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Neurology > seizure epilepsy > Flashcards

seizure epilepsy Flashcards

1
Q

differences between seizures & epilepsy?

A

seizure - one occurrence

epilepsy - chronic occurrences of seizures

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2
Q

what is a seizure?

A

period where a group of neurons in brains are synchronously firing, when they should not be.

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3
Q

cause of a seizure?

why does this happen basically?

A

sudden excitatory signals happening over and over again

↑excitatory neurotransmitter or ↓inhibitory neurotransmitters

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4
Q

what is the main excitatory neurotransmitter?

what receptor does it hit?

A

glutamate

hitting NMDA receptors

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5
Q

what is the main inhibitory neurotransmitter?

what receptor does it hit?

A

GABA

hitting on GABA receptors

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6
Q

what is the main excitatory neurotransmitter?

what receptor does it hit?

when this excitatory neurotransmitter hits this receptor, what happens?

A

glutamate

NMDA receptor

Ca2+ influx –> AP generated

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7
Q

what is the main inhibitory neurotransmitter?

what receptor does it hit?

when this inhibitory neurotransmitter hits this receptor, what happens?

A

GABA

GABA receptors

Cl- influx –> AP inhibited

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8
Q

how are seizures categorised/ defined?

-4 ways

A

is it local or general

which lobe effected

by level of consciousness

based on symptoms

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9
Q

1 hemisphere or 1 lobe having a seizure,

what is this called?
-2 name

if he is conscious, what is it called then?
-2 names

if he has impaired consciousness, what is it called then?

A

focal aka partial

aware or simple

focal impaired awareness

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10
Q

Both hemispheres having a seizure,

what is this called?

A

generalised seizures

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11
Q

define tonic seizures?

what might happen to pt, especially scary in older people?

A

muscle stiffen & flex

pt falls backwards

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12
Q

define atonic seizures?

A

muscles floppy

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13
Q

what might happen to pt, especially scary in older people?

A

pt falls forward

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14
Q

person has seizure with violent muscle contractions.

what kind of seizure is this?

A

Clonic

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15
Q

define tonic-clonic seizures?

A

= muscles tense & then rapidly relax & contract

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16
Q

define myoclonic seizures?

A

short muscle twitches

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17
Q

what is the most common type of seizure based on symptoms?

A

Tonic-clonic

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18
Q

person has seizure where they lost consciousness but then quickly regained consciousness, looks like they spaced out.

what seizure was this?

A

Absence seizures

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19
Q

pt has focal to bilateral hemisphere seizure.

what is this seizure called?

A

secondary generalised seizures

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20
Q

define status epilepticus ?

what type of seizure is this normally based on symptoms?

A

Seizures ≥ 5 minutes

tonic-clonic

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21
Q

status epilepticus is not an emergency.

true or false?

A

false

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22
Q

drug class to treat status epilepticus?

A

benzodiazepines

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23
Q

Epilepsy Prevalence in the UK? %

A

0.8%

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24
Q

RF for epilepsy?

-3

A

Cerebral palsy – 30% have epilepsy
Tuberous sclerosis
Mitochondrial disease

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25
Q

mostly epilepsy just happens, whether there are RF or not.

true or false?

A

true

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26
Q

pt has 1 lobe or hemisphere having a seizure.

if he is conscious, what is this type of seizure called?
-2 names

if he has impaired consciousness, what is it called then?
-2 names

A

focal aware or simple partial

focal impaired or complex partial

27
Q

age group and gender that has most absence seizure?

A

3-10year olds

girls

28
Q

prognosis for absence seizures?

A

90-95% grow out of it in adolescence

29
Q

1st line Mx for absence seizures?

-2 drugs

A

Sodium valproate & ethosuximide

30
Q

how does syncope differ from epilepsy?

(i. e. what features does syncope have that epilepsy does not).
- 4

A

syncope:

nausea
darkened vision
muffled ears beforehand,
gradually lose consciousness

31
Q

driving rules for someone who just had a seizure?

A

no driving 6 months

32
Q

driving rules for someone who was just diagnosed an epileptic?

A

must be seizure-free 12 months to drive again

33
Q

Antiepileptic meds inhibit what anticoagulant med?

A

warfarin

34
Q

Antiepileptics are contraindicated in pregnancy.

why?

which antiepileptics is particularly problematic in pregnancy?

A

they are teratogenic

sodium valproate

35
Q

drug group used to target epilepsy?

- has two names

A

Antiepileptic aka anticonvulsant

36
Q

1st line long term Mx for focal seizures?
-name

drug group of this drug?

this drug can however actually exacerbate two types of seizures, which ones?

A

carbamazepine

Antiepileptic aka anticonvulsant

absence & myoclonic seizures.

37
Q

1st line long term Mx for general seizures?
-name

drug group of this drug?

A

sodium valproate

Antiepileptic/anticonvulsant

38
Q

define general seizures?

A

Both hemispheres having seizure

39
Q

what is the postictal phase ?

A

feel drowsy for ~15 min post seizure

40
Q

genera symptoms of seizures?

A

Altered levels of consciousness

Muscle tightening/floppiness/contraction etc.

Bite tongue
Incontinence of urine
Postictal phase

41
Q

Symptoms of a focal seizure depend on locality.

what is the differentiating symptom if seizure is in

frontal lobe
parietal lobe
occipital lobe (3)
temporal lobe (2)

A

frontal lobe – head/leg movement, posture is weak

parietal lobe- paraesthesia

occipital lobe – floaters/flashes/colours (visual)

temporal lobe – hallucinations, lip smacking

42
Q

which Ix is used to record brain activity?

A

Electroencephalogram

43
Q

person is having a seizure,

it has only been a couple of minutes.

what is the 1st line acute Mx here?

A

1st: ABCDE + recovery position

44
Q

person is having a seizure,

it has been 5 minutes.

what drug can you give to help stop seizure?

  • class
  • routes
A

Benzodiazepine

intranasally
under tongue

45
Q

person is having a seizure,

it’s been over 10 minutes.

what is this seizure called now?

A

status epilepticus

46
Q

child is having a seizure,

what medication is 1st line to stope seizure acutely here.

  • name
  • preferred route
A

diazepam

rectal

47
Q

what are the two main drugs used to prevent seizures?

moa of each?

A

Sodium valproate - ↑GABA

Carbamazepine - blocks Na+ channels

48
Q

moa of BZD?

-step by step

A

↑GABAA –> ↑Cl- influx –> causes rapid hyperpolarisation and ∴ neuronal inhibition

49
Q

child has myoclonic seizure in morning after poor sleep.

what seizure is this?

A

juvenile myoclonic epilepsy

50
Q

juvenile myoclonic epilepsy age of onset

A

12

51
Q

sex most effected by juvenile myoclonic epilepsy?

A

females

52
Q

best drug to stops symptoms of juvenile myoclonic epilepsy?

A

sodium valproate

53
Q

juvenile myoclonic epilepsy is an umbrella term, what three seizures come under it which the pt will experience?

A

myoclonic
tonic-clonic
absence

54
Q

why should you be careful of using sodium valproate in female teenage with juvenile myoclonic epilepsy?

A

malformations in pregnancy

55
Q

pt has juvenile myoclonic epilepsy,

what do you see in EEG?

A

3-6Hz spikes

56
Q

define epileptic seizure

define non-epileptic seizures

A

abnormal electrical discharge in the brain

no abnormal electrical discharge

57
Q

non-epileptic seizures aka?

A

pseudoseizure

58
Q

how can prolactin be used to differentiate between epileptic seizures and non-epileptic seizures?

A

Prolactin goes up in epileptic seizures but not pseudoseizures

59
Q

how can tongue biting be used to differentiate between epileptic seizures and non-epileptic seizures?

A

epileptic = bite sides of tongue

pseudo epileptic = bite tip of tongue.

60
Q

Non - Epileptic seizure causes

A

mental stress
diabetes
sleep
arrhtymia

61
Q

features of non - epileptic seizures that make it differ from epileptic seizures?

  • 4
  • (in terms of symptoms)
A

Eyes closed
Alert through event
No post ictal phase
Will not respond to AED’s

62
Q

CNS triggers of seizures?

-6

A 
Strokes 
Haemorrhage in brain 
Cortex is malformed 
Hippocampus is sclerosed
Trauma to brain 
Infection
63
Q

what electrolyte imbalances can cause triggers seizure?

-3

A

hyponatraemia, hypocalcaemia, hypomagnesemia

64
Q

PNS triggers of seizures?

-6

A 
Electrolyte imbalance – hyponatraemia, hypocalcaemia, hypomagnesemia 
Drugs – cocaine 
Alcohol withdrawal – super common! 
Hypoglycaemia  
Arrhythmia

Neurology (40 decks)

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