Epilepsy Management Flashcards
What is the first mandatory investigation done to someone who is suspected of having a seizure or a period of syncope?
ECG
When is a CT scan indicated over MRI acutely in suspected seizure or syncope?
- Skull fracture
- Head injury w/ seizure
- Deteriorating GCS
- GCS not 15/15 4 hrs after arrival
- Focal signs
- Suggestion of other pathology
When is EEG used in epilepsy/seizure/syncope?
- Classification of epilepsy
- Confirmation of non-epileptic attack
- Surgical evaluation
- Conformation of non-convulsive status
How long should a patient not drive for after their first seizure, car & HGV?
Car - 6 months
HGV - 5 years
How long should a patient not drive for after a diagnosis of epilepsy, car & HGV?
Car - 1 year / 3 years if during sleep
HGV - 10 years of no seizures off medication
How long do epileptic seizures normally last?
seconds - minutes
What are the two broad classifications of epileptic seizure?
Generalized
Partial - Focal sight of origin
What investigations are used to classify epileptic seizures?
Semiology
EEG
Name the types of partial epileptic seizure?
Simple - Without impaired consciousness
Complex: with impaired consciousness
What are the different types of generalized epileptic seizure?
- Absence
- Myoclonic
- Atonic
- Tonic
- Tonic-clonic
What are some key features of generalized epilepsy?
- Genetic predisposition
- Present in childhood and adolescence
- Generalized spike-wave abnormality on EEG
What are some key features of partial/focal epilepsy?
- Localized
- Can generalize laterally
What is the treatment of choice and an alternative for primary generalized epilepsy?
Treatment of choice: Sodium valporate
Alternative: Lamotrigine
How does juvenile myoclonic epilepsy present?
- Early morning jerks
- Generalized seizures
Risk factors: Sleep deprivation & flashing lights
What medication is given for focal onset epilepsy?
Carbamazepine or Lamotrigine
