Exam 5 Flashcards
Severe unilateral pain + lacrimation
Cluster headache
Management of cluster headache
a) acute
b) prophylactic
a) 100% oxygen, triptan (nasal or subcut)
b) verapamil, prednisolone
Treatment for migraine:
a) abortive
b) prophylactic
a) triptan + simple analgesia
b) propanolol, pizotifen, TCA
Pain in trigeminal distribution, unilateral, triggered by light touch
Trigeminal neurlagia
Throbbing temple pain + jaw claudication + visual loss
Temporal arteritis
Features suggesting raised ICP (4)
Worse in the morning and with coughing/bending
Visual disturbance
Papilloedema
Abducens palsy
Treatment of raised ICP (2)
Treat the cause
Mannitol IV
Intense unilateral eye pain + mid-dilated pupil
Acute angle closure glaucoma
Treatment of acute angle closure glaucoma
Miosis with pilocarpine
Commonest cause of a stroke in young people
Carotid or vertebral artery dissection
Key features in a seizure history?
BEFORE- what was happening, prodrome?
DURING- aura, onset, duration, loss of consciousness, tongue biting, incontinence
AFTER- recovery, any residual weakness
Main classification of seizures
Partial (with a focal onset- 2/3 go on to become generalized)
Generalised
Seizures:
a) loss of consciousness, limbs stiffen and then jerk
b) brief pauses of around 10 seconds,usually present in childhood
c) seizures provoked by fever in otherwise healthy children; usually brief and tonic/tonic-clonic
d) generalised seizure with brief, rapid muscle jerks
e) focal features + DISTURBANCE OF CONSCIOUSNESS/AWARENESS
a) tonic-clonic seizures
b) absence seizures
c) febrile convulsions
d) myoclonic seizures
e) complex partial seizures
First-line prophylactic treatment for
a) generalised seizures
b) partial seizures
c) absence seizures
a) sodium valproate
b) carbamezapine
c) sodium valproate, ethosixumide
What is lamotrigine used for in seizure prophylaxis?
2nd line for tonic-clonic, myoclonic, partial seizures
Management of status (3)
Airway and breathing
Lorazepam/diazepam
Second line- phenytoin, valproate
Definition of status epilepticus?
Seizures lasting more than 30 mins, or repeated seizures without intervening consciousness
Side-effects of sodium valproate (5)
Teratogenic-neural tube defects, avoid in pregnancy Alopecia Weight gain Fatigue Nausea
How does sodium valproate work?
Increases GABA activity
What dose of folic acid should women taking AEDs be given in pregnancy?
5mg per day starting well before pregnancy
