Seizure Disorders Flashcards
List risk factors for epilepsy
Birth and abnormal development
Past seizures
Head injury (LOC)
Family history
Drugs
Alcohol
List drugs that are common precipitants of epilepsy
Antibiotics
Tramadol
Anti-emetics
Opioids
Aminophylline
What is the mandatory first investigation in all patients presenting with a seizure?
ECG
Which seizure patients usually qualify for MRI/CT?
Intracranial pathology
Trauma
Focal signs
Low GCS
What is the rule regarding driving after your first seizure?
Can’t drive until seizure-free for:
car: 6 months
hgv: 5 years
What is the rule regarding driving with epilepsy?
Can’t drive until seizure-free for:
car: 1 year
hgv: 10 years
Define “seizure”
Abnormal discharge of electrical activity in the brain
Define “epilepsy”
A tendency for repeat epileptic seizures
Define “epileptic seizure”
Abnormal synchronisation of neural activity, usually excitatory, causing interruption of brain activity
What are the 2 classifications of epileptic seizure?
Focal
Generalised
What is the difference between focal and generalised epileptic seizure?
Focal: part of brain structurally abnormal causing focal symptoms
Generalised: neural cortical pathways conduct seizure to different brain areas
Which is more common in children and young people - focal or generalised epileptic seizures?
Generalised epileptic seizures
What is the treatment of choice for focal seizures?
Carbamazepine
Lamotrigine
What is the treatment of choice for generalised seizures?
Sodium valproate
Lamotrigine
Which patient group in particular should not be given sodium valproate and why?
Young girls
Teratogenic
Which epileptic drug can make generalised seizures worse?
Carbamazepine
List clinical features of functional non-epileptic attack
Prominent motor activity
Collapse
Fear, gasping, hyperventilation
Prolonged duration (up to 20mins)
What is status epilepticus?
Recurrent epileptic seizures without full recovery of consciousness
List some precipitants of status epilepticus
Infection
Trauma
Metabolic disorders
Withdrawal of anti-convulsants
Which drugs should be administered for acute seizure by carers at home?
Diazepam (rectal)
Which drug is preferred over diazepam for immediate control of acute seizure?
Lorazepam (iv)
