Epilepsy (primary generalised) Flashcards
What is epilepsy?
“A condition where seizures reoccur caused by abnormal neuronal discharges.”
What does primary generalised mean?
There are no features attributed to only one hemisphere
What may be a cause of a seizure?
Withdrawal
- Alcohol
- Benzodiazepines
Hypo/hyper natraemia
Hypocalcaemia
Infection
- Encephalitis
- Meningitis
Space occupying lesions
What may be present in the history of someone presenting with a first seizure?
Myoclonic jerks Abscences Family history <25 years old Deja vu Rising sensation from the abdomen
What common findings are present after an epileptic seizure?
Tongue biting
Incontinence
DDx?
Vasovagal syncope
Hypoxic seizure
Concussion
Arryhthmia
All these are ruled out by tongue biting and incontinence
Tests of epilepsy?
EEG
Hypoventilation and photic studies to elicit a seizure
- Will show a generalised abnormality
Video telemetry
Study this then answer the next cards
PREVENTATIVES 1st line: - Sodium valproate - Lamotrigine - Ethosuximide for abscences
2nd line:
- Topiramate
ABORTIVES
1st line
- Phenytoin
- Carbamezapine
STATUS EPILEPTICUS
- Lorazepam
- Midazolam
Final line is anaesthesia
What are the 1st line preventatives for epilepsy?
Sodium valproate
Lamitrogine
Ethosuximide
- for abscences
What are the 2nd line preventatives for epilepsy?
Topiramate
What are the 1st line abortives for epilepsy?
Phenytoin
Carbamezapine
What are the 1st line abortives for status epilpticus?
Lorazepam
Midazolam
What is the final line abortive treatment for epilepsy/status epilepticus?
Anaesthesia
What is status epilepticus?
A single tonic clonic seizure or group of tonic clonic seizures lasting over 30 mins
What does SUDEP mean?
Sudden unexpected death in epilepsy
