Neurology Flashcards
(21 cards)
What are the signs for a simple seizure?
- No impairment of awareness,
- focal Sx,
- no post-ictal Sx
What are the signs for a complex seizure?
- awareness impaired, commonly from temporal lobe,
- post-ictal confusion
What are the 3 types of primary generalized seizures?
- Absence - brief, pauses, presents in childhood
- Tonic-Clonic - LOC, stiff and jerky, confusions and drowsy after
- Myoclonic - Sudden jerk of single limb/trunk
What is an Atonic seizure?
Sudden loss of tone causing fall, no LOC
What is given in prelonged and recurrent seizures?
Buccal Midazolam
Name 4 things that can lower the seizure threshold
- Alcohol
- Drugs
- Sleep reduction
- Sex
What is the first and second line treatment for focal seizures?
- Carbamazepine or Lamotrigine
2. Sodium Valproate
What is the 1st, 2nd and 3rd line treatment for Generalised Tonic-Clonic seizures?
- Sodium Valproate
- Lamotrigine
- Carbamazepine
What is the treatment for absence seizures?
- Sodium Valproate
2. Lamotrigine or ethosuximide
What is the 1st and 2nd line treatment for myoclonic/tonic/atonic seizures?
- sodium Valproate
2. Lamotrigine
What treatment is used for Refractory/uncontrolled focal seizures
Carbamazepine, Clobazam, Gabapentin, Lamotrigine, Keppra, Oxcarbazepine, Sodium Valtproate, Topiramate
What medication is used in infantile spasm?
Prednisolone or Vigabatrin
What is the first line treatment for seizures caused by Tuberous Sclerosis
Vigabatrin
When is phenytoin indicated?
- Status epilepticus where benzodiazepines inaffective
- Further down the line treatment for regular generalised/focal seizures
When is phenytoin contra-indicated?
- Absence seizrues
What are the side effects from Sodium valproate?
- Appetite
- Liver failure
- Pancreatitis
- Reversible hair loss/reduced OCP effect
- Oedema
- Ataxia
- Teratogenicity, tremor, thrombocytopaenia
- Encephalopathy
What are common side effects of carbamazepine?
- Ataxia
- Drowsiness
- GI disturbance
- Erythematous skin rash
- Blurred vision
What are common side effects of Lamotrigine?
- Nausea, dizziness, ataxia
- Maculo-papular rash - 10%
What is a very rare complication of Lamotrigine?
Steven-Johnson Syndrome
What is advised when women are taking the OCP and AEDs?
- Take 50mcg more oestrogen
When can you consider stopping anticonvulsants?
- Normal CNS examination, IQ and EEG prior to withdrawal
- Seizure-free for >2yrs
- No juvenile myoclonic epilepsy
