Flashcards in Epilepsy Deck (30)
What could be the cause of a blackout?
First epileptic seizure
How do you tel what type of blackout a person had?
History from patent
History form witnesses
What symptoms can occur prior to syncope?
Hot and sweating
What are the triggers for vasovagal syncope?
Standing up quickly
Watching/experiencing medical procedures
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
What is the main cause of a hypoxic seizure?
Continued oxygen deprivation
Where can hypoxic seizures occur?
Individuals kept upright in a faint
What is the cause of a concussive seizure?
After a blow to the head
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
What are the investigations for a possible first seizure?
Consider alcohol and drug influence
What advice should be given to patients?
Enquire about employment
Enquire about potentially dangerous leisure activities
Provide safety info sheets
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
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
What are the ILAE classifications of epilepsy for generalised seizures?
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
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
What are the main investigations for diagnosing epilepsy?
MRI (under 50yo)
Video-telemetry if unsure
What is the first line treatment for primary generalised epilepsy?
What is the first line treatment for partial and secondary generalised seizures?
What is the first line treatment for absence seizures?
What are the side effects of sodium valproate?
Transient hair loss
What are the side effects of carbamazepine/
Low serum sodium levels
What are the side effects of lamotrigine?
What are the side effects of levetiracetam?
What are the side effects of topiramate?
Word finding difficulties
Tingling hands and feet
What is the second line of treatment for generalised epilepsy?
What are the side effects of zonisamide?
What is status epilepticus?
Prolonged or recurrent tonic-clonic seizures persisting for more than 30 minutes with no recovery period between seizures
What is the first line of treatment for status epilepticus?