Seizures

Question 1

what are triggers of seizures?

Answer 1

drugs 
alcohol 
sleep disturbance 
electrolyte disturbance (especially hyponatraemia and hypocalcaemia)
intracerebral haemorrhage 
infection

Question 2

what is the first line treatment for generalised seizures?

Answer 2

Na valproate or lamotrigine

Question 3

what is the first line treatment for focal seizures?

Answer 3

carbamazepine

2nd line: lamotrigine

Question 4

what is the treatment for absence seizures?

Answer 4

1st line: Ethosuximide

2nd line: Carbamazepine

Question 5

what are the side effects of carbamazepine?

Answer 5

rash 
agranulocytosis
AV conduction delays
nystagmus
ataxia 
SIADH (causing hyponatraemia)

Question 6

what are the side effects of lamotrigine?

Answer 6

rash
tremor
diplopia

Question 7

what are the side effects of na valproate?

Answer 7

weight gain
rash
neutropenia
teratogenic

Question 8

what are the specific focal seizures and their presentations?

Answer 8

frontal lobe

• Jacksonian features (one sided)
• dyaphasia
• Todds palsy (focal weakness post seizure)

parietal lobe

• sensory i.e. tingling/pins and needles
• motor

temporal lobe

• de ja vu
• rising epigastric feeling
• olfactory, gustatory, auditory hallucinations
• post ictal aura common
• automatisms

occipital lobe
- spots and lines

Question 9

what are the 4 main generalised seizures?

Answer 9

absence
myoclonic
atonic
tonic-clonic