Flashcards in 9. Epilepsy Deck (15):
What is epilepsy?
Neurological condition characterised by recurrent and unpredictable SEIZURES - sudden irregular discharge of electrical activity (synchronous neuronal activity) in the brain causing a physical manifestation such as sensory disturbance, loss of consciousness or convulsions.
1. primary - idiopathic
2. secondary - identifiable cause, e.g. head injury, hypoxia, tumour, stroke, infection, hypoglycaemia, drugs
What are convulsions?
Rhythmic uncontrolled shaking movements of the body due to rapid and repeated contraction/relaxation of the body.
What is an aura?
Perceptual disturbance experienced by some prior to a seizure (e.g. strange light, unpleasant smell, confusing thoughts).
What are the 2 major types of seizures?
1. Partial/focal - involves 1 hemisphere or lobe
2. Generalised - both hemispheres affected
What are the 2 main types of partial seizures?
1. Simple - normal consciousness, but may involve strange sensations or jerking movements in specific muscle groups depending on affected neurones
2. Generalised - impaired consciousness (loss of awareness and/or memory)
Which area of the brain is affected in partial seizures presenting with auras (e.g. auditory hallucinations, rush of memories)? With abnormal movements?
1. Temporal lobe epilepsy can cause auras (most common, often onset in 1st-2nd decade).
2. Frontal lobe epilepsy can cause contralateral motor signs (2nd most common).
P presents with seizure causing muscle stiffening (fell backwards). Type of seizure?
P presents with seizure causing short muscle twitches. Type of seizure?
P presents with seizure causing him to 'space out' for several secs. Type of seizure?
P presents with seizure causing violent and rhythmic body contractions. Type of seizure?
P presents with seizure causing muscle relaxation (fell forwards). Type of seizure?
P presents with seizure causing muscle stiffening followed by convulsions. Type of seizure?
What is status epilepticus?
Epileptic seizures occurring continuously without consciousness recovery for over 5min. Usually caused by tonic-clonic seizures. Medical emergency.
P presents with status epilepticus. How would you manage them?
i. ABCDE assessment
ii. Benzodiazepines: midozalam (5mg buccal) or lorazepam (4mg IV)
iii. Further dose if unresponsive after 5min
iv. IV phenytoin if still unresponsive after 10-15min