Epilepsy Flashcards
Causes for seizures
seizuring VITAMIN
Vascular - strokes, embolic strokes
Infections - meningitis, encephalitis
Trauma - head injuries
AV malformation - cavernous malformations
Metabolic - hypoglycaemia, hyponatremia, hypoxia
Idiopathic - primary or secondaries
Neoplasms - sleep deprivation, drug overdose, fever, eclampsia, hydrocephalus, multiple sclerosis
Anti-epileptic drugs
ABCD SHIP Aliphatic carboxylic acid Benzodiazepines/barbiturates Cyclic GABA analogues Deoxybarbiturate Succinimides Hydantoin Iminostilbenes Phenyltriazine
What are the most common anti-seizure medications (ASMs) previously called AEDs?
"BILLY CS" Benzodiazepines (clobazam, midazolam) Lamotrigine (Lamictal®) Levetiracetam (Keppra®) Carbamazepine (Tegretol®) Sodium valproate (Epilim®)
What are the side effects of phenytoin?
PHENYTOIN cytochrome P-450 interaction Hirsutism Enlarged gums (gingival hyperplasia) Nystagmus Yellow-browning of skin (melasma) Teratogenicity Osteomalacia Interacts with folate Neuropathy
What are other medications used for seizures?
"PLZ TP" Phenytoin Lacosamide Zonisamide Topiramate Perampanel
Symptoms of epilepsy
“VITAMINS D”
V-Vascular (stroke, bleeding, AV malformations)
I-Infections (meningitis, brain abcesses)
T-Trauma (road accidents, penetrating injuries)
A-Autoimmune diseases (CNS vasculities, SLE)
M-Metabolic disorders (hypoglycemia, hyponatremia)
I-Idiopathic cause unknown
N-Neoplasms (space occupying tumours)
S-Psychiatric disorders
D-Drugs (alcohol, phencyclidine, cocaine)
What are the different anti-epileptic drugs?
"BHAISAB" B-Barbiturates (phenobarbitone) H-Hydantoins (phenytoin) A-Aliphatic carboxylic acids (valproic acid) I-Iminostilbenes (carbamazepine) S-Succinimides (ethosuccimide) A-Adjunct newer drugs (lamotrigine, felbamate, gabapentin, vigabatrim) B-Benzodiazepines (clonazepam, diazepam)
What are the causes of seizures?
“VITAMINES”
V-Vascular (IC bleed, aneurysms, vasculitis)
I-Infections (bacteria, TB, viral toxoplasma)
T-Trauma (head injury, birth injury, treatment (drugs))
A-Alcohol, AV malformatons
M-Metabolic (hypoglycaemia, hyponatremia, uremia, hypo/hypercalcemia)
I-Idiopathic without any cause
N-Neoplasms (primary CNS tumours, metastatic lesions)
E-Errors of metabolism (inborn errors of metabolism)
S-Scar epilepsy (old lesions can act as epileptic foci)
Drugs that treat simple partial and complex partial seizures
“Lamb top gave funny carbs”
Lamb=Lamotrigine different Na blocker different lamb is “black sheep” different fx on bipolar disorder
Top=Topiramate (complex mechanism cannot be explained off the top a ma head also helps migraines)
Gave=Gabapentin wishes it worked like GABA (inhibitory neurotransmitter) has pent up frustration how does it really work?
Funny: phenytoin keeps na channels inactive Laugh: patient convulsating for a long time status epilepticus is funny
Carbs: Carbamazepine keeps Na channels inactive amazed people try to feel better Carbamazepine is the first line treatment for trigeminal neuralgia
What are some features of valproate?
“vALPROate”
A=Anaemia
L=Liver (hepatotoxcitiy)
P=Pancreatitis
rO= a hole in the neural tube defect of spina bifida the pouch that spina bifida occurs in
“Dez bryant is a salty player” due to that it reminds of sodium voltage-gated channels that they are being inhibited
What are some features of phenytoin?
“If they don’t salt the roads your car will need a toin”
Snow hyperplasia=gingival hyperplasia
Salt=decrease sodium voltage-gated ion channels
toin=phenytoin
Fetal hydantoin syndrome ends in toin same as phenytoin
If they don’t salt the road there will be zero order on the roads
If they don’t salt the roads you will be inducing toe trucks to come rescue the cars
Gingerval hyperplasia reminds of snow hyperplasia (snow everywhere) which is why you will need a toin
What are the features of ethosuximide?
“Absence seizures sux”
Absence=absence seizures
Sux= ethosuximide
What anti-epileptics cause steven johnson’s syndrome?
"Ethan, Carl, Larry, Steven and Johnson" E=Ethosuximide C=Carbamazepine L=Lamotrigine Steven and johnson=Steven johnson's syndrome
What medication treats trigeminal neuralgia?
“You chew carbs with your cheeks”
Carb=carbamazepine
Carbamazepine causes trigeminal neuralgia
Describe the features of lamotrigine
“Lame-o!”
Lamotrigine works on seizures by working on glutamate and decreasing sodium voltage-gated ion channels
