Epilepsy - PMKT Flashcards
Which are the features commonly comprising the auras preceding temporal lobe seizures? [3]
Viscerosensory symptoms such as a rising epigastric sensation and
Experiential phenomena such as fear, déjà and jamais vu, visceral and auditory illusions, and complex auditory/ visual/gustatory/olfactory hallucinations.
Core features of true generalised epileptic seizures include? [5]
Sudden onset with injury.
Convulsions, with eyes open typically lasting < 5 minutes.
Lateral tongue biting.
Urinary and faecal incontinence.
Post-ictal dowsiness, confusion or weakness (Todd’s paresis).
What is the next appropriate treatment in a status epilepticus patient who has not responded to two boluses of Lorazepam? [1]
Phenytoin infusion.
Describe the pharmacokinetics of Phenytoin? [1]
Phenytoin has saturable metabolism so at therapeutic ranges (around 300mg/d) has non-linear kinetics - small increases in dose can lead to large changes in plasma concentration.
What is the most dangerous side effect of Lamotrigine? [1]
Stevens-Johnson syndrome or Toxic Epidermal Necrolysis
What is the difference between simple and complex seizures? [1]
Consciousness is impaired in complex seizures but not in simple seizures
What are the clinical features of a myoclonic seizure? [1]
Sudden jerk of a limb, trunk, or face.
What are the local features of a parietal lobe seizure? [1]
Sensory symptoms such as tingling and numbness; motor symptoms - due to spread of electrical activity to the pre-central gyrus in the frontal lobe.
Which anti-epileptic medication is associated with increased risk of developing kidney stones? [1]
Topiramate
What is the first-line treatment of myoclonic seizures? [1]
Sodium Valproate
What is the first-line treatment of absence seizures? [2]
Sodium Valproate or Ethosuximide.
Which factor can precipitate absence seizures? [1]
Hyperventilation
What is the first-line treatment of focal seizures [2]
Carbamazepine or Lamotrigine.
Which drug worsens myoclonic seizures? [1]
Carbamazepine.
What is the first-line treatment of status epilepticus in a patient in hospital? [1]
IV Lorazepam.
First line antiepileptic for generalised seizures in young women? [1]
Lamotrigine (or levateracetam)
focal impaired awareness seizure
Psychogenic non-epileptic seizures
What is the first-line treatment for tonic or atonic seizures (male patient)?
Sodium valproate
benzodiazepines
Most commonly first-line medication for focal seizures - lamotrigine or levetiracetam
Ethosuximide
tonic-clonic generalised seizure
