Epilepsy & Seizures Flashcards
Epilepsy Febrile convulsion
What is epilepsy?
Epilepsy is a neurological condition characterized by an increased tendency to have epileptic seizures due to abnormal electrical activity in the brain.
What is a seizure?
A seizure is a burst of abnormal electrical activity in the brain, disrupting its normal function. Symptoms vary depending on the brain area affected.
What are common triggers for seizures?
Triggers include lack of sleep, alcohol, stress, flashing lights, dehydration, infections, and missed medication doses.
True or False: Every case of epilepsy has a known cause.
False. Many cases are idiopathic, though some are linked to genetic factors, head trauma, infections, or strokes.
What are the two major categories of seizures?
Focal seizures (begin in one area of the brain) and generalized seizures (affect the entire brain).
Fill in the blank: A ___ seizure involves a brief loss of awareness without convulsions, commonly seen in children
Absence.
What is a focal aware seizure?
A seizure where the person remains conscious but may have sensory, motor, or autonomic symptoms.
What diagnostic tools are used for epilepsy?
EEG (electroencephalogram), MRI/CT scans, and blood tests to identify underlying causes or triggers.
True or False: An EEG can always confirm a diagnosis of epilepsy
False. EEG findings may be normal between seizures.
What is the first-line treatment for generalized seizures?
Sodium valproate, unless contraindicated (e.g., pregnancy).
Name a common side effect of carbamazepine.
Drowsiness, dizziness, nausea, vomiting, ataxia, blurred vision, diplopia, headache, rash
Fill in the blank: Women with epilepsy should take ___ to reduce the risk of neural tube defects in pregnancy.
Folic acid.
What is status epilepticus?
A medical emergency where seizures last more than 5 minutes or occur back-to-back without recovery.
What is SUDEP?
Sudden Unexpected Death in Epilepsy, a rare but serious complication often occurring during sleep.
True or False: Epilepsy can impact a person’s ability to drive.
True. Patients must be seizure-free for one year to drive in most countries.
What should you do if someone is having a seizure?
Ensure safety by removing nearby hazards, timing the seizure, and avoiding restraining the person. Place them in the recovery position after the seizure.
What medication is commonly used for prolonged seizures in an emergency?
Buccal midazolam or rectal diazepam.
What lifestyle adjustments can help manage epilepsy?
Regular sleep, avoiding known triggers, adherence to medication, and safety precautions during high-risk activities.
True or False: Epilepsy is always a lifelong condition.
False. Some individuals may outgrow it or achieve remission.
What are febrile convulsions?
Seizures associated with fever in children aged 6 months to 5 years, typically triggered by a rapid rise in core body temperature.
What age group is most commonly affected by febrile convulsions?
Children aged 6 months to 5 years.
What is the most common trigger for febrile convulsions?
Viral infections causing a rapid rise in temperature.
What defines a simple febrile seizure?
A generalized tonic-clonic seizure lasting less than 15 minutes, with no recurrence within 24 hours.
True or False: Simple febrile seizures result in long-term neurological deficits.
False.
What are the characteristics of complex febrile seizures?
Seizures lasting >15 minutes, recurring within 24 hours, or with focal symptoms.
True or False: Complex febrile seizures are associated with a higher risk of underlying conditions.
True.
What should be done during a febrile seizure?
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.
Why is it important to check blood glucose during a febrile seizure?
To rule out hypoglycemia as a contributing factor.
What is the focus of the post-seizure assessment?
Identifying the source of the fever and ruling out serious conditions like meningitis.
True or False: Routine imaging is required after a simple febrile seizure.
False.
When are blood tests or lumbar punctures indicated after a febrile seizure?
If a serious infection, such as meningitis, is suspected.
What should parents be reassured about regarding febrile seizures?
That most febrile seizures are benign, self-limiting, and have a low risk of epilepsy.
List reasons to admit a child with febrile seizures.
Complex seizures, prolonged postictal state, diagnostic uncertainty, or red-flag symptoms like persistent neurological signs or meningism.
What is the risk of epilepsy after a simple febrile seizure?
Slightly higher than the general population but remains low overall.
What are key red flags in children with febrile seizures?
Signs of meningitis (e.g., neck stiffness), prolonged seizures, recurrent episodes within 24 hours, or systemic illness signs (e.g., abnormal vital signs).
True or False: Febrile convulsions always indicate a serious underlying condition.
false
List four possible causes of loss of consciousness (LoC).
Fainting.
Epilepsy.
Panic attacks.
Arrhythmias.
True/False: Dissociative attacks are a psychological cause of LoC.
true
What are three critical elements to evaluate in the history of a seizure or faint?
Pre-ictal (before the event).
Ictal (during the event).
Post-ictal (after the event).
What is a key distinguishing feature of syncope compared to epilepsy?
Rapid recovery within seconds.
What are two key approaches to managing dissociative seizures?
Early recognition with clear explanation.
Psychological involvement and support.
Dissociative seizures should not be treated with _________ or _________ due to the risk of placebo effects.
benzodiazepines; antiepileptic drugs.
What investigations are typically conducted in a first seizure clinic?
ECG.
MRI.
EEG.
What are the general principles of epilepsy treatment?
Aim for monotherapy.
Attain the maximum tolerated dose before changing/adding drugs.
Avoid abrupt withdrawal.
True/False: Most cases of epilepsy are controlled with 1–2 drugs.
true
What is the first-line treatment for Idiopathic Generalized Epilepsy (IGE) ?
Sodium valproate (epilim).
In women of childbearing age, _________ or _________ are often used instead of sodium valproate.
Lamotrigine; Levetiracetam.
What is the first-line treatment for status epilepticus if IV access is available?
IV lorazepam 2–4 mg.
If status epilepticus persists beyond 5 minutes and IV access is unavailable, _________ or _________ can be administered.
buccal midazolam; PR diazepam.
True/False: Patients with refractory status epilepticus should be loaded with phenytoin and referred to HDU/ITU.
true.
Name three safety modifications for patients with epilepsy at home.
Use showers instead of baths.
Install radiator covers.
Use carpets instead of hard flooring.
