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Neurology RIA > Loss of consciousness > Flashcards

Loss of consciousness Flashcards

1
Q

3 factors that can lower seizure threshold in those susceptible to them

A
  • severe disease
  • dehydration
  • infection
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2
Q

Transient loss of consciousness due to a postural change is likely to be due to

A

vasovagal syncope

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3
Q

4 features of syncope

A
  • light headedness
  • nausea
  • vomiting
  • greying out of vision
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4
Q

clues to focal onset seizures (3)

A
  • unexplained smell
  • deja vu
  • focal muscle jerking/twitching
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5
Q

first memory upon arrival for:

a) syncopal blackout
b) epileptic seizures

A

a) regain awareness and memory for events quickly

b) may remember nothing

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6
Q

4 features favouring epileptic seizures

A
  • tongue biting
  • urinary + faecal incontinece
  • pain
  • injuries
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7
Q

physical signs of syncope

A
  • pale
  • sweaty
  • light headedness
  • nausea
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8
Q

physical signs of focal onset seizure

A
  • focal twitching
  • forced head turning
  • eye deviation
  • blank staring
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9
Q

rhythmic clonic jerks following rigid tonic phase: jerking movements reduces in amplitude and frequency

A

generalised tonic clonic seizures

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10
Q

brief myoclonic jerks of low amplitude and less rhythmic

A

syncope

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11
Q

condition of recovery following

a) syncope
b) seizure
c) NEAD

A

a) rapid recovery
b) 15 min drowsy
c) pseudosleep = prolonged unresponsiveness

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12
Q

6 investigations in a seizure/LoC

A
  • vital signs
  • oxygenation
  • ECG
  • blood tests
  • BM reading
  • CT scan
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13
Q

Electrolyte abnormalities that can cause seizures (2)

A
  • hyponatraemia

- hypocalcaemia

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14
Q

complex and simple describe what?

A

consciousness in a seizure

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15
Q

temporal lobe seizures can involve:

A
  • memory disturbances: e.g. deja vu
  • hallucinations
  • automatism
  • psychic phenomena
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16
Q

types of hallucinations in temporal lobe seizures

A
  • olfactory

- auditory

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17
Q

examples of automatism

A
  • lip smacking
  • absent mindedly plucking at clothes
  • repetitive mumbling
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18
Q

e.g. of more complex automatism

A

getting undressed with no or only partial awareness/recollection

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19
Q

causes of epilepsy

A
  • birth history

- febrile convulsions

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20
Q

what is atrophy and scarring of the temporal lobe called

A

Mesial temporal sclerosis

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21
Q

what are the risk factors for children with febrile convulsions going on to develop MTS or epilepsy?

A
  • prolonged + severe febrile convulsions
  • multiple attacks
  • transient hemiparesis
  • atypical age for febrile convulsion
  • minor pyrexia at the time of febrile convulsion
  • fhx epilepsy
22
Q

typical age of febrile convuslsions

A

18 months

23
Q

syncope is …

A

loss of consciousness caused by a lack of cerebral blood flow

24
Q

3 P’s of pre-syncopal features:

A

P - Positional: upright position

P - Provoking factors: pain, emotional shock, dehydration

P - Prodromal feeling: light headedness, dizzy, visual blurring, ringing in ears

25
Q

physical features of NEAD? (6)

A
  • violent shaking of arms + legs
  • head shakes from side to side
  • upset + cries on coming round
  • pelvic thrusting
  • back arching
  • preserved consciousness
26
Q

Epilepsy is …

A

a recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain

27
Q

examples of aura

A
  • strange feeling in gut
  • deja vu
  • strange smells
  • flashing lights
28
Q

post ictal features of seizures

A
  • headache
  • confusion
  • myalgia
  • dysphasia
29
Q

structural causes of epilepsy (4)

A
  • cortical scarring
  • poor cerebral developmemt
  • SOL
  • stroke
30
Q

non epileptic causes of seizures

A
  • trauma
  • stoke
  • haemorrhage
  • raised ICP
  • alcohol/benzo withdrawal
31
Q

What is a generalized seizure and what are the types (5)

A

Electrical discharge throughout both sides, LoC immediately

  • Absence
  • Tonic-Clonic
  • Myoclonic
  • Atonic
  • Infantile spasms
32
Q

3 types of Partial seziures

A
  • Simple
  • Complex
  • Partial seizure with secondary generalisation
33
Q

1st and 2nd line treatment for Partial seizures

A

1) Lamotrigine

2) Na valporate

34
Q

1st line treatment for generalised seziures

A

Na valporate

35
Q

localising features for frontal lobe partial seizure

A
  • head/leg movements
  • posturing
  • post ictal weakness
36
Q

localising feature for parietal lobe partial seizure

A

paraesthesia

37
Q

localising feature for occipital lobe partial seizure

A

flashers + floaters

38
Q

3 features of simple partial seizures

A
  • awareness is unimpaired
  • focal symptoms
  • no post ictal symptoms
39
Q

what age group are absence seizures mostly seen in

features?

A

3-10 year olds

suddenly stops speaking mid sentence and then carried on where left off

40
Q

Investigations following a generalised seizure:

A
  • EEG
  • Blood glucose
  • FBC
  • Electrolytes
  • Toxicology screen
  • CT head (if presence of neurological deficits)
  • Serum prolactin
  • LP (if concerns of primary CNS infection)
41
Q

when should anti-epileptic medication be commenced?

A

Following 1 seizure if any of the following are present:

  • patient has a neurological deficit
  • Brain imaging: structural abnormality
  • EEG findings
  • Patient or family members consider the risk of having another epileptic seizure to be unacceptable
42
Q

how does Na Valporate work to reduce seizure activity

A

increases GABA activity

43
Q

Side effects of Na Valporate, as per the penumonic

A 
V - Valporate 
A - apetite increase 
L - Lfts watch over first 6m
P - Pancreatitis 
O - Oedema 
R - reversible alopecia 
A - Ataxia 
T - Teratogenecity, tremor, thrombocytopaenia 
E - Encephalopathy due to high ammonia
44
Q

common side effects of Lamotrigine (3)

A
  • blurred vision
  • aggression
  • dry mouth
45
Q

severe complication of Lamotrigine

A

Skin rash: stevens johnson syndrome

46
Q

4 side effects of carbamazepine

A
  • drowsiness
  • dizziness
  • headache
  • double vision
47
Q

DVLA guidance regarding switching anti-epileptic medications

A

stop driving for 6 months due to recognised risk of breakthrough seizures

48
Q

2 medications that lower seizure thresholds

A
  • amitryptyline

- tramadol

49
Q

metabolic disturbances that can lower seizure thresold

A
  • hypoglycaemia

- hyponatraemia

50
Q

medically refractory epilepsy is

A

seizures that have failed to come under control with at least 2 different anticonvulsant drugs

Neurology RIA (11 decks)

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