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Neuro > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is epilepsy?

A

The recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain, manifesting in seizures. It is an ongoing liability to recurrent epileptic seizures.

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2
Q

What is an epileptic seizure?

A

Paroxysmal / unprovoked event in which changes of behaviour, sensation or cognitive processes are caused by excessive, unusually synchronised neuronal discharges in the brain.

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3
Q

How long does an epileptic seizure usually last?

A

They normally last 30 -120 seconds

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4
Q

Can epilepsy go into remission?

A

Yes

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5
Q

What are the main differences between a normal seizure and an epileptic seizure?

A

Non-epileptic seizures are

  • Situational
  • Longer, closed mouth / eyes during tonic-clonic movement, pelvic thrusting, do not result from sleep
  • No incontinence or tongue biting
  • Normally no medical cause (might be psychological)
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6
Q

What are the three elements of a seizure?

A
  1. Prodrome
  2. Aura
  3. Postictally
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7
Q

What are the two classifications of a seizure?

A
  • Primary, generalised

- Partial/focal

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8
Q

What are the features of a generalised seizure?

A
  • Simultaneous onset of electrical discharge throughout whole cortex (involving both hemispheres)
  • Bilateral symmetrical and synchronous motor manifestations
  • Always associated with loss of consciousness or awareness
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9
Q

What are the features of a partial/focal seizure?

A
  • Focal onset, with features referable to a part of one hemisphere eg temporal lobe
  • Often seen with underlying structural disease
  • Electrical discharge is restricted to a limited part of the cortex of one cerebral hemisphere
  • These may later become generalised (eg secondarily generalised tonic-clonic seizures)
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10
Q

What are 3 risk factors for epilepy?

A
  • Family history
  • Premature born babies who are small for their age
  • Childhood febrile convulsions
  • Abnormal blood vessels in brain
  • Alzheimer’s or dementia
  • Use of drugs eg cocaines
  • Alcohol withdrawal
  • Stroke / brain tumour / infection
  • Trauma
  • Cortical scarring (eg head injury, cerebrovascular disease)
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11
Q

What are the 5 types of generalized seizure?

A
  1. Generalised Tonic-clonic seizure
  2. Typical Absence Seizure
  3. Myoclonic Seizure
  4. Tonic seizure
  5. Atonic seizure
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12
Q

What is a tonic-clonic seizure?

A

Tonic phase
- Rigid stiff limbs -person will fall to floor if standing
Clonic phase
- Generalised, bilateral, rhythmic muscles jerking lasting seconds - minutes
- Eyes remain open and tongue is often bitten
- May be incontinence
- Followed by a period of drowsiness, confusion or coma for several house postictally

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13
Q

What is an absent seizure?

A

A loss and regain of consciousness. Patient may stop and stare into space.

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14
Q

Who do absent seizures most commonly occur in?

A

Children

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15
Q

What is a myoclonic seizure?

A
  • Sudden isolated jerk of a limb, face or trunk

- Patient may be thrown suddenly to the ground, or have a violently disobedient limb

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16
Q

What is a tonic seizure?

A
  • Sudden sustained increased tone with a characteristic cry’grunt
  • Intense stiffening of body (tonic)
    Stiffening NOT FOLLOWED by jerking
17
Q

What is an atonic seizure?

A
  • Sudden loss of muscle tone and cessation of movement resulting in a fall
18
Q

What are the three types of partial/focal seizure?

A
  • Simple partial seizure
  • Complex partial seizure
  • Secondary generalised seizure
19
Q

What is the difference between a simple partial seizure and a complex partial seizure?

A 
Simple = remains conscious 
Complex = loss of consciousness
20
Q

What investigations would you do if you suspected epilepsy in someone?

A
  • EEG
  • MRI
  • CT head
  • Blood tests
  • Genetic testing
21
Q

What are the two main complications with epilepsy?

A
  • Status Epilepticus

- Sudden unexpected death epilepsy (SUDEP)

22
Q

What is Status Epilepticus?

A

Continuous seizures without recovery of consciousness (more than 10 min or 2 more more seizures without recovery of consciousness between them over a similar time frame). This is a medical emergency.

23
Q

Give 3 emergency measures you would have to consider before treatment in an epileptic patient?

A
  • Glucose levels
  • Patient if of no harm to themselves
  • Prolonged seizures - treat with rectal/ IV diazepam or lorazepam
  • Effectiveness of benzos will reduce over time
24
Q

What drugs would you use in the treatment of epilepsy?

A
  • Oral sodium valproate
  • Oral lamotrigine
  • Oral carbamazepine
25
Q

What is the broad name of drugs given in epilepsy?

A

Anti-convulsives

Neuro (17 decks)

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