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Epilepsy > General Epilepsy > Flashcards

General Epilepsy Flashcards

1
Q

When should you call an ambulance during an epileptic seizure?

A

If the seizure lasts for more than 5 minutes.
If it is the persons first seizure.
If they request an ambulance.
If they have multiple seizures in a row.

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2
Q

What happens to the brain when a person has a seizure?

A

Normal electrical patterns in the brain are interrupted by sudden and relatively intense bursts of electrical energy that can affect a persons consciousness, body movement and sensations.

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3
Q

What is a seizure?

A

A seizure involves the disruption of the normal activity in the brain through neuronal instability.

Seizures prevent the brain from interpreting and processing incoming sensory signals and controlling muscles.

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4
Q

What are the symptoms of a seizure?

A

The symptoms depend on the location of the source of/and where the abnormal electricity spreads.

They range from tingling in the finger to a “generalised” seizure, where a person loses consciousness, becomes stiff and jerks.

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5
Q

What causes a provoked seizure?

A

Metabolic disorders such as hypoglycaemia or electrolyte imbalance.

Withdrawal from massive amounts of alcohol or sedatives.

A high sleep deprivation.

Excessive use of stimulants, or substance misuse.

High fever/hypoxia.

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6
Q

What is the cause of unprovoked seizures?

A

Traumatic brain injury.

Birth trauma.

Brain tumours.

Genetics.

Vascular diseases (affect the brains blood vessels)

Neurotransmitter GABA imbalance.

Parasitic infections.

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7
Q

What is the epidemiology of epilepsy?

A

1-4% of the population.

1-2% of these people know how regular their seizures are (have a diagnosable genetic aetiology for their seizure occurrence).

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8
Q

What are tonic-clonic seizures?

A

“Grand mal” seizures.

A mass discharge of neutrons on both cerebral hemispheres.

The body becomes rigid and jerks.

Tonic clonic is the term for describing “stiffness-violent”.

The tonic phase is where the body stiffens up, and the clonic phase the body will be “violent”.

Grand mal is the term for “great sickness” that is often preceded by an Aura.

Tonic clonic seizures often alternate.

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9
Q

What are absence seizures?

A

These are non-convulsive seizures.

The person may be unaware of their surroundings and stare off, however these usually only last between 5 and 30 seconds.

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10
Q

What are atonic seizures?

A

These include a loss of muscle tone, which causes a person to fall down.

This is very rare in adults.

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11
Q

What is a myoclonic seizure?

A

Twitching and jerking movements of certain body parts involving the motor cortex.

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12
Q

What is status epilepticus?

A

A frequent, long lasting electrical activity with no regain of consciousness between attacks.

These can last in excess of 20 minutes.

This can be fatal, and requires immediate medical attention.

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13
Q

What is a simple partial seizure?

A

Also known as “Jacksonian” or “focal” seizures.

These are short seizures with no loss of consciousness.

Symptoms are seeing, hearing or smelling something odd.

During this seizure, the body may jerk.

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14
Q

What is a complex partial seizure?

A

These are psychomotor seizures.

They are seizures that consist of a change, but there is no loss of consciousness.

Deja vu may occur, and people may see/hear things, or have a memory resurface.

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15
Q

What conditions can be mistaken for a seizure?

A

Syncope.

Psychosomatic seizures.

Breath-holding spells.

Paroxysmal REM sleep behaviour.

Panic attacks.

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16
Q

How can having epilepsy affect an individual?

A

They may restrict a person from driving or working.

It can affect their self-esteem - advise the patient that they are in control of how their epilepsy affects them.

Advise that most epilepsy can be controlled with medication, some will find control from the first medication they try whilst others may have to work with their neurologist to find the right dosage and combination of medications.

17
Q

What surgery is available for people with epilepsy?

A

Temporal lobe surgery -
Removal of the cortex of the temporal love where the epileptic seizure starts. The hippocampus and amygdala may also be removed.

Corpus callostomy - this is where the corpus callosum is cut to separate the right and left cerebral hemispheres. This procedure is done to prevent the spread of the seizure from one side of the brain to the other.

Hemispherectomy- this is where one cerebral hemisphere is removed. This is a rare surgical intervention. It is reported that children can function reasonably well, but they often find it difficult to use the arm on the opposite side of the body (e.g right brain and using left arm)

18
Q

What other treatments are available for epilepsy?

A

Vagal nerve stimulation- an electrical stimulator is placed uni the Vagus nerve. The function of the vagus nerve is for sensory, motor and autonomic functions of the viscera.

Ketogenic diet - a high fat, and low protein/carbohydrate diet.

19
Q

What is the role of the professional in dealing with a patient with epilepsy?

A

They must understand the following:

The specific type of seizure with a clear description of what happens.

What type of seizure control the patient has achieved.

If a person has a specific warning or an aura.

What is involved in the persons recovery period.

Has the person ever been injured as a result of their seizure?

Has the person got any other disabilities?

What medication are they on and are they compliant with their medication?

20
Q

What is an aura?

A

This can present as confusion, aggression, a strange smell or seeing flashing lights.

Not all people have an aura.

21
Q

When does recovery start after a seizure?

A

When the person stops thrashing, their breathing settles down and they gain consciousness, though may present as asleep before waking.

They may be confused or disorientated, or have no memory of the event. This usually lasts for 5-10 minutes.

They are often tired or sleepy after their seizure.

22
Q

What are the four stages of a grand mal fit?

A

Aura.

Tonic - fall to the ground, increased muscle tone which lasts 15-30 seconds. Their breathing may stop and they may become cyanosed.

Clonic - person thrashed about, may be incontinent, breathing with spasms, excessive salivation which causes frothing. This lasts between 30-60 seconds.

Recovery.

23
Q

What is a hysterical seizure?

A

Where a person is wary of where they can fall etc

24
Q

What time of day are seizures most likely to happen?

A

At night.

25
Q

What is syncope during a seizure?

A

When an individual stops breathing

26
Q

What is a psychogenic seizure?

A

These occur intentionally by the individual

27
Q

What is a paroxymal seizure?

A

This happens in an ultra sleep state

Epilepsy (2 decks)

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