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BDS3 BAMS Diseases of Human Systems > Neurology - Epilepsy > Flashcards

Neurology - Epilepsy Flashcards

1
Q

What is epilepsy

A

it is associated with reduced GABA levels in the brain leading to abnormal cell to cell message propagation

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2
Q

What are the signs and symptoms of a febrile seizure

A 
fever
face may turn blue or red
eyes rolling upward
loss of consciousness
muscles and limbs jerk in unnatural movements
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3
Q

Who is at risk of febrile seizures

A

> 38 degrees childen

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4
Q

How do we cool febrile seizures

A 
paracetamol 
ibuprofen 
remove clothes
cool sponging
cool bath
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5
Q

What is the classification of epilepsy

A

split into generalized and partial

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6
Q

What can generalized epilepsy be split into

A

tonic/clonic
absence
myoclonic/atonic

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7
Q

What can partial epilepsy be split into

A

simple partial
complex partial
simple sensory

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8
Q

What are epilepsy triggers

A

idiopathic
trauma
CNS disease
social

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9
Q

What trauma can trigger epilepsy

A

head injury

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10
Q

What Cns diseases can trigger epilepsy

A

tumor, stroke

CJD, meningitis encephalitis

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11
Q

What social aspects can cause epilepsy

A

late nights, alcohol, hypoglycemia

flashing lights

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12
Q

What are tonic clonic seizures

A 
prodromal aura
loss of consciousness/continence
initial tonic (stiff)
clonic (contraction/relaxation)
post-ictal drowsiness
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13
Q

What is Petit Mal seizures

A

short lived episodes (5-15 seconds)
loss of awareness - eyelids flutter, vacant stare, stops activity, loss of response

childhood usually
can be multiple attacks in single day

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14
Q

What are medical risks of tonic clonic seizures

A

injury

asphyxia

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15
Q

How can we try to minimize injury from tonic clonic seizures

A

protect where possible

remove objects from the mouth if possible

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16
Q

How can we try to reduce the impact of asphyxia

A

use supplemental oxygen
guedel airway if possible
suction secretions

17
Q

What are social risks

A

pregnancy
sudden death
social

18
Q

What is the risk with pregnancy

A

metabolism upset and drug reactions

risk to unborn child

19
Q

Why may sudden death occur in tonic clonic seizures

A

asphyxiation or aspiration

20
Q

What are social issues with sonic clonic seizures

A

certain occupations can’t be done

can’t drive

21
Q

What are precipitators for tonic/clonic seizures

A

withdrawal/poor medication compliance

epileptogenic drugs

fatigue/stress

infection

menstruation

22
Q

What are epileptogenic drugs

A

some GA agents
alcohol
tricyclics

23
Q

What are partial seizure

A

motor localized to one region of brain

may move/spread to other motor areas (jacksonian seizure)

24
Q

What are the changes that can occur in partial seizures

A

sensory

may effect visual, auditory, taste, smell

25
Q

What is complex partial seizures result in

A

automatism - repetitive purposeless movements

lip smacking and grimacing

26
Q

How do complex partial seizures occur

A

When diff areas of the brain are effected to produce connective movements

27
Q

What is the preventative treatment for epilepsy

A

anticonvulsant drugs

28
Q

What are the anticonvulsant drugs for tonic-clonic seizures

A

gabapentin, phenobarbitone, lamotrigine

29
Q

What drug is used for absence seizures

A

levitiracetam

30
Q

What is the treatment for emergency in epilepsy

A

most require supportive tx ONLY if UNCONSCIOUS - airway and oxygen

status epileptics requires benzodiazepines

31
Q

What are the drugs used for epilepsy

A

gaba receptor actions

sodium channel actions

32
Q

What are the gala receptor action drugs

A

valproate - gaba transaminase inhibitor

benzodiazepines - gaba receptor action on CL- enhanced

33
Q

What are the sodium channel action drugs

A

carbamazepine - stbailises

phenytoin

34
Q

What are the surgeries for epilepsy

A

removal of focal neurological lesions - brain tumours (benign)

35
Q

What are focal seizures

A

identifiable point of origin within the brain

not well controlled by meds

36
Q

What are dental aspects of epilepsy

A

complications of fits
complications of treatment
know emergency care

37
Q

What are the complications of fits dentally

A

oral soft tissue injury

dental injury/fracture

38
Q

What are the complications of tx dentally

A 
gingival hyperplasia (phenytoin) 
bleeding tendency (valproate) 
folate deficiency (rare)
39
Q

how do we assess risk of fit

A 
good and bad phases
ask when last 3 fits took place
ask about compliance with medcaiton
ask about changes in medication
treat at times of low risk

BDS3 BAMS Diseases of Human Systems (11 decks)

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