Neurology 8 - Epilepsy Flashcards
investigations x 3 epilepsy
EEG
MRI
ECG
generalised tonic clonic seizures
classic one
loss of consciousness
muscle tensing and jerking all over
tongue biting, incontinence, groaning, irreg breathing
post ictal phase (confused, drowsy, irritable, depressed)
management of all seizure types
tonic clonic focal absence atonic myoclonic infantile spasms
tonic clonic
- sodium valproate
- lamotrigine, carbamazepine
focal seizures
inverse of above
absence
1. sodium val or ethosuxmide
atonic
1. SV or lamotrigine
myoclonic
- SV
- lamotrigine, levetiracetam, topiramate
infantile spasms
pred, vigabatrin
describe focal seizures
affect the temporal lobe
so affect hearing, speech, memory+emotions
hallucinations
memory flashbacks
deja vu
strange autopilot actions
describe absence seizures
usually children
blank, staring into space for 10-20 seconds
most stop as older
describe atonic seizures
‘drop’ seizures
3 minute lapse in muscle tone
start in childhood
may indicate Lennox Gastaut syndrome
describe myoclonic seizures
brief jumpy muscle contractions
remain awake during
typically in children as part o juvenile myoclonic epilepsy
describe infantile spasms
rare
starts around 6 months
clusters of full body spasm
poor prognosis
sodium valproate side effects
teratogenic
avoid in all women unless strict contraception + no alternative
liver damage, hepatitis
hair loss
tremor
notable side effects of carbamazepine
agranulo
aplastic anaemia
inducer
notable phenytoin side effects
folate and vit D deficiency
notable ehtosuximide side effects
night terrors
rashes
lamotrigine notable side effects
Stevens Johnson syndrome
leukopenia
define status epilepticus
emergency
seizure over 5 minutes or more than 3 in an hour
management of status epilepticus
ABCDE approach secure airway high flow oxygen assess cardioresp check blood glucose IV accesss
IV lorazepam 4mg stat, repeat after 10 mins if still going
if persistent - IV phenobarbitol or phenytoin
