Epilepsy Symposia Flashcards
What is epilepsy
Recurring, unprovoked, spontaneous seizures
What does a generalised onset mean?
Electrical discharges appear to start over the whole brain at the same time
What does partial/facial onset mean?
Electrical discharges appear to start in one cortical region and then may remain localised or spread over the whole brain
Describe frontal lobe seizures
Forced head and eye deviation to contralateral side
Difficulty speaking, unresponsiveness
Repetitive movements
Pt can be fully aware whilst it is happening
Epileptogenesis
Process where parts of normal brain converted to hyperexcitable brain
Epileptic seizure
Explosion of synchronous activity
Rhythmic firing of AP by neurons
What are febrile convulsions/seziures
Fever-induced
Can be due to point mutation in Na+ channel causing abnormally slow inactivation
Describe temporal lobe seizures
- physical
- cognitive
- affective
Preceded by warnings of deja vu, rising epigastric sensation, followed by lip-smacking and speech arrest Hallucinations Pallor/flushing Can mimic panic attacks Changes in smell
Parietal lobe seizures
Positive sensory symptoms
Tingling, pain
Distortion of body shape
Sensory Jacksonian March
Describe the tonic phase in a tonic clonic seizure
Continuous muscle spasms Will fall May have cyanosis due to thorax muscle contracting Tongue biting Incontinence
Describe the clonic phase in a tonic clonic seizure
Rhythmic jerking slows & gets larger in amplitude as the seizure ends
Describe the postictal phase in a tonic-clonic seizure
Coma Drowsiness Headache Confusion Muscle aching
Jacksonian march
Simple, partial seizures
Patient aware- localised discharge
Symptoms
- Lip smacking
- sudden muscle contraction
- sudden head and eye deviation
- lasts very briefly
Describe occipital lobe seizures
Visual hallucinations
Amaurosis on onset
-blackout
perampanel
AMPA receptor antagonist
non-competitive inhibitor
reduce spread / generalisation of seizure
well tolerated with improved alertness