epilepsy and loss of consciousness Flashcards
what is epilepsy
transient episode of abnormal electrical activty
what are the 2 main types of epileptic seizures
focal and generalised
where do focal seizures commonly originate from in the brain
temporal lobe
what are the 2 main types of focal seizures and what differentiates them
simple and complex
complex: patients lose consciousness
what clinical sign indicates a seizure is epileptic rather than functional
patient has bitten the lateral aspect of their tongue
what is a focal seizure
seizure that originates in one hemisphere of the brain
what is a generalised seizure
seizure that involves both sides of the brain
what are the 4 main types of generalised seizures
absence, myoclonic, atonic, tonic clonic
name some risk factors for generalised seizures
sleep deprivation, flashing lights
how does a tonic clonic seizure present
LOC, muscle tensing and muscle jerking
how does a myoclonic seizure present
sudden brief muscle contraction - sudden jump
first line management of focal seizures
lamotrigine or levetiracetam
management of absence seizures
ethosuximide
management of generalised tonic clonic seizures in men
sodium valproate
management of generalised tonic clonic seizures in women
lamotrigine or levetiracetam
management of myoclonic seizures in men
sodium valproate
management of myoclonic seizures in women
levetiracetam
management of tonic and atonic seizures in men
sodium valproate
management of tonic and atonic seizures in women
lamotrigine
how does sodium valproate work
increases the activity of GABA which has a calming effect on the brain
name some symptoms associated with focal seizures
deja vu, strange smells, tastes and sound sensations, unusual emotions
what are febrile seizures
tonic-clonic seizures caused by a high fever
what drug may worsen myoclonic seizures
carbemazapine
what are the 3 main types of status epilepticus
generalised convulsive
non-convulsive
epilepsia partialis continua
what is generalised convulsive status epilepticus
generalised convulsions without cessation
can cause damage to brain: excitotoxicity and neuronal death
what is epilepsia partialis continua
continual focal seizures, consciousness preserved
how do we confirm a diagnosis of epilepsia partialis continua
EEG
side effect to not miss in carbamazepine
agranulocytosis
how does agranulocytosis present
symptoms of infection: fever and chills, sore throat, muscle weakness and fatigue
what happens in agranulocytosis
neutrophil count becomes very low
management of status epilepticus in the community
buccal midazolam first
rectal diazepam if needed
management pathway of status epilepticus in hospital
IV lorazepam x2
IV phenobarbital or phenytoin
intubation and ventilation
what is functional neurological disorder
sensory and motor symptoms not explained by any neurological disease
what is whack a mole sign in FND
spread of tremor to another part of the body if the tremor is restrained by the examiners hand
what is the most common gait presentation of FND
dragging leg
standard management for FND
CBT
management of motor FND
physiotherapy
