seizures

Question 1

what type of epilepsy are absence seizures?

Answer 1

generalised

Question 2

what is the typical age range for absence seizures?

Answer 2

3-10 years old and more common in girls than in boys

Question 3

which things may provoke an absence seizure?

Answer 3

eizures may be provoked by hyperventilation or stress

Question 4

what is the management and prognosis of an absence seizure?

Answer 4

sodium valproate and ethosuximide are first-line treatment

good prognosis - 90-95% become seizure free in adolescence

Question 5

what are the branches of the trigeminal nerve?

Answer 5

v1- ophthalmic branch = Ophthalmic nerve lesions may result in a sensory deficit of the globe, lacrimal glands, side of the nose, upper eyelids, and frontal sinuses. There may also be a loss of the corneal reflex

v3- mandibular branch

Question 6

how can you remember the side effects of sodium valporate?

Answer 6

V - VALPROATE:
A - Appetite increase --> weight gain
L - Liver failure
P - Pancreatitis
R - Reversible hair loss (alopecia)
O - Oedema
A - Ataxia
T - Teratogenic, tremor, thrombocytopaenia
E - Enzyme inducer (p450), encephalopathy (due to high ammonia)

Question 7

what is Todds paresis?

Answer 7

A focal weakness, typically of the frontal lobe (motor strip), may occur following a focal-onset seizure - this is called Todd’s paresis. During a focal seizure, patients can either be aware or unaware of their surroundings.

Question 8

what are the symptoms of a temporal lobe focal seizure?

Answer 8

Hallucinations (auditory/gustatory/olfactory), Epigastric rising/Emotional, Automatisms (lip smacking/grabbing/plucking), Deja vu/Dysphasia post-ictal)

Question 9

what are features of frontal lobe seizures?

Answer 9

Head/leg movements, posturing, post-ictal weakness (Todd’s paresis) , Jacksonian march

Question 10

what are features of a parietal lobe seizure?

Answer 10

Paraesthesia

Question 11

what are features of an occipital lobe seizure?

Answer 11

Floaters/flashes

Question 12

which drug makes absence seizures worse?

Answer 12

carbamazepine

Question 13

how can you differentiate between a generalised tonic clonic seizure and a vagal syncope episode?

Answer 13

tonic clonic seizures have longer post octal phases

Question 14

in which type of seizure do patients grab their clothes?

Answer 14

temporal lobe

Question 15

what type of epilepsy does Jacksonian movements suggest?

Answer 15

frontal