Epilepsy

Question 1

give 3 consequences of a diagnosis of epilepsy

Answer 1

morbidity
mortality
cost
psychosocial

Question 2

define a clinical diagnosis

Answer 2

an intellectual process whereby all available sources of
information, from the purely clinical to the highly technical,
are integrated with a view to arrive at a meaningful
conclusion

Question 3

5 steps for the diagnostic process for seizures

Answer 3

1. Was it a seizure?
2. What type of seizure?
3. What is the cause?
4. Is it epilepsy?
5. What impairment is it causing?

Question 4

define seizure

Answer 4

transient occurrence of signs and/or symptoms due to abnormal
excessive or synchronous neuronal activity in the brain

Question 5

5 ddx for seizures

Answer 5

syncope
hypoglycaemia 
hyperventilation 
anoxic seizures
movement disorders
TIA
Tics 
Migraine

Question 6

How can we classify seizures?

Answer 6

duration
onset + spread
cause

Question 7

when do we diagnose status epilepticus for a tonic clonic seizure

Answer 7

after 5 minutes

Question 8

5 causes of seizures

Answer 8

metabolic upset 
traumatic brain injury 
stoke
haemorrhage
infection 
alcohol and drugs 
febrile

Question 9

5 causes of epilepsy

Answer 9

post traumatic
post stroke
tumours
vascular malformations 
hippocampal sclerosis 
unknown

Question 10

define epilepsy

Answer 10

.a disorder of the brain characterized by an enduring predisposition
to generate epileptic seizures and by the neurobiologic, cognitive,
psychological, and social consequences of this condition

Defined by any of the following conditions:
– At least two unprovoked (or reflex) seizures occurring more than 24 hours apart
– One unprovoked (or reflex) seizure and a probability of further seizures similar
to the general recurrence risk (at least 60%) after two unprovoked seizures,
occurring over the next 10 years
– Diagnosis of an epilepsy syndrome

Question 11

when do you do an EEG

Answer 11

when clinical diagnosis or strong suspicion

Question 12

5 main consequences of seizures

Answer 12

medical- injury, drowning, drug effects

education- age of onset, seizure type

employment

family life/ social networks

neuropsychological deficits

emotional adjustments

Question 13

4 main causes of death in epilepsy

Answer 13

treatment 
suicide
underlying disease
seizure related
status epilepticus

Question 14

Mx of status epilepticus

Answer 14

ABC approach
10mg diazepam, midazolam or 4mg lorazepam 2 doses
intubate