General Tonic Clonic Seizures

Question 1

Risk Factors/causes

Answer 1

Idiopathic, sinus venous thrombosis, cerebral haemorrhage, infection (encephalit, meningit), ion imbalance and alcohol withdrawal

Question 2

Presentation

Answer 2

Triggered by alcohol/sleep withdrawal, early morning episodes, aura, post-ictal (confusion, drowsiness, amnesia).
Symptoms include:
Incontinence, jerky movements (awake), sudden falls, loss of memory, Deja Vu
Signs:
Neurofibromatosis (cafe au ait spots)

Question 3

Investigation

Answer 3

Bloods: U and E, FBC, LFT, calcium and glucose.
Imaging: Ct Head, MRI head
EEG (must be active sieze, for supportive diagnosis)

Question 4

Management for Generalised

Answer 4

Treat underlying cause

For general after second episode: Sodium valproate, lamotrigine or Levetiracetam.

Question 5

Management for Focal

Answer 5

First line is lamotrigine or carbamazepine.

If either not tolerated, then sodium valproate.