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FINALS - NEURO > epilepsy + seizures > Flashcards

epilepsy + seizures Flashcards

1
Q

which conditions have an assoc with epilepsy

A

cerebral palsy // tuberous sclerosis // mitochondrial disease

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2
Q

where do focal vs generalised seizures occur

A

focal = localised part of the brain, 1 sided // generalised = all parts of brain imparied, both sides

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3
Q

RF for developing epilepsy

A

brith and development, past seizures, head injury, FH

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4
Q

stages of a seizure

A

aura (maybe) –> seizure –> post-ictal

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5
Q

what are focal aware (simple) seizures

A

focal seizures affecting one side of the brain –> symptoms correlate with area of brain –> awareness usually not impaired

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6
Q

frontal lobe focal seizure symptoms

A

motor movement // jacksonian march - clonic movements start distally and move proximally

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7
Q

parietal lobe focal seizure symptoms

A

sensory signs

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8
Q

occipital lobe focal seizure symptoms

A

visual flashes, hallucinations

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9
Q

what are focal impaired awareness (complex) seizures + symptoms

A

aura (rising epigastric feeling) // LOC // repetiitve movement usually lip smacking, grabbing // last 1 min // post-ictal confusion

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10
Q

where do focal impaired awareness seizures usually occur in brain

A

temporal lobe

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11
Q

symptoms absence seizures

A

abrupt LOC and patient stares into space // tone preserved // no post-ictal confusion // lasts 10 secs

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12
Q

who usually gets absence seizures

A

girls aged 3-10

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13
Q

EEG absence seizure

A

3Hz bilateral wave pattern

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14
Q

symptoms myoclonic seizures

A

brief muscle contractions in small groups of muscles –> a single jerk

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15
Q

what are symptoms of juvenile myoclonic eplipesy + what age

A

12-18 // brief myoclonic jerks // happens in morning or when sleep deprived // daytime abscence

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16
Q

what does juvenile myoclonic epilepsy usually develop too

A

tonic-clonic

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17
Q

symptoms tonic seizure

A

brief LOX –>fall –> extended neck and back, stiff body

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18
Q

symptoms clonic seizure

A

repeated myoclonic movements // parts of body shake and jerk frequently

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19
Q

phases tonic clonic seizures

A

tonic: LOC, fall, tongue biting, incontinence // clonic: start to jerk around, eyes roll back // post-ictal confusion + headache

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20
Q

what are secondary seizures

A

when previous focal seizures spread to bilateral general seizures

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21
Q

general symptoms post-ictally

A

headache, drowsy, confused for around 15 minutes

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22
Q

invx seizures

A

ECG!! // MRI // EEG

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23
Q

mx tonic-clonic seizures

A

1 = sodium valproate // 2 = lamotrigene or levetiracetam

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24
Q

mx absence seizures

A

1 = ethosuximide // 2 = sodium valpraote, lamotrigene or levetiracetam

25
Q

mx myoclonic seizures

A

1 = sodium valproate // 2 = levetiracitam

26
Q

mx tonic seizures

A

1 = sodium valproate // 2 - lamotrigine

27
Q

mx focl seizures

A

1 = lamotrigene, levetiracetam // 2 = carbamazepine

28
Q

SE sodium valproate

A

teratogenic // P450 inhibitor // alopecia

29
Q

carbamezepine SE

A

p450 inducer // dizzy, drowsy // ataxic // SIADH // visual disturbance

30
Q

SE phenytoin

A

p450 inducer // ataxia // coarse facial features // peripheral neuropathy // gingival hyperplasia

31
Q

mechanism + SE lamotrigiene

A

Na channel blocker // stevens johnson

32
Q

what age do febrile convulsions occur at

A

6 months - 5 years

33
Q

simple febrile convulsion symptoms

A

general (tonic clonic) // < 15 mins // no recurrence

34
Q

complex febrile convulsion symptoms

A

15-30 mins // focal seizure // may have repeat seizures

35
Q

immediate mx febrile seizure

A

phone ambulance if more than 5 mins // anti pyretics do not reduce change

36
Q

mx recurrent febrile convulsion

A

rectal diazepam or buccal midazolam

37
Q

what is status eplipticus

A

seizure >5 mins OR >2 seizures within 5 mins

38
Q

1st, 2nd, 3rd line mx status elipticus

A

1 = IV benzo eg lorazepam // 2 = add on phenytoin or phenobarbitol // 3 = general anaesthesia

39
Q

when can benzos be repeated in status elipticus

A

after 10-20 mins, only once

40
Q

inital mx status elipticus in community

A

rectal diazepam or buccal midazolam

41
Q

adult dose rectal diazepam status elipitucs

A

10-20mg (max 30)

42
Q

adult dose buccal midazolam status elipitucs

A

10mg

43
Q

what should all women with epilepsy take prior to pregnancy

A

5mg folic acid

44
Q

risk to baby with sodium valproate

A

neural tube defect

45
Q

risk to baby with phenytoin

A

cleft palate

46
Q

if a pregnant women is taking phenytion what should be given in last month of pregnancy

A

vit K

47
Q

safest AED pregnancy

A

monotherapy lamotrigine

48
Q

is breast feeding safe on AEDs

A

yes - except barbiturates

49
Q

which contraception is adviced for women on AED

A

copper coil or depo injfection

50
Q

what contraception is UKMEC3 taking AEDs

A

COCP + POP (not for lamotrigene)

51
Q

symptoms pseudoseizure

A

gradual onset // pelvic thrusting // FH epilepsy // female // crying after // only in public

52
Q

what blood test can differentiate pseudoseizure from epilepsy

A

true eplipesy = raised prolcatin

53
Q

DVLA ban following a one off seizure

A

6 months and reassess

54
Q

DVLA ban following seizure when awake/ established epilepsy

A

seizure free for 12 months

55
Q

DVLA ban following seizure when asleep

A

can drive if no awake attack for 3 years

56
Q

DVLA ban following withdrawal AED

A

6 months after last dose

57
Q

DVLA buses and lorries 1 off seizure

A

5 years

58
Q

when can AEDs be considered to be stopped

A

seizure free 2 years, wean off over 2-3 months

FINALS - NEURO (16 decks)

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