Neuro Flashcards
Define seizure.
A convulsion caused by a paroxysmal discharge of cerebral neurones.
Define epileptic seizure.
Excessive, unsynchronised neuronal discharges in the brain cause paroxysmal changes in behaviour, sensation or cognitive processes.
How long do epileptic seizures tend to last for?
30 - 120 seconds.
What are febrile convulsions?
Febrile convulsions are epileptic seizures accompanied by fever. They usually occur early in viral infection and tend to be brief generalised tonic-clonic seizures.
How long do non-epileptic seizures tend to last for?
1 - 20 minutes.
Give 3 signs of non-epileptic seizures.
- Eyes closed.
- Talking/crying.
- Pelvic thrusting.
What is the first line AED offered to those suffering from focal seizures?
Carbamazepine. Surgery may also be offered.
What would you expect to see in a myoclonic seizure?
Isolated muscle jerking.
What would you expect to see in a tonic seizure?
Generalised increase in tone.
What would you expect to see in an atonic seizure?
Transient loss of muscle tone.
What would you expect to see in a generalised tonic-clonic seizure?
Sudden onset rigid phase followed by a convulsion in which the muscles jerk rhythmically.
What is the first line AED offered to those suffering from generalised tonic-clonic seizure?
Sodium valporate.
Why must you do an ECG in those suffering from seizures?
To check for arrhythmia as the cause e.g. long-QT syndrome
What investigations might you want to do in someone presenting with seizures.
- Eye witness account/video is invaluable!
- ECG.
- EEG.
- MRI or CT.
Give 3 potential side effects of AED’s.
- Cognitive disturbances
- Heart disease.
- Drug interactions.
- Teratogenic.
Define syncope.
A transient loss of consciousness due to global cerebral hypoperfusion with rapid onset, short duration and spontaneous complete recovery.
What are absence seizures?
Seizures where there is a transient loss of consciousness with an abrupt onset and termination.
Momentary unresponsive stare with motor arrest, lasts <30s.
Developmentally normal but can interfere with school.
How might you investigate suspected absence seizures?
- Observe an episode - hyperventilation, ask the child to blow on a windmill.
- EEG - would show 3-second spike and wave discharges.
What medications can be given to treat absence seizures?
Ethosuximide or Sodium Valporate.
Give some possible side effects of Ethosuximide and Sodium Valporate.
Ethosuxamide - rash, nausea, D+V.
Sodium Valporate - weight gain, hair loss, teratogenic.
What can absence seizures evolve into?
Juvenile myoclonic epilepsy (JME).
What are the signs of juvenile myoclonic epilepsy?
Clumsiness and GTCS that occur shortly after waking and are often provoked by sleep deprivation.
Describe the epidemiology of infantile spasms (West syndrome).
Presents in the first 4 to 8 months of life
More common in male infants
Often associated with a serious underlying condition Carries a poor prognosis
Give 2 features of infantile spasms.
- characteristic ‘salaam’ attacks: flexion of the head, trunk and arms followed by extension of the arms. This lasts only 1-2 seconds but may be repeated up to 50 times
- progressive mental handicap
Give 2 ix and results of infantile spasms.
EEG shows hypsarrhythmia in two-thirds of infants
CT demonstrates diffuse or localised brain disease in 70% (e.g. tuberous sclerosis)
Give 2 mx of infantile spasms.
vigabatrin is now considered first-line therapy
ACTH is also used
