Seizures and Epilepsy

Question 1

What are the HEEADD features of a seizure?

Where is the seizure likely to be occurring in the brain with these symptoms?

Answer 1

Hallucinations
Epigastric rising
Emotional Automatisms eg. lip smacking
Deja-vu
Dysphasia (post-ictal)

Temporal lobe

Question 2

Where would seizure be located in the brain if the main symptom was parasthesia?

Answer 2

Parietal lobe

Question 3

How would a seizure of the occipital lobe present?

Answer 3

Flashes/floaters

Visual abnormality

Question 4

What are the first-line drugs for focal seizures?

Answer 4

Carbamezapine or lamotrigine

Question 5

What is the first line drug for tonic-clonic seizures?

Answer 5

valproate

Question 6

What is the first-line drugs for absence seizures?

Answer 6

valproate or ethosuximide

Question 7

What drug should be avoided in absence seizures?

Answer 7

Carbamezapine

Question 8

What is the treatment for status epileptics in the community?

Answer 8

Buccal midazolam

Rectal diazepam

Question 9

What is the treatment for status epileptics in hospital (with IV access available)?

Answer 9

1st line: 2x doses of IV midazolam (10 mins apart)

2nd line: IV phenobarbital or phenytoin

Question 10

Where is a seizure likely to have occurred if there is post-ictal weakness?

What is the name for this phenomenon?

Answer 10

Frontal lobe

Bell’s palsy

Question 11

Where is a seizure likely to be occur if there is localised limb jerking or Jacksonian march?

Answer 11

Frontal lobe