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Flashcards in Epilepsy Deck (30)
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1

What could be the cause of a blackout?

Syncope
First epileptic seizure
Hypoxic seizure
Concussive seizure
Cardiac arrhythmia
Narcolepsy
Movement disorder
Migraine

2

How do you tel what type of blackout a person had?

History from patent
History form witnesses
Diagnostic investigations

3

What symptoms can occur prior to syncope?

Light-headed
Nausea
Hot and sweating
Tinnitus
Tunnel vision

4

What are the triggers for vasovagal syncope?

Prolonged standing
Standing up quickly
Trauma
Venepuncture
Watching/experiencing medical procedures
Coughing
Micturition

5

What are the main differences in the features of syncope and seizures?

Syncope: upright posture, pallor common, gradual onset. rapid recovery, incontinence rare, injury rare
Seizure: any posture, pallor uncommon, sudden onset. incontinence common, slow recovery, injury quite common

6

What is the main cause of a hypoxic seizure?

Continued oxygen deprivation

7

Where can hypoxic seizures occur?

Individuals kept upright in a faint
Aircraft
Dentist

8

What is the cause of a concussive seizure?

After a blow to the head

9

What are some of the features of a non epileptic attack?

More common in females
History of abuse
Can be prolonged
May look bizarre
History of medically unexplained problems
Resemble a generalised tonic clonic seizure

10

What are the investigations for a possible first seizure?

Blood sugar
ECG
Consider alcohol and drug influence
CT head

11

What advice should be given to patients?

Driving regulations
Enquire about employment
Enquire about potentially dangerous leisure activities
Provide safety info sheets

12

What are the features suggestive of epilepsy?

History of myoclonic jerks especially in morning
Absences or feeling strange with flickering lights
History of deja vu rising sensation from abdomen

13

What is epileptic seizure?

Intermittent stereotyped disturbance od consciousness, behaviour, emotion, motor function or sensation which, on clinical grounds is believed to result from abnormal neuronal discharges

14

What are the ILAE classifications of epilepsy for generalised seizures?

Tonic-clonic
Myoclonic
Clonic
Tonic
Atonic
Absence

15

What is the classification of a focal seizure?

Characterised according to aura, motor features, autonomic features and degree of awareness or responsiveness
May evolve into convulsive seizure

16

What are the differences between a generalised and a focal seizure?

Generalised: no warning, under 25yo, history of absences and myoclonic jerks, EEG abnormality, family history
Focal: any age, focal abnormality on EEG, MRI may show cause

17

What are the main investigations for diagnosing epilepsy?

EEG
MRI (under 50yo)
Video-telemetry if unsure

18

What is the first line treatment for primary generalised epilepsy?

Sodium valproate
Lamotrigine
Levetiracetam

19

What is the first line treatment for partial and secondary generalised seizures?

Lamotrigine
Carbamazepine

20

What is the first line treatment for absence seizures?

Ethosuximide

21

What are the side effects of sodium valproate?

Tremor
Weight gain
Ataxia
Nausea
Drowsiness
Transient hair loss
Pancreatitis
Hepatitis

22

What are the side effects of carbamazepine/

Ataxia
Drowsiness
Nystagmus
Blurred vision
Low serum sodium levels
Skin rash

23

What are the side effects of lamotrigine?

Skin rash
Difficulty sleeping

24

What are the side effects of levetiracetam?

irritability
Depression

25

What are the side effects of topiramate?

Weight loss
Word finding difficulties
Tingling hands and feet

26

What is the second line of treatment for generalised epilepsy?

Topiramate
Zonisamide

27

What are the side effects of zonisamide?

Bowel upset
Cognitive problems

28

What is status epilepticus?

Prolonged or recurrent tonic-clonic seizures persisting for more than 30 minutes with no recovery period between seizures

29

What is the first line of treatment for status epilepticus?

Midazolam
Lorazepam
Diazepam

30

What is the second line of treatment for status epilepticus?

Phenytoin
Valproate