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Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

If someone has a blackout but its confirmed not to be epilepsy what could it be ?

A
  • Syncope
  • One off seizure
  • Sleep disorder
  • Movement disorder
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2
Q

What are the 3 different types of syncope ?

A
  1. Reflex - Taking blood
  2. Cardiogenic - Arrythmias
  3. Orthostatic - Dehydration/Medication related
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3
Q

What may stop syncope from occurring ?

A

Sitting the person down/getting them a drink

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4
Q

Which type of syncope is usually seen on exertion ?

A

Cardiogenic

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5
Q

When assessing a patient for syncope what should you do ?

A
  • BP, pulse
  • Listen to heart
  • ECG
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6
Q

What is the definition of epilepsy ?

A

Tendency to have recurrent seizures

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7
Q

Name the generalised seizures

A
  • Absence seizures
  • Juvenile myoclonic epilepsy
  • Generalised tonic-clonic seizures
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8
Q

Name the focal seizures

A
  • Simple partial seizures
  • Complex partial seizures
  • Secondary generalised
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9
Q

What is seen on investigation of generalised seizures ?

A
  • Generalised abnormality on EEG
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10
Q

What is seen on investigation of focal seizures ?

A

Focal abnormality of EEG

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11
Q

How do generalised seizures usually present ?

A

< 25 years old

No warning

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12
Q

How do focal seizures usually present ?

A

Any age
May get a warning sign
MRI may show cause

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13
Q

Features of generalised tonic clonic seizures

A
  • Eyes rolling
  • Period of rigidity and then jerking
  • Tongue bitting
  • Groans
  • Tend to cluster/ may be irritable beforehand
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14
Q

Features of absence seizures

A
  • Often in children
  • Triggered by bright lights or hyperventilation
  • Sudden arrest in activity then continues what they are doing
  • Staring and eyelid flickering
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15
Q

Features of juvenile myoclonic epilepsy

A
  • Lack of sleep or alcohol may triggers then
  • Can have an absence seizure or GTC
  • Will often have early morning myoclonus and drop things or have brief jerks
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16
Q

Features of a complex partial seizures

A
  • Aura
  • Temporal lobe
  • Lip smacking and repetitive movements
  • Sudden arrest of activity and staring into space
17
Q

Which seizure type do you not lose consciousness ?

A

Simple partial seizures

18
Q

How do you investigate seizures ?

A
  • ECG and routine bloods to rule out other causes
  • CT of head in >50s
  • MRI in most patients
  • EEG
  • Video-telemetry is unsure of diagnosis
19
Q

What is the management of epilepsy ?

Non-medication

A
  • Conversation with an epilepsy nurse
  • Discussion around driving
  • Discuss anti-epileptic drugs
20
Q

What are the first line treatments of epilepsy ?

A
  • Soidum valproate
  • Lamotrigene
  • Ethosuxamide in absence seizures
21
Q

What are the second line treatments of epilepsy ?

A
  • Valproic acid

- Topiramate

22
Q

What are the side effects of Lamotrigene ?

A

Difficulty sleeping and a rash

23
Q

Contraindications of Sodium Valproate and Valproic acid ?

Side effects ?

A

Pregnancy or women or child-bearing age. Sodium valproate can cause weight gain and nausea

24
Q

What drug can be used during pregnancy to treat epilepsy ?

A

Topiramate

25
Q

What are the driving regulations when someone has only has one seizure and confirmed not to be epilepsy ?

A

6 months after to drive car

5 years after to drive HGV

26
Q

What are the driving regulations when someone has only has had epilepsy diagnosed but hasn’t had a seizure for a while ?

A

12 months seizure free for a car

10 years seizure free for a HGV

27
Q

What are the rules about daytime seizures turning into night one ?

A

They have to have this pattern for at least 3 years before driving.

28
Q

What is Status Epilepticus ?

A

Prolonged or recurrent tonic-clonic seizures persisting more than 30 minutes with no recovery.

29
Q

What is the first line treatment for SE ?

A

Diazepam, Lorazepam

30
Q

What is the 2nd line treatment for SE ?

A

IV sodium valproate

31
Q

What is the 3rd line treatment for SE ?

A

Propofol - Induce a coma

32
Q

What is a pseudo-seizure ?

A
  • Occur at rest or when stressed
  • Patient can tell you lots of detail about the event
  • Pelvic movements are common

Neurology (16 decks)

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