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Phase 3a - Neurology > Epilepsy & Seizures > Flashcards

Epilepsy & Seizures Flashcards

1
Q

What is epilepsy?

A

Epilepsy is a neurological condition characterized by an increased tendency to have epileptic seizures due to abnormal electrical activity in the brain.

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2
Q

What is a seizure?

A

A seizure is a burst of abnormal electrical activity in the brain, disrupting its normal function. Symptoms vary depending on the brain area affected.

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3
Q

What are common triggers for seizures?

A

Triggers include lack of sleep, alcohol, stress, flashing lights, dehydration, infections, and missed medication doses.

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4
Q

True or False: Every case of epilepsy has a known cause.

A

False. Many cases are idiopathic, though some are linked to genetic factors, head trauma, infections, or strokes.

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5
Q

What are the two major categories of seizures?

A

Focal seizures (begin in one area of the brain) and generalized seizures (affect the entire brain).

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6
Q

Fill in the blank: A ___ seizure involves a brief loss of awareness without convulsions, commonly seen in children

A

Absence.

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7
Q

What is a focal aware seizure?

A

A seizure where the person remains conscious but may have sensory, motor, or autonomic symptoms.

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8
Q

What diagnostic tools are used for epilepsy?

A

EEG (electroencephalogram), MRI/CT scans, and blood tests to identify underlying causes or triggers.

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9
Q

True or False: An EEG can always confirm a diagnosis of epilepsy

A

False. EEG findings may be normal between seizures.

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10
Q

What is the first-line treatment for generalized seizures?

A

Sodium valproate, unless contraindicated (e.g., pregnancy).

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11
Q

Name a common side effect of carbamazepine.

A

Drowsiness, dizziness, nausea, vomiting, ataxia, blurred vision, diplopia, headache, rash

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12
Q

Fill in the blank: Women with epilepsy should take ___ to reduce the risk of neural tube defects in pregnancy.

A

Folic acid.

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13
Q

What is status epilepticus?

A

A medical emergency where seizures last more than 5 minutes or occur back-to-back without recovery.

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14
Q

What is SUDEP?

A

Sudden Unexpected Death in Epilepsy, a rare but serious complication often occurring during sleep.

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15
Q

True or False: Epilepsy can impact a person’s ability to drive.

A

True. Patients must be seizure-free for one year to drive in most countries.

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16
Q

What should you do if someone is having a seizure?

A

Ensure safety by removing nearby hazards, timing the seizure, and avoiding restraining the person. Place them in the recovery position after the seizure.

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17
Q

What medication is commonly used for prolonged seizures in an emergency?

A

Buccal midazolam or rectal diazepam.

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18
Q

What lifestyle adjustments can help manage epilepsy?

A

Regular sleep, avoiding known triggers, adherence to medication, and safety precautions during high-risk activities.

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19
Q

True or False: Epilepsy is always a lifelong condition.

A

False. Some individuals may outgrow it or achieve remission.

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20
Q

What are febrile convulsions?

A

Seizures associated with fever in children aged 6 months to 5 years, typically triggered by a rapid rise in core body temperature.

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21
Q

What age group is most commonly affected by febrile convulsions?

A

Children aged 6 months to 5 years.

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22
Q

What is the most common trigger for febrile convulsions?

A

Viral infections causing a rapid rise in temperature.

23
Q

What defines a simple febrile seizure?

A

A generalized tonic-clonic seizure lasting less than 15 minutes, with no recurrence within 24 hours.

24
Q

True or False: Simple febrile seizures result in long-term neurological deficits.

A

False.

25
Q

What are the characteristics of complex febrile seizures?

A

Seizures lasting >15 minutes, recurring within 24 hours, or with focal symptoms.

26
Q

True or False: Complex febrile seizures are associated with a higher risk of underlying conditions.

A

True.

27
Q

What should be done during a febrile seizure?

A

Follow the ABCDE approach, ensure airway safety, place the child in the recovery position, and do not restrain the child or place anything in their mouth.

28
Q

Why is it important to check blood glucose during a febrile seizure?

A

To rule out hypoglycemia as a contributing factor.

29
Q

What is the focus of the post-seizure assessment?

A

Identifying the source of the fever and ruling out serious conditions like meningitis.

30
Q

True or False: Routine imaging is required after a simple febrile seizure.

A

False.

31
Q

When are blood tests or lumbar punctures indicated after a febrile seizure?

A

If a serious infection, such as meningitis, is suspected.

32
Q

What should parents be reassured about regarding febrile seizures?

A

That most febrile seizures are benign, self-limiting, and have a low risk of epilepsy.

33
Q

What is the approximate recurrence rate of febrile seizures?

A

0.33

34
Q

List reasons to admit a child with febrile seizures.

A

Complex seizures, prolonged postictal state, diagnostic uncertainty, or red-flag symptoms like persistent neurological signs or meningism.

35
Q

True or False: Simple febrile seizures typically require hospital admission.

A
36
Q

What is the risk of epilepsy after a simple febrile seizure?

A

Slightly higher than the general population but remains low overall.

37
Q

What are key red flags in children with febrile seizures?

A

Signs of meningitis (e.g., neck stiffness), prolonged seizures, recurrent episodes within 24 hours, or systemic illness signs (e.g., abnormal vital signs).

38
Q

True or False: Febrile convulsions always indicate a serious underlying condition.

A

false

39
Q

List four possible causes of loss of consciousness (LoC).

A

Fainting.
Epilepsy.
Panic attacks.
Arrhythmias.

40
Q

True/False: Dissociative attacks are a psychological cause of LoC.

A

true

41
Q

What are three critical elements to evaluate in the history of a seizure or faint?

A

Pre-ictal (before the event).
Ictal (during the event).
Post-ictal (after the event).

42
Q

What is a key distinguishing feature of syncope compared to epilepsy?

A

Rapid recovery within seconds.

43
Q

What are two key approaches to managing dissociative seizures?

A

Early recognition with clear explanation.
Psychological involvement and support.

44
Q

Dissociative seizures should not be treated with _________ or _________ due to the risk of placebo effects.

A

benzodiazepines; antiepileptic drugs.

45
Q

What investigations are typically conducted in a first seizure clinic?

A

ECG.
MRI.
EEG.

46
Q

What are the general principles of epilepsy treatment?

A

Aim for monotherapy.
Attain the maximum tolerated dose before changing/adding drugs.
Avoid abrupt withdrawal.

47
Q

True/False: Most cases of epilepsy are controlled with 1–2 drugs.

A

true

48
Q

What is the first-line treatment for Idiopathic Generalized Epilepsy (IGE) ?

A

Sodium valproate (epilim).

49
Q

In women of childbearing age, _________ or _________ are often used instead of sodium valproate.

A

Lamotrigine; Levetiracetam.

50
Q

What is the first-line treatment for status epilepticus if IV access is available?

A

IV lorazepam 2–4 mg.

51
Q

If status epilepticus persists beyond 5 minutes and IV access is unavailable, _________ or _________ can be administered.

A

buccal midazolam; PR diazepam.

52
Q

True/False: Patients with refractory status epilepticus should be loaded with phenytoin and referred to HDU/ITU.

A

true.

53
Q

Name three safety modifications for patients with epilepsy at home.

A

Use showers instead of baths.
Install radiator covers.
Use carpets instead of hard flooring.

54
Q
A

Phase 3a - Neurology (18 decks)

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