Epilepsy & Seizures

Question 1

What is epilepsy?

Answer 1

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

Question 2

What is a seizure?

Answer 2

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

Question 3

What are common triggers for seizures?

Answer 3

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

Question 4

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

Answer 4

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

Question 5

What are the two major categories of seizures?

Answer 5

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

Question 6

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

Answer 6

Absence.

Question 7

What is a focal aware seizure?

Answer 7

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

Question 8

What diagnostic tools are used for epilepsy?

Answer 8

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

Question 9

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

Answer 9

False. EEG findings may be normal between seizures.

Question 10

What is the first-line treatment for generalized seizures?

Answer 10

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

Question 11

Name a common side effect of carbamazepine.

Answer 11

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

Question 12

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

Answer 12

Folic acid.

Question 13

What is status epilepticus?

Answer 13

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

Question 14

What is SUDEP?

Answer 14

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

Question 15

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

Answer 15

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

Question 16

What should you do if someone is having a seizure?

Answer 16

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

Question 17

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

Answer 17

Buccal midazolam or rectal diazepam.

Question 18

What lifestyle adjustments can help manage epilepsy?

Answer 18

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

Question 19

True or False: Epilepsy is always a lifelong condition.

Answer 19

False. Some individuals may outgrow it or achieve remission.

Question 20

What are febrile convulsions?

Answer 20

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

Question 21

What age group is most commonly affected by febrile convulsions?

Answer 21

Children aged 6 months to 5 years.

Question 22

What is the most common trigger for febrile convulsions?

Answer 22

Viral infections causing a rapid rise in temperature.

Question 23

What defines a simple febrile seizure?

Answer 23

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

Question 24

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

Answer 24

False.

Question 25

What are the characteristics of complex febrile seizures?

Answer 25

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

Question 26

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

Answer 26

True.

Question 27

What should be done during a febrile seizure?

Answer 27

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.

Question 28

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

Answer 28

To rule out hypoglycemia as a contributing factor.

Question 29

What is the focus of the post-seizure assessment?

Answer 29

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

Question 30

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

Answer 30

False.

Question 31

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

Answer 31

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

Question 32

What should parents be reassured about regarding febrile seizures?

Answer 32

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

Question 33

List reasons to admit a child with febrile seizures.

Answer 33

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

Question 34

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

Answer 34

Slightly higher than the general population but remains low overall.

Question 35

What are key red flags in children with febrile seizures?

Answer 35

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

Question 36

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

Answer 36

false

Question 37

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

Answer 37

Fainting. Epilepsy. Panic attacks. Arrhythmias.

Question 38

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

Answer 38

true

Question 39

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

Answer 39

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

Question 40

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

Answer 40

Rapid recovery within seconds.

Question 41

What are two key approaches to managing dissociative seizures?

Answer 41

Early recognition with clear explanation. Psychological involvement and support.

Question 42

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

Answer 42

benzodiazepines; antiepileptic drugs.

Question 43

What investigations are typically conducted in a first seizure clinic?

Answer 43

ECG. MRI. EEG.

Question 44

What are the general principles of epilepsy treatment?

Answer 44

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

Question 45

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

Answer 45

true

Question 46

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

Answer 46

Sodium valproate (epilim).

Question 47

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

Answer 47

Lamotrigine; Levetiracetam.

Question 48

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

Answer 48

IV lorazepam 2–4 mg.

Question 49

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

Answer 49

buccal midazolam; PR diazepam.

Question 50

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

Answer 50

true.

Question 51

Name three safety modifications for patients with epilepsy at home.

Answer 51

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