Lecture 26: Epilepsy & Blackouts Flashcards
What can cause a blackout?
- Vasovagal Syncope
- Hypoxic Seizure
- Concussive Seizures
- Cardiac Arrhythmia
- Non-epileptic attacks
Define and describe Vasovagal syncope/neurocardiogenic and its clinical presentation?
FAINTING
Its the body overeacting to certain stimuli such as the sight of blood or extreme emotional distress
- Light headed
- Nausea
- Hot/Sweating
- Tinnitus
- Tunnel Vision
What could trigger vasovagal syncope?/neuro-cardiogenic syncope
- Prolonged Standing or standing up too fast
- Trauma
- Venepuncture
- Seeing/experiencing medical procedures
- Urination
- Coughing
Whats the difference between a seizure and syncope?
- Syncope tends to happen when your upright
- Pallor is common in syncope
- Syncope has a gradual onset vs a sudden onset seizure
- Injury & incontinence are rare in syncope
- Recover rapidly from syncope but not seizure
- Syncope is triggered, precipitants for seizures are rare
How does a hypoxic seizure occur?
People who faint and then are kept upright keep fainting and dont breath –> Seizure
Occurs a lot in aircraft where people cant end up lying down
What is a non-epileptic attack?
SEizures similar to epilepsy but not caused by electrical activity in the brain.
They are often linked to stress or past abuse
Which gender are more likely to suffer blackouts?
Women
When you have a patient who blacked out what do you want to know?
- What they were doing
- Any warning feelings or Aura
- Similar previous history
- Any injury or incontinence
- How responsive are/were they, what collour did they go, did they move or make sound
- Whats their pulse like
- Past medical, psych, alcohol/drug and family history
Investigations for syncope
- Blood Sugar (Cause of fainting)
- ECG (Cardiac Arrythmias)
- Consider drugs/alcohol
- CT head
What features on a first seizure would suggest epilepsy?
Primary Generalised Epilepsy:
- History of myoclonic jerks (particularly in morning)
- Absences
- Feeling strange +/- flickering lights
Focal Onset Epilepsy:
- Deja Vu
- Rising in abdomen
- Episodes where they look blank and smack lips
How would you advise someone who’s just had their first seizure?
- Driving Regulations
- Inquire about employment or potentially dangerous activities
- Refer to clinic
Define Epilepsy?
Neurological disorder where there is an abnormal electrical activity in the brain.
Characterised by:
- Sudden recurrent episodes of sensory disturbances
- Convulsions
- Loss of consciousness
When does epilepsy present?
Mainly in infants then its pretty low until the elderly where theres another spike
With what groups is epilepsy more common?
People with learning difficulties (22% of people with LD)
What are the classifications of Epilepsy?
Primary Generalised Epilepsy (Generally congenital and young)
Focal or Partial Epilepsy (Any age, due to focal brain damage)
