Epilepsy Flashcards Preview

Neurology > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (53):
1

in a falls history, what aspects should be asked about in the "before" segment

pallor
light headedness
triggers - flashing lights
posturing of limbs
head turning

2

in a falls history what aspects should be asked about in the "during" segment

tonic
clonic
rigidity
responsiveness and awareness

3

in a falls history what aspects should be asked about in the "after" segment

speed of recovery
disorientation

4

risk factors for epilepsy

complicated birth
delayed development
previous seizures including febrile
head injury
family history
drugs
alcohol

5

list drugs precipitating epileptic seizures

theophylline
tramadol
opioids
penicillins
cephalosporins
quinolones
lithium
lidocaine
antidepressants
anticholinergics
prochlorperazine

6

which single investigation should all people who have had a fall/collapse get?

ECG

7

which cardiac condition is it vital not to miss in terms of falls

LQTS

8

who gets a CT scan acutely

skull fracture
deteriorating GCS
focal neurological deficit head injury with seizure failure of GCS 15/15 after 4 hours
suggestion of other pathology

9

what is an EEG and is it a good test to diagnose epilepsy after a collapse

electroencephalogram
it is a dreadful test and should not be used to diagnose epilepsy after a collapse

10

what is an EEG used for

to classify epilepsy
confirm non-epileptic attack/non-convulsive status
surgical evaluation

11

differential diagnoses of collapse

syncope
seizure
hypoglycaemia
pseudoseizure
sleep phenomena
parasomnias
migraine
cataplexy
tonic spasms of MS

12

how long until you are able to drive a car after your first seizure

6 months

13

how long until you are able to drive a HGV/PCV after your first seizure

5 years

14

1 seizure = epilepsy, true or false

false

15

when can you drive a car if you have epilepsy

1 year being seizure free
or 3 years during sleep

16

when can you drive a HGV/PCV if you have epilepsy

after being medication free for 10 years

17

define epilepsy

a tendency to recurrent spontaneous epileptic seizures

18

define seizure

abnormal synchronisation of electrical activity
- excitatory
- inhibitory

19

what is SUDEP

sudden unexplained death in epilepsy

20

how are seizures classified

focal/partial
generalised

21

describe focal seizures

irritation occurs in a certain area of the brain eg stroke, haemorrhage, demyelination, tumour

22

focal seizures can have secondary generalisation, true or false

true

23

describe generalised seizures

abnormal electrical activity all over the brain

24

how can epilepsy be classified

focal
generalised

25

how can focal epilepsy be classified

simple
complex

26

describe simple focal epilepsy

consciousness NOT impaired

27

describe complex focal epilepsy

consciousness IS impaired

28

define focal epilepsy

recurrent focal seizures +- 2ndary generalisation

29

how can generalised epilepsy be classified

absence
atonic
tonic
tonic clonic / primary generalised
myoclonic

30

define generalised epilepsy

recurrent generalised seizures

31

what group of epilepsy is Juvenile Myoclonic Epilepsy and what is the best treatment

primary generalised
Na valproate but lamotrigine is used as an alternative

32

what group of epilepsy is Complex partial epilepsy with hippocampal sclerosis and what is the best treatment

focal epilepsy
carbamazepine or lamotrigine
occurs in <30 yo

33

what is the benefit of anti epileptic drugs AEDs

to reduce likelihood of having more seizures in the first place

34

AEDs are prescribed after 1 seizure, true or false

FALSE
not prescribed after a one off seizure

35

carbamazepine is used for focal/generalised epilepsy only

focal
makes generalised epilepsies worse

36

what is phenytoin and what is it used for
side effects?

anti-convulsant
acute management only
enzyme inducer

37

what is Na valproate and what is it used for

Na channel inhibitor anti convulsant
all types of epilepsy

38

side effects of Na valproate

TERATOGENIC
weight gain
hair loss
fatigue

39

what is carbamazpine and what is it used for

Na channel blocker anti convulsant
focal epilepsy only

40

what is lamotrigine and what is it used for

Na channel blocker anti convulsant
focal and generalised epilepsies

41

what is a side effect of lamotrigine and what is done as a result

Steven Johnson Syndrome
dose is slowly titrated up

42

what is levetiracetam
side effects?

anti convulsant
well tolerated but can cause mood swings

43

what is a side effect of topiramate

weight loss
parasthesia
poor cognition
sedation
dysphasia
enzyme inducer

44

which anti convulsants induce hepatic enzymes and why is this a problem

carbamazepine
oxcarbazine
phenobarbitol
phenytoin
primodone
topiramate
They alter the efficacy of the OCP

45

Progestogen only pills and implants can be used with antoconvulsants, true or false

FALSE, they should not be used

46

how should contraception be managed in ladies on anti-convulsants

need higher dose of contraceptive pill and morning after pill

47

management of women wanting to get pregnant on AEDs

preconceptual counselling
risk benefit balance with drugs
high dose folic acid + vit K

48

what is status epilepticus SE

recurrent epileptic seizure without full recovery of consciousness
continuous seizure lasting >30 min

49

what types of status epilepticus are there

generalised convulsive
non-convulsive
continuous focal seizures

50

list precipitants of SE

severe metabolic disorders
abrupt withdrawal of AEDs
infection
trauma
SAH
treating absence seizures with carbamazepine

51

why is SE so dangerous

multi organ failure
excitotoxicity results in neuronal death

52

investigations in SE

ABCDE
bloods - FBC, LFT, U+E
+- CT scan

53

pharmacological management of SE

benzodiazepines: buccal/IM midazolam twice maximum with 5 minute intervals
phenytoin
Na valproate
keppra
thiopentone, propofol - ICU!