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ENT, neuro, eyes > Seizures > Flashcards

Seizures Flashcards

1
Q

Where are focal seizures originating from?

A

Specific area on one side of brain

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2
Q

Awareness types in focal seizures and types

A

Focal aware
Focal impaired awareness
Awareness known
Motor, non motor or auras

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3
Q

Types of general seizure

A

Tonic-clonic
Tonic
Clonic absence
Atonic

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4
Q

When do yuo start antiepileptics after one seizure?

A

Patient has a neurological deficit
brainimaging -> structural abnormality
EEG - unequivocal epileptic acitivty
Patient/family/carers = unacceptable risk of another seizure

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5
Q

How long off driving after first unprovoked seizure?

A

6 months - if no relevant EEG activity or structural abnormality(then 12 months)

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6
Q

How long can’t drive after seizure if established epilepsy or multiple seizures?

A

12 months

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7
Q

When is surgeyr an option for epilepsy?

A

Focal - specific part of brain can be resected

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8
Q

What is an epileptic seizure?

A

Sudden transient attack of symptoms and signs due to abnormal electrical activity in the brain, leading to a disturbance in consciousness, beahviour, emotion, motor function or snesation

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9
Q

when does a seizure occur in the brain?

A

Imbalance between excitatory and inhibitory forces within network of cortical neurones in favour of sudden onset excitation, from alteration of brain function, genes, subcellular signalling to widespread neuronal circuits

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10
Q

Causes

A

Idiopathic
Cerbrovascular disease

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11
Q

What casues of cerebrovascular disease can cause seizures?

A
  • cerebral infrction, haemorrhage, venous thrombosis
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12
Q

What drugs canc cause seizures?

A

Phenothiazines, isonia\is, TCAs, benzodiazepines, binge drinking, alcohol

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13
Q

Which metabolic disorders can cause seizures?

A

Uraemia
Hypoglycaemia
Hypo/ernatremia
Hyper/ocalcemia

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14
Q

What types of encephalitits can cause seizures?

A

Viral
Autoimmune eg anti-NMDA receptor
anti-LG11

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15
Q

Complciations of epilepsy

A

Injuries during seizures eg tongue biting
Social stigmatism, occupational issues
Anxiety/depression
Status epilepticus
Sudden unexplained death in epilepsy
Increased mortality rate

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16
Q

What can precede seizures?

A

Aura - dependent on part of brain effected eg visual, deja vu etc

17
Q

Triggers for seizures

A

Sleep deprivation, stress, light sensitivity, alcohol use

18
Q

What happens in a tonic seizure?

A

Short lived, abrupt, generalised muscle stiffening - may cause a fall - with rapid recovery

19
Q

What happens in generalised tonic clonic seizure?

A

Generalised stiffening and subsequent rhythmic jerking of limbs, urinary incontinence and tongue biting

20
Q

When do absence seizures occur?

A

Childhood

21
Q

Atonic seizure

A

Sudden onset of loss of muscle tone causing falls

22
Q

Mycolonic seizure

A

Brief, ‘shock-like’ involuntary single or multiple jerks

23
Q

What post ictal phenomena can happen after a seizure?

A

Drowsiness, headaches, amnesia or confusion (usually occur only after gneralised tonic and/or clonic seiures)

23
Q

What post ictal phenomena can happen after a seizure?

A

Drowsiness, headaches, amnesia or confusion (usually occur only after gneralised tonic and/or clonic seiures)

24
Q

Investigations

A

Bloods
EEG
ECG
Neuroimaging - MRI brain, CT brain
Polysomnography
Handheld video recordngs

25
Q

Why is an ambulatory EEG often used?

A

EEG can often be normal when a seizure is not occuring - have to wait for a seizure to occur to pick up on abnoormal activity

26
Q

What is investgiation of choice fro seizures?

A

MRI brain

27
Q

When is an MRI most useful?

A

Don;t respond to 1st line meds
Focal onset history

28
Q

What is status epilepticus?

A

Seizure over 5 minutes or multiple with no break between them

29
Q

1st line management of status epilepticus

A

IV lorezapam up to 4mg
Buccal midazolam 10mg or rectal diazepam 10-20mg if no IV access

30
Q

2nd line in status epilepticus

A

IV phenobarbital or pheyntoin

31
Q

What give if no IV access 1st line

A
32
Q

What to take measurements from in status epilepticus

A

VBG, ECG, oxygen saturations, temp, pulse rate + BP

33
Q

How to treat hypoglycaemia, alcohol/malnourishment in status epilepticus?

A

IV dextrose if hypoglycaemia
IV thiamine if alcoholism/malnourishment suspected

ENT, neuro, eyes (34 decks)

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