

57
Q

How do you manage status epilepticus

A

Stabilise patient - ABC
Must find the underlying cause – bloods and CT
Check blood glucose to exclude hypo
MUST start treatment early – after 10 mins
Give benzodiazepines to stop - can give a second dose after 5mins
DO NOT give more than 2 doses
Give phenytoin or normal AED treatment at full dose
Send to intensive care if they don’t recover after 30mins

58
Q

If someone has just starting seizing what do you do

A

Monitor the person carefully

It should stop on its own, but treat as status if it goes on longer than 10 mins

59
Q

At what age does generalised epilepsy typically present

A

Commonly presents in

childhood & adolescence

Neurology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions