Epilepsy Flashcards
1
Q
Conditions associated with epilepsy:
A
- cerebral palsy
- tuberous sclerosis
- mitochondrial disease
2
Q
Febrile convulsions:
A
- children 6mo - 5yo
- usually early in viral infection as temp rises rapidly
- brief and generalised tonic/tonic-clonic
3
Q
Alcohol withdrawal seizures:
A
- after suddenly stopping with drinking
- chronic alcohol enhances GABA mediated inhibition of CNS and inhibits NMDA glutamate receptors
- withdrawal - decreased inhibitory GABA and increased NMDA glutamate transmission
- peak incidence at 36 hours
- benzodiazepines to reduce risk
4
Q
Psychogenic non-epileptic seizures:
A
- pseudoseizures
- no characteristic electrical discharges
- history of mental health problems or personality disorder
5
Q
How are seizures classified?
A
- where they begin in brain
- level of awareness during seizure
- other features
6
Q
Focal seizures:
A
- previously partial seizures
- specific area on one side of brain
- level of awareness varies: focal aware, focal impaired awareness and awareness unknown
- motor (e.g. Jacksonian march), non motor (e.g. deja vu, jamais vu) or features such as aura
7
Q
Generalised seizures:
A
- both sides of brain at onset
- consciousness lost immediately
- motor (e.g. tonic-clonic) and non-motor (e.g. absence)
8
Q
Specific types of generalised seizures:
A
- tonic clonic (grand mal)
- tonic
- clonic
- typical absence (petit mal)
- myoclonic: brief, rapid muscle jerks
- atonic
9
Q
Focal to bilateral seizure:
A
- starts on one side of brain in specific area before spreading to both lobes
- perviously secondary generalised seizures
10
Q
Special epilepsy forms in children:
A
- Infantile spasms (West’s syndrome)
- Lennox-Gastaut syndrome
- benign rolandic epilepsy
- Juvenile myoclonic epilepsy (Janz syndrome)
11
Q
Infantile spasms:
A
- brief spasms in first few months
- flexion of head, trunk limbs and tension of arms (Salaam attack): 2 seconds repeated up to 50 times
- progressive mental handicap
- hypsarrythmia on EEG
- usually secondary to neuro abnormality and may be cryptogenic
- poor prognosis
12
Q
Lennox-Gastaut syndrome:
A
- extension of infantile spasms
- onset 1-5yrs
- atypical absence, falls, jerks
- 90% moderate-severe mental handicap
- EEG: slow spike
- keratogenic diet may help
13
Q
Benign rolandic epilepsy:
A
-paraesthesia (e.g. unilateral face) usually on waking up
14
Q
Juvenile myoclonic epilepsy (Janz syndrome):
A
- onset teens
- more girls
- infrequent generalised seizures often in morning
- daytime absences
- sudden, shock like myoclonic seizure
- usually good response to sodium valproate
15
Q
Phase after seizure where patient feel drowsy and tired for 15 min:
A
postictal phase
