1.04 Epilepsy - Google Docs PDF

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medical Student notes - epilepsy (Sheffield phase 3a exam) ...

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1.4 Epilepsy Seizure = clinical manifestaon of disordered electrical acvity in the brain (paroxysmal discharge of cerebral neurons) Epilepsy = Tendency to recurrent seizures

Elements of a seizure: prodrome (rare) → aura →seizure →post ictal Causes ● 2/3 idiopathic (familial) ● structural: corcal scarring (head injury), developmental, SOL, stroke, ● others: SLE, sarcoidosis, ● (non epilepc seizures: trauma, stroke, haemorrhage, ^ICP, alcohol. Metabolic disturbances ag hypoxia) Diagnosis ● 3 key quesons: o 1- Is it really a seizure? (take a good Hx). o 2- What type of seizure, paral or generalized? (onset). o 3- Any Triggers? Seizure classificaon Paral Seizures (focal onset, one hemisphere, oen underlying structural disease) Simple paral: awareness unimpaired, with focal motor/sensory. No post ictal sx Complex paral: awareness impaired, may have aura. Most commonly temporal lobe (rising epigastric sensaon)

Primary generalised Seizures (electrical discharge throughout cortex, no localising features) Absence (pet mal) brief 5m ● OR repeated seizures without regaining consciousness Management

Quick correctable causes hypoglycaemia - get a BM Alcohol/malnutrion - give pabrinex (low thiamine, wernicke's encephalopathy) Pregnant - are they eclampc (IV Mg)...