Types of Epilepsy Flashcards
What type of seizure does the presence of an aura suggest?
Temporal lobe focal seizure
What are types of aura in epilepsy?
- Deja vu
- Strange smells
- Flashing lights
What may occur post-ictally in epilepsy?
- Headache
- Confusion
- Myalgia
What is Todd’s palsy?
- Temporary post-ictal weakness (transient neurological deficit) after a focal seizure in the motor cortex
- Face, arm or leg weakness, aphasia, gaze palsy
- Lasts ~30 min-36h
What can occur post-ictally after a focal seizure in the temporal lobe?
Dysphasia
What is one organic cause of seizures?
Anti-VGKC-complex encephalitis (anti voltage gated potassium channel antibodies)
What do all patients with a seizure need to be referred for?
Specialist assessment and investigation in < 2 weeks
What are key features of an epileptic seizure?
- Tongue biting
- Slow recovery
- Funny turns/odd behaviour in the past
- Deja vu and odd episodic feelings of fear
What are potential triggers of an epileptic seizures?
- Alcohol
- Stress
- Flickering lights/TV
What types of seizures are often seen with underlying structural disease?
Focal seizures
What are the 3 types of focal/partial seizure?
1) Without impairment of consciousness
2) With impairment of consciousness
3) Evolving to bilateral, convulsive seizure
What are the features of a focal seizure without impairment of consciousness?
- Focal motor, sensory, autonomic or psychic symptoms
- NO post-ictal symptoms
What are the features of a focal seizure with impairment of consciousness?
- Impaired awareness either at seizure onset or following a simple partial aura
- Post-ictal confusion
From where do focal seizure with impairment of consciousness usually arise from?
Temporal lobe
What type of generalised seizure do ⅔ of focal seizures typically become?
Convulsive
What are the 4 types of generalised seizures?
1) Absence
2) Tonic-clonic
3) Myoclonic
4) Atonic (akinetic)
What are the key features of absence seizures?
- Brief (< 10s) pauses
- e.g. suddenly stops talking in mid-sentence then carries on where left off
- Presents in childhood
What are the key features of tonic-clonic seizures?
- LOC
- Limbs stiffen (tonic) then jerk (clonic) - may have one without the other
- Post-ictal confusion and drowsiness
What are the key features of myoclonic seizures?
- Sudden jerk of a limb, face or trunk
- May be thrown suddenly to the ground or have a violently disobedient limb
What are the key features atonic seizures?
- Sudden loss of muscle tone causing a fall
- No LOC
What are the key features of a temporal lobe focal seizure?
- Automatisms - primitive oral (lip smacking) or manual movements (fiddling), impaired awareness
- Dysphasia
- Deja vu or jamais vu
- Emotional disturbance and derealisation (out of body experience)
- Hallucinations - smell, taste or sound
- Delusional behaviour
- Bizarre associations
What are the key features of a frontal lobe focal seizure?
- Posturing or peddling movements of the legs
- Jacksonian march - spreading focal motor seizure with retained awareness often starting with face or thumb
- Motor arrest
- Subtle behavioural disturbances
- Dysphasia or speech arrest
- Post-ictal Todd’s palsy
What are the key features of a parietal lobe focal seizure?
- Sensory disturbances - tingling, numbness, pain (rare)
- Motor symptoms - due to spread to the pre-central gyrus
What are the key features of an occipital lobe focal seizure?
Visual phenomena e.g. spots, lines, flashes
