Q to work on #3 Flashcards
How do you classify Bipolar disorder
Via the DSM-V Classification
Bipolar I: Must be one manic episode
Bipolar II: depressive episode(s) and hypomanic episodes
Cyclothymic: lower grade depressive and hypomanic symptoms
Treatment for Bipolar disorder is?
Antipsychotics (Olanzapine and Haloperidol) and sleeping medication (zopiclone)
Lithium has a small effect
Sodium Valporate may be used prophylactically
What is a focal “partial” seizure, and the two subtypes
a seizure that’s limited to one hemisphere of the brain, where there is a focused site where the seizure begins.
This can be:
- Focal Seizure with retained awareness
- Focal Seizure with a loss of awareness
A generalised seizure is? and name the 6 subtypes..
Where there is widespread brain activity.
- Absence seizure
- Myoclonic
- Tonic-clonic “convulsions”
- Tonic
- Clonic
- Atonic “drop attacks”
Is PNES a form of epilepsy?
No. Psychogenic Non-Epileptic Seizures are common <55, and areoften triggered by stress or trauma. No electircal activity will be seen on EEG and the patient should be treated with therapy
An absence seizure causes?
How long does it last?
What movement may the patient make?
A1: unconsciousness without convulsions
Lasts 2-10secs
Repetitive movements such as
- chewing movements
- rapid breathing
- rhythmic blinking
- slight movements or tugging at clothing
Describe what you would see in a Tonic-clonic Seizure
- Person immediately loses consciousness
-
Tonic Phase: They may make a short, loud cry as their chest muscles contract , and their muscles will stiffen causing them to fall to the ground
- Pressure may cause faecal or urinary incontinence
- Clonic Phase: the extremities will jerk rhythmically, saliva may froth, breathing may be irregular
- Seizure can last 2-5 minutes and patient will regain consciousness slowly
What is an atonic seizure?
hyen there is a surge of electrical activity, causing a loss of muscle tone = a “drop seizure”
The person usually retains consciousness
What condition is atonic ‘drop’ seizures associated with?
Lennox Gastaut Syndrome: a severe form of epilepsy that begins in childhood and is associated with intellectual disability
Describe how a clonic seizure would look
Loss of control of various body parts with jerking, potential loss of consciousness.
Starts in childhood and may progress to tonic-clonic
Are tonic seizures common? What are they associated with medically?
They are rare and associated with Lennox-Gastaut Syndrome and Multiple Sclerosis
What would you see in a Tonic Seizure
- Facial and truncal spasm
- Flexion and extension of extremeties
- Impaired consciousness
Describe a Myoclonic Seizure and
They involve abrupt muscle jerks in parts or all of the body.
- eg; A hand may suddenly fling out, a shoulder may shrug, a foot may kick, or the entire body may jerk.*
- They are associated with Childhood epilepsy and don’t impari consciousness*
Differential diagnoses of epilepsy?
Syncope
Narcotic use
TIA
Migraine
Panic attack
PNES
When would you have reason to treat a seizure acutely, and what would you do?
- If there was a something triggering the episode
- REMOVE the trigger
- If the seizures goes longer then 5-10 minutes and is defined as Status elipticus
- Initially: Benzodiazipine rg; lorazepam or midazolam
- Long term: Non-benzodiazipine anti-seizure med:
Susceptible
Immune due to natural infection
Immunised with Hepatitis B vaccination
Acutely infected
Crhonically infected
Interpretation unclear; four possibilities:
- Resolved infection (most common)
- False-positive anti-HBc, thus susceptible
- “Low level” chronic infection
- Resolving acute infection
