Epilepsy and Seizures Flashcards
What is a seizure?
A short episode of symptoms caused by a burst of abnormal electrical activity in the brain
What is epilepsy?
The ongoing liability to recurrent seizures
What can auras look like?
Deju-Vu
Change in smell, Vision orTaste
When are seizure most common?
Infancy and old age
Who are focal seizures more common in?
The elderly (Cortical abnormality)
If in a focal aware seizure there was motor signs such as stiffness, twitching or spasm which lobe of the brain would it most likely to located in?
The frontal lobe
What is a Jacksonian march?
A phenomenon where a focal aware seizure spreads from distal part of the limb towards the ipsilateral face
If in a focal aware seizure there was sensory manifestations such as tingling or numbness of pain what area of the brain is most likely affected?
Parietal lobe
If in a focal aware seizure there is visual phenomenon such as flashing lights, colours or hallucinations what is the likely lobe?
Occipital lobe
If in a focal aware seizure there is changes in mood/behaviour and a rising epigastric sensation then which lobe of the brain is it most likely in?
Temporal lobe
Focal impaired awareness seizures arise from which lobe in the majority of cases?
Temporal lobe
What is the most common cause of messiah temporal lobe epilepsy?
Hippocampal sclerosis
What are the 3 distinct components of complex partial seizures?
Aura
Abscence
Automitism
TRUE/FALSE
Awareness is always impaired on generalised seizures
TRUE
Where is the abnormality in generalised seizures?
Cortical network
What are the types of generalised seizure?
Absence Myoclonic Clonic Tonic Tonic-Clonic Atonic
With an absence seizure there is still post-ictal confusion TRUE/FALSE
FALSE
In what type of seizure are there 3 Hz generalised spike-waves?
Absence seizures
When do juvenile myoclonic epilepsy seizures tend to occur?
First hour or so after wakening
What age does juvenile myoclonic epilepsy tend to occur?
12-18
What age do clonic seizures tend to occur?
Neonates/young children
What drug in avoided in myoclonic seizures?
Carbamazepine
Brief LOC, patient falls to the ground, often extension of the neck, upturning of the eyes and arching of the back is characteristic of which type of seizure?
Tonic seizure
When his EEG indicated?
1-Classification of epilepsy
2-Confirmation of non-epileptic status
3-Surgical evaluation
4-Confirmation of non-convulsive status
What are some differentials of seizures?
Syncope TIAs Migraines Hypoglycaemia Tonic spasms of MS
Give anticonvulsants to all who present with seizures TRUE/FALSE
NAA, Whatcha playin
Only give drugs if they have epilepsy, do NOT GIVE DRUGS IF THEY PRESENT WITH A SINGLE SEIZURE
What is the first line treatment of absence seizures?
Ethosuximide
What is 1st line for focal seizures?
Lamotrigine or carbamazepine
What is the mode of action for sodium Valporate?
Na+ channel inactivation with increased GABA concentration
What anticonvulsant drug is used in pregnancy as it is not teratogenic?
Lamotrigine
What is Status epilepticus?
A convulsive seizure which continues for a prolonged period (5 minutes+)
OR
When convulsive seizures occur one after the other with no recovery inbetween
What is the treatment for status epileptics in the community v in hospital?
Community- Midazolam
Hospital-Lorazepam
What is some of the lasting damage that status epileptics can cause?
Respiratory insufficiency
Hypotension
Hyperthermia
Rhabdomyolysis
