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NMF: Neurology > EPILEPSY + SEIZURES > Flashcards

EPILEPSY + SEIZURES Flashcards

1
Q

Describe a typical absence seizure

A

usually in childhood
a few a day
sudden start and end
unresponsive for 5-10 seconds

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2
Q

Lip smacking is indicative of epilepsy affecting which lobe?

A

temporal lobe

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3
Q

Generalised seizure in women of child-bearing age

A

lamotrigine

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4
Q

How long is driving restricted after an epileptic seizure?

A

CAR:

  • If no diagnosis + first seizure = 6 months
  • if awake = 1yr
  • if asleep = can still drive if no seizures awake for past 3yrs

BUS/LORRY

  • If no diagnosis + first seizure = 5yr
  • If diagnosis = must be seizure and medication free for 10yr
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5
Q

Investigations for epilepsy

A

ECG
CT if skull #, deteriorating GCS, focal signs or head injury
EEG

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6
Q

What does an EEG show for primary generalised?

A

generalised spike-wave abnormalities

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7
Q

What is the cause of a
a) primary generalised
b) focal
seizure?

A

a) genetic

b) structural

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8
Q

What is the difference between prodrome and aura?

A

prodrome are the changes in mood and behaviour

aura is the awareness before a seizure eg. dejavu, smells

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9
Q

In which type of seizure do you get post-ictal dysphasia?

A

focal temporal

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10
Q

Localising features of a temporal seizure

A

HEAD

Hallucinations (auditory/gustatory/olfactory)
Epigastric rising/Emotional
Automatisms (lip smacking/grabbing)
Deja vu/Dysphasia post-ictal

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11
Q

Localising features of a frontal seizure

A

Movements of the head or legs
Posturing
Post-ictal weakness

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12
Q

Localising features of a parietal seizure

A

paraesthesia

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13
Q

Localising features of an occipital seizure

A

floaters/flashes

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14
Q

manage a first ever seizure

A

admit for 24 hours

bloods, drug screen, EEG, CT/MRI

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15
Q

What is the difference between a simple partial and a complex partial seizure?

A

complex has impaired awareness +/- post-ictal symptoms whereas simple does not

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16
Q

What is a Jacksonian-March seizure?

A

a spreading frontal motor seizure with retained awareness

17
Q

What does tonic clonic mean?

A 
tonic = limbs stiffen
clonic = limbs jerk
18
Q

What is an atonic seizure?

A

a sudden loss of muscle tone causing a fall

no LOC

19
Q

What are infantile spasms associated with?

A

tuberous sclerosis

20
Q

Can epilepsy be managed in primary care?

A

no, specialist review is needed following a 1st seizure

21
Q

During which phase of a tonic-clonic seizure does the patient become cyanosed?

A

tonic phase (1min)

22
Q

1st line treatment for a focal seizure

A

carbamazepine

23
Q

2nd line treatment for a focal seizure

A

lamotrigine
sodium valproate
topimarate

24
Q

1st line treatment for a generalised seizure

A

sodium valproate

25
Q

SE of sodium valproate

A

teratogenic, nausea, tremor, oedema, ataxia, pancreatitis, weight gain, liver failure, encephalopathy, thrombocytopenia

VALPROATE
Appetite inc
Liver failure
Pancreatitis
Reversible hair loss
Oedema
Ataxia
Teratogenic, tremor, thrombocytopenia
Encephalopahy
26
Q

What is the biggest issue with lamotrigine?

A

takes months to titrate up to therapeutic dose

27
Q

SE of lamotrigine

A

rash, SJS, tremor, agitation, diplopia

28
Q

Sodium valproate MOA

A

Increases GABA activity and targets voltage channels

29
Q

Lamotrigine MOA

A

Sodium channel blocker

30
Q

Which type of seizure is made worse by carbamazepine?

A

general

31
Q

SE of carbamazepine

A

leucopenia, drowsiness, double vission, blurred vision, impaired balance

32
Q

Carbamazepine MOA

A

Binds to sodium channels increasing their refractory period

33
Q

Phenytoin MOA

A

Binds to sodium channels increasing their refractory period

34
Q

Phenytoin SE

A

LOTS

P450 inducer, dizziness, ataxia, drowsiness, gum hypertrophy, coarse facial features, peripheral neuropathy

35
Q

Treat acute seizure

A

10mg rectal diazepam

36
Q

If a patient in an acute seizure does not respond to rectal diazepam what is the term?

A

status epilepticus

37
Q

Which AED induce hepatic enzymes and affect contraception?

A

carbamazepine
phenytoin
topiramate

38
Q

Which forms of contraception shouldnt be used with enzyme-inducing AEDs?

A

COCP
POP
progesterone implant

inc dose of morning after pill and depo

NMF: Neurology (9 decks)

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