Epilepsy_Flashcards COPY
What is the immediate action if a patient is suspected of having a first epileptic seizure?
Urgently refer to a neurologist (first fit clinic).
What advice should be given to parents and carers regarding epilepsy?
Advise on how to recognise a seizure, record any future episodes, avoid dangerous activities until diagnosis is confirmed, seek help if another seizure occurs before referral.
What are the main goals of long-term management for epilepsy?
Promote independence and confidence, and involve the school in the management plan.
What types of therapy may be required for deep bleeds into muscles and joints in patients with haemophilia?
Analgesia and physiotherapy.
Which drug should be avoided in children with prolonged epileptic seizures?
Morphine (for children < 12 years).
What are the first-line medications for tonic-clonic seizures in generalised epilepsy?
Sodium valproate for boys and girls who are not of childbearing potential. Otherwise, offer lamotrigine or levetiracetam.
What are the side effects of sodium valproate?
Weight gain, hair loss, rare idiosyncratic liver failure.
What are the side effects of carbamazepine/oxcarbazepine?
Rash, neutropenia, hyponatraemia, ataxia, liver enzyme induction, interferes with other medications.
What are the alternative treatments for myoclonic seizures in generalised epilepsy?
Topiramate.
What are the adjunctive therapies for focal epilepsy?
Carbamazepine, clobazam, gabapentin, lamotrigine, oxcarbazine, valproate, topiramate.
What should be done if a seizure lasts more than 5 minutes?
Call ambulance OR give rescue medication (buccal midazolam or rectal diazepam).
What are the non-drug treatment options for children with intractable epilepsies?
Ketogenic diets (low carb, fat-based), vagal nerve stimulation, surgery (only in children with epilepsy that has a well-localised structural cause).
What are the key points for PACES regarding epilepsy?
It is a tendency to have unprovoked seizures, aim to promote independence and confidence, the school should be made aware of the condition, avoid situations where having a seizure could lead to injury or death (e.g. deep baths, swimming unsupervised), driving is only allowed after 1 year free of seizures.
