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Neurology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is epilepsy?

A

A recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain, manifesting as seizures

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2
Q

What fraction of epilepsy is idiopathic?

A

2/3

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3
Q

What are some causes of epilepsy?

A

Cortical scarring, space-occupying lesions, stroke

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4
Q

What is a prodrome?

A

Change in mood or behaviour lasting hours or days before a seizure

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5
Q

What does it suggest if a patient experiences an aura?

A

A partial seizure

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6
Q

What might a patient experience postictally?

A

Headache, confusion, myalgia, sore tongue, temporary weakness after focal seizure in motor cortex, dysphagia after a temporal lobe seizure

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7
Q

What is a focal/partial seizure?

A

Focal onset with features that can be referable to a single lobe

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8
Q

What are the subcategories of focal seizure?

A

Simple partial seizure, complex partial seizure, partial seizure with secondary generalisation

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9
Q

What manifestations are typical of a temporal focal seizure?

A

Aura, deja vu or jamais vu, auditory hallucinations, anxiety, automatisms

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10
Q

What manifestations are typical of a frontal focal seizure?

A

Motor features, Jacksonian march, post-ictal Todd’s palsy

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11
Q

What manifestations are typical of a parietal focal seizure?

A

Sensory disturbances

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12
Q

What manifestations are typical of an occipital focal seuzure?

A

Visual phenomena

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13
Q

What are generalised seizures?

A

Simultaneous electrical discharge throughout the whole cortex, bilateral and symmetrical motor manifestations and always associated with loss of consciousness and lack of awareness

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14
Q

What is an absence seizure?

A

Pale and stare blankly for a few seconds

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15
Q

What is a tonic-clonic seizure?

A

Grand mal, loss of consciousness, limbs stiffen and then jerk

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16
Q

What is a myoclonic seizure?

A

Sudden jerk of limb, face or trunk

17
Q

What is an atonic seizure?

A

Sudden loss of muscle tone causing a fall

18
Q

What could be provoking causes of a seizure?

A

Trauma, stroke, haemorrhage

19
Q

What investigations would you do?

A

EEG, MRI/CT, bloods to rule out potential causes, genetic testing

20
Q

How are seizures due to non-epileptic attack disorder different to epileptic seizures?

A

More gradual onset, prolonged, abrupt termination, closed eyes

21
Q

What is first line management of focal/partial seizures?

A

Carbamazepine or lamotrigine

22
Q

What is first line management of generalised tonic-clonic seizures?

A

Sodium valproate if not able to child bear, lamotrigine if able to

23
Q

What is first line management of absence seizures?

A

Sodium valproate if not able to child bear, ethosuximide if able to

24
Q

What is first line management of myoclonic seizures?

A

Sodium valproate if not able to child bear, levetiracetam/topiramate if able to

25
Q

What is first line management of tonic or atonic seizures?

A

Sodium valproate if not able to child bear, lamotrigine if able to

26
Q

What is a common side effect of sodium valproate?

A

Nausea

27
Q

What is a common side effect of lamotrigine?

A

Rash

28
Q

How should you switch AEDs?

A

Introduce the new drug slowly then withdraw the old drug once the new one is established

29
Q

When might you consider surgery?

A

If single epileptogenic focus can be identified

30
Q

What are some potential complications?

A

Falls, injuries, sudden unexpected death in epilepsy

31
Q

What are some risk factors?

A

FH, Premature babies, abnormal cerebral blood vessels, drugs

32
Q

What is a tonic seizure?

A

High tone and therefore rigid, stiff limbs

33
Q

What is a clonic seizure?

A

Rhythmic muscle jerking

34
Q

What is a simple partial seizure?

A

No affect on consciousness or memory, no post-ictal symptoms

35
Q

What is a complex partial seizure?

A

Memory/awareness affected, most commonly from temporal lobe, post-ictal confusion if temporal

36
Q

What is a partial seizure with secondary generalisation?

A

Partial start that develops into a generalised seizure

37
Q

How do you manage prolonged seizures?

A

Benzodiazepines

38
Q

Generally, what drugs would you give?

A

Sodium valproate to males, lamotrigine to females

Neurology (22 decks)

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