epilepsy and loss of consciousness

Question 1

what is epilepsy

Answer 1

transient episode of abnormal electrical activty

Question 2

what are the 2 main types of epileptic seizures

Answer 2

focal and generalised

Question 3

where do focal seizures commonly originate from in the brain

Answer 3

temporal lobe

Question 4

what are the 2 main types of focal seizures and what differentiates them

Answer 4

simple and complex
complex: patients lose consciousness

Question 5

what clinical sign indicates a seizure is epileptic rather than functional

Answer 5

patient has bitten the lateral aspect of their tongue

Question 6

what is a focal seizure

Answer 6

seizure that originates in one hemisphere of the brain

Question 7

what is a generalised seizure

Answer 7

seizure that involves both sides of the brain

Question 8

what are the 4 main types of generalised seizures

Answer 8

absence, myoclonic, atonic, tonic clonic

Question 9

name some risk factors for generalised seizures

Answer 9

sleep deprivation, flashing lights

Question 10

how does a tonic clonic seizure present

Answer 10

LOC, muscle tensing and muscle jerking

Question 11

how does a myoclonic seizure present

Answer 11

sudden brief muscle contraction - sudden jump

Question 12

first line management of focal seizures

Answer 12

lamotrigine or levetiracetam

Question 13

management of absence seizures

Answer 13

ethosuximide

Question 14

management of generalised tonic clonic seizures in men

Answer 14

sodium valproate

Question 15

management of generalised tonic clonic seizures in women

Answer 15

lamotrigine or levetiracetam

Question 16

management of myoclonic seizures in men

Answer 16

sodium valproate

Question 17

management of myoclonic seizures in women

Answer 17

levetiracetam

Question 18

management of tonic and atonic seizures in men

Answer 18

sodium valproate

Question 19

management of tonic and atonic seizures in women

Answer 19

lamotrigine

Question 20

how does sodium valproate work

Answer 20

increases the activity of GABA which has a calming effect on the brain

Question 21

name some symptoms associated with focal seizures

Answer 21

deja vu, strange smells, tastes and sound sensations, unusual emotions

Question 22

what are febrile seizures

Answer 22

tonic-clonic seizures caused by a high fever

Question 23

what drug may worsen myoclonic seizures

Answer 23

carbemazapine

Question 24

what are the 3 main types of status epilepticus

Answer 24

generalised convulsive
non-convulsive
epilepsia partialis continua

Question 25

what is generalised convulsive status epilepticus

Answer 25

generalised convulsions without cessation can cause damage to brain: excitotoxicity and neuronal death

Question 26

what is epilepsia partialis continua

Answer 26

continual focal seizures, consciousness preserved

Question 27

how do we confirm a diagnosis of epilepsia partialis continua

Answer 27

EEG

Question 28

side effect to not miss in carbamazepine

Answer 28

agranulocytosis

Question 29

how does agranulocytosis present

Answer 29

symptoms of infection: fever and chills, sore throat, muscle weakness and fatigue

Question 30

what happens in agranulocytosis

Answer 30

neutrophil count becomes very low

Question 31

management of status epilepticus in the community

Answer 31

buccal midazolam first rectal diazepam if needed

Question 32

management pathway of status epilepticus in hospital

Answer 32

IV lorazepam x2 IV phenobarbital or phenytoin intubation and ventilation

Question 33

what is functional neurological disorder

Answer 33

sensory and motor symptoms not explained by any neurological disease

Question 34

what is whack a mole sign in FND

Answer 34

spread of tremor to another part of the body if the tremor is restrained by the examiners hand

Question 35

what is the most common gait presentation of FND

Answer 35

dragging leg

Question 36

standard management for FND

Answer 36

CBT

Question 37

management of motor FND

Answer 37

physiotherapy