Seizures Flashcards
What questions would you ask in a history regarding the cause?
- Illnesses
- Missing medication
- New medication (interactions)
- Alcohol excess
- Use of recreational drugs
- Metabolic disturbances
- Broken sleep, fatigue and jetlag
- GI disturbances (may impair absorption of AED)
What is the anatomical importance of the frontal lobe?
- Primary motor cortex
- Broca’s area – motor speech area (left)
- High order functions (intellectual, judgemental and predictive faculties and planning of behaviour)
What is the anatomical importance of the parietal lobe?
• Primary somatosensory cortex
What is the anatomical importance of the temporal lobe?
• Primary auditory cortex
• Wernicke’s area - understanding speech (left)
• Hippocampus
o Memory and emotional aspects of behaviours
o Amygdala (Receive fibres from olfactory tract - smell)
What is the anatomical importance of the occipital lobe?
• Primary visual cortex
What are the signs of a focal temporal seizure?
- Automatisms
- Dysphagia
- Deja vu
- Emotional disturbance
- Hallucinations of small, taste or sound
- Bizarre associations
What are the signs of a focal frontal seizure?
- Posturing or peddling movements
- Jacksonian march (spreading focal motor seizure with retained awareness)
- Motor arrest
- Subtle behavioural disturbances
- Dysphagia
What are the signs of a focal parietal seizure?
- Sensory disturbances
What are the signs of a focal occipital seizure?
- Visual phenomena
What are febrile convulsions?
- Seizures provoked by fever in otherwise normal children
- Occur between ages 6 months - 5 years
What are the clinical features of febrile convulsions?
- Usually occur early in a viral infection as the temperature rises rapidly (high fever)
- Seizures are usually brief, lasting <5 minutes
- Commonly tonic-clonic
What is mesial temporal sclerosis?
Seizures originating in the temporal lobe due to scarring caused by febrile convulsions
When is stopping AEDs considered?
Seizure free for >2yrs, with AEDs being stopped over 2-3 months
What are the DVLA guidelines for epilepsy or multiple unprovoked seizures?
Car and motorcycle
- Cannot drive for 12 months from date of last seizure
Bus and lorry
- Must remain seizure free for 10 years without epilepsy medication
What are the DVLA guidelines for a first unprovoked seizure?
Car and motorcycle
- Cannot drive for 6 months from date of last seizure, or for 12 months if there is an underlying causative factor that may increase risk
Bus and lorry
- Driving must cease for 5 years from date of seizure
