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NEURO > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Differential diagnosis for blackout / fainting?

A
  • Syncope
  • First seizure
  • Hypoxic seizure
  • Concussive seizure
  • Cardiac arrhythymia
  • Non-epileptic attack (narcolepsy / migraine etc.)
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2
Q

Important questions for the patient after blackout episode?

A
  • Feelings before / after
  • Level of responsiveness during / after attack
  • Motor involvement?
  • Breathing / vocalization
  • Behaviour after attack
  • Incontinence?
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3
Q

Most common cause of syncope? Prodrome symptoms?

A
  • Vasovagal syncope: fainting due to overreaction to certain triggers (emotion / sight of blood etc.)

Prodrome:

  • Light headedness / nausea / sweating / feeling warm
  • Tinnitus (noise/ringing in ears)
  • Tunnel vision
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4
Q

What is a hypoxic seizure? Concussive seizure?

A

Hypoxic:
- Occurs when person kept upright during a faint, patient may have a succession of collapses & seizure-like activity may occur

Concussive:
- Occurring after any blow to the head

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5
Q

How are cardiac arrhythmias and seizures related?

A
  • Cardiac arrhythmia can cause blackout

- Seizures can cause cardiac arrhythmias

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6
Q

How does a non-epileptic attack present? Who is at risk?

A
  • Can resemble a seizure, may involve bizarre body movements
  • More common in women, people with a history of abuse
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7
Q

Investigations of suspected first seizure?

A
  • Blood glucose
  • ECG
  • Alcohol & drug history
  • CT head
  • Calcium / Magnesium / U&E / LFT / EEG
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8
Q

What is an epileptic seizure?

A
  • An intermittent disturbance of consciousness, behaviour, emotion, motor function or sensation that is believed to be due to abnormal neural discharges
  • Epilepsy is a condition in which seizures occur
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9
Q

What are the different classes of seizure according to the International League Against Epilepsy (ILEA)?

A
  • Tonic-clonic seizures
  • Myoclonic seizures
  • Clonic seizures
  • Tonic seizures
  • Atonic seizures
  • Absence seizures
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10
Q

How are focal seizures different from generalized seizures?

A
  • Focal seizures are due to disruption of electrical impulses in one part of the brain
  • Generalized seizures due to abnormal electrical discharge involving the entire brain
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11
Q

How can focal seizures progress?

A

Simple focal and complex focal seizures can become secondary generalized seizures

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12
Q

Difference between a simple partial/focal seizure and a complex partial/focal seizure?

A
  • Simple: Person is aware they are having a seizure

- Complex: person is unaware

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13
Q

What age do generalized and focal seizures tend to occur? Is there a prodrome for either?

A

Generalized:
- people <25 years old, no warning before seizure

Focal/Partial:
- Any age, may get an aura before

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14
Q

Differences in causes of generalized and focal seizures?

A

Generalized:
- Usually genetic/idiopathic/metabolic etc., may have history of myoclonic jerks

Focal:
- Cause can be any focal brain abnormality

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15
Q

Investigations when suspected epilepsy?

A
  • EEG for primary generalized epilepsy
  • MRI / CT for patients with possible focal onset seizure
  • Video-telemetry if uncertain about diagnosis
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16
Q

Treatment for primary generalized epilepsies?

A
  • Sodium valproate
  • Lamotrigine
  • Levetiracetam
17
Q

Treatment for partial/focal and secondary generalized epilepsies?

A
  • Lamotrigine

- Carbamazepine

18
Q

What is an absence seizure? Treatment?

A
  • Seizure causing lapse in awareness, “staring into space”

- Ethosuximide

19
Q

Treatment for status epilepticus?

A

First line:
- Lorazepam (buccal/intra nasal), Midazolam (oral), Diazepam (IV / rectally)

Second Line:
- Valproate, Phenytoin

20
Q

Side effects of the different drugs used to treat seizures?

A

cba typing them now but in the slides

21
Q

What is status epilepticus?

A

According to slides: prolonged or recurrent tonic-clonic seizures persisting for more than 30mins with no recovery period between seizures

According to google: a single seizure lasting more than 5 mins or two or more seizures within 5 mins without the person returning to normal between them

22
Q

Who is usually affected by status epilepticus?

A
  • Usually occurs in patients with no previous history of epilepsy (stroke, tumour, alcohol)
23
Q

Prognosis of status epilepticus attack?

A
  • Mortality greatest in the very young and the very old (29% for those <1 year old)
  • 90% of deaths due to underlying cause, mortality greatest when secondary to stroke, encephalitis, mass lesions & trauma
24
Q

Possible causes of epilepsy?

A
  • Idiopathic
  • Genetic
  • Metabolic (alcohol withdrawal / low glucose)
  • Post-trauma
  • Hypoxic damage
  • Brain tumours
  • Cerebrovascular disease
  • Alzheimers disease

NEURO (52 decks)

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