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Neuro > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is epilepsy?

A

Tendency to recurrent seizures
Or investigation shows >60% likelihood of recurrence over 10 years
Background electrical activity is disrupted

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2
Q

What should be a top priority when assessing collapse?

A

Obtain 3rd party account

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3
Q

What are some underlying causes of cardiogenic syncope?

A

Aortic stenosis

Arrhythmia

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4
Q

What are some underlying causes of orthostatic syncope?

A

Dehydration
Anti-hypertensive meds
Endocrine
Autonomic nervous system

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5
Q

What are some underlying causes of reflex (neuro-cardiogenic) syncope?

A

Cough
Urination
Medical procedures such as taking blood

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6
Q

What are some clinical components in the assessment of syncope?

A

Heart sounds
Blood pressure
Heart block
QT ratio

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7
Q

What situations may provoke a seizure?

A 
Alcohol withdrawal
Drug withdrawal
Within a few days of head injury
Within 24 hours of a stroke
Within 24 hours of neurosurgery
Severe electrolyte disturbance
Eclampsia
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8
Q

What is a myoclonic seizure?

A

Brief muscle jerk

Patient awake and able to think clearly throughout

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9
Q

What are some post hoc features of a generalised tonic clonic seizure?

A

Lateral sever tongue biting
Incontinence
First recollection in ambulance or hospital
Muscle pain

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10
Q

What may a 3rd party report of a generalised tonic clonic seizure?

A

Groaning sound
Rigid phase
Eyes open
Mouth foaming

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11
Q

What are some features of absence seizures?

A 
May be provoked by hyperventilation or photic stimulation
Sudden arrest of activity
Brief staring
Eyelids may flutter
Re-start what they were doing
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12
Q

What are some features of juvenile myoclonic epilepsy?

A

Provoked by alcohol or sleep deprivation
Can have absence and GTC seizures
Will often have brief limb jerks in the morning

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13
Q

What are the first steps in managing seizures?

A 
Refer to first seizure clinic
Do an ECG
Routine bloods (Glc)
CT
MRI
EEG
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14
Q

What medications may be used to treat primary generalised epilepsies?

A

Sodium valproate

Lamotrigine

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15
Q

What medications may be used to treat focal and secondary generalised seizures?

A

Lamotrigine

Carbamezepine

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16
Q

Whaat medication may be used to treat absence seizures?

A

Ethosuximide

17
Q

What medication may be used to treat seizures in an acute setting

A

Lorazepam
Midazolam (diazepam)

Valproate or phenytoin for status epilepticus

18
Q

What are some side effects of phenytoin?

A

Arrhythmia
Hepatitis
Medication interactions

19
Q

What are some side effects of Sodium Valproate?

A 
Tremor 
Weight gain
Ataxia
Nausea
Drowsiness
Hepatitis
20
Q

What are some side effects of Carbamazepine?

A

Ataxia
Drowsiness
Hepatitis
(Avoid in women of child bearing age)

21
Q

What are some side effects of Lamotrigine?

A

Skin rash

Difficulty sleeping

22
Q

What are some side effects of Levetiracetam?

A

Irritability

Depression

23
Q

What are the driving regulations for after a single seizure?

A

A patient may drive a car after 6 months if their investigations are normal and they have had no further events

24
Q

What are the driving regulations for a patient with epilepsy?

A

Patients with epilepsy can drive a car once they have been seizure free for a year or have only had seizures arising from sleep for a year

25
Q

What is status epilepticus?

A

Prolonged or recurrent tonic-clonic seizures persisting for more than 30 minutes with no recovery period between seizures

26
Q

What is the first line treatment of SE?

A

Midazolam
Lorazepam
Diazepam

27
Q

Describe some characteristics of a pseudoseizure.

A

Patient may descrobe what others said during the episode but little of the events themselves
Witnesses may identify stress as a trigger

Neuro (29 decks)

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