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AMK Miscellaneous > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What are the requirements for a clinical diagnosis of epilepsy?

A

At least 2 seizures more than 24 hours apart.

1 unprovoked seizure and probability of another seizure greater than the general population.

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2
Q

At what point can it be said that Epilepsy has been resolved?

A

Seizure free for 10 years, medication free for 5 years.

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3
Q

What investigations need to be done to rule out incidental causes of epilepsy symptoms?

A

EEG - some people have abnormal brain activity but not epilepsy - structural pattern
- EEG would show abnormal photo paroxysmal response

MRI - rue out structural cause

Genetic - epilepsy syndrome in children

Hyponatraemia/infection - elderly
Video/witness of the seizure

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4
Q

What are the differential diagnoses of epilepsy?

A 
Movement disorders (focal, frontal seizure)
TIA
Narcolepsy 
Cardiovascular - syncope and arrhythmias
Hyperventilation
Hypoglycaemia
Infection
Panic attacks
Non-epileptic seizures
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5
Q

What is status epilepticus?

A

seizure lasting longer than 5 minutes
or
more than three seizures without recovery

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6
Q

How do you manage status epilepticus?

A

ABC - secure airway, high flow oxygen, large bore IV access

Take bloods - ABG, FBC U&E, tox screen, electrolytes

GCS, head injury, glucose

IV lorazepam 0.1mg/kg (4mg)

5 mins later: IV lorazepam 0.1mg/kg (4mg)

Another 5 mins: IV phenytoin 20mg/kg at 50mg/min and cardiac monitor/ 10mg/kg in 200mg bolus over 2 mins every 5 mins
Bleep ITU and anaesthetics

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7
Q

Long term management for epilepsy

A

Avoid triggers

AEDs after 2nd seizure or if risk of second seizure is high

Monotherapy - sodium valproate/carbamazapine
(beware of interactions with contraception) (need double dose of emergency contraception)

During pregnancy need 5mg folic acid OD

Keep a seizure diary

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8
Q

When would you consider stopping AEDs?

A

after no seizures for 2 years

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9
Q

What’s the definition of a seizure?

A

Transient occurrence of sign or symptoms due to abnormal electrical activity in the brain, leading to a disturbance of consciousness, behaviour, emotion, motor function or sensation.

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10
Q

What are the types of generalised seizure?

A 
Absence
Myoclonic
Atonic
Clonic
Tonic
Tonic clonic
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11
Q

How would you recognise an Absence seizure?

A

loss of consciousness

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12
Q

How would you recognise a myoclonic seizure?

A

jerks

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13
Q

How would you recognise a atonic seizure?

A

drop attacks, loss of tone

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14
Q

How would you recognise a clonic seizure?

A

rigidity

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15
Q

How would you recognise a tonic seizure?

A

moving

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16
Q

How would you recognise a tonic clonic seizure?

A

combination of movement and rigidity

rhythmic jerking

17
Q

What are the different types of focal seizure?

A

start in one hemisphere
simple
evolving
focal dyscognitive

18
Q

How would you recognise a simple focal seizure

A

retain awareness

19
Q

How would you recognise a focal evolving seizure?

A

start simple and spread

20
Q

How would you recognise a focal dyscognitive seizure?

A

consciousness affected

21
Q

What are the signs and symptoms of a frontal lobe seizure?

A 
motor most common
uncontrolled emotion - giggling, screaming
last about 30 seconds
not an impairment of consciousness
can be frequent - stress induced
22
Q

What are the signs and symptoms of temporal lobe epilepsy?

A 
most common form of focal seizure
80% start in the hippocampus
visual hallucinations
motion sickness
deja vi
unusual smell
23
Q

What are the signs and symptoms of parietal lobe epilepsy?

A 
rare
somatosensory
body image 
complete hallucinations
pain in the face and arm
24
Q

What are the signs and symptoms of occipital lobe epilepsy?

A

image stuck on vision
colour, lights, flashing
eyelid fluttering
nystagmus, eyes rolling around

25
Q

what EEG results suggest absence seizures

A

a synchronous discharge

26
Q

management of absence seizures

A

ethosuximide

AMK Miscellaneous (22 decks)

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