Epilepsy Matt Beaumont
Epilepsy Definition: Chronic neurological disorder, recurrent unprovoked _______, transient symptoms associated abnormal activity in the brain. Seizure: Paroxysmal abnormality of motor, sensory, autonomic, cognitive function Prevalence: _______
Types (ILAE 2010) Generalised- both___________ (absence, myoclonic, tonic, tonic-clonic, atonic) Focal- arise 1/part 1 hemisphere Frontal- motor phenomena Temporal- auditory and sensory Occipital- ______/ phenomena Parietal- contralateral dysaesthesia
Investigations EEG- suspected Epilepsy- abnormal background, abnormal wave complexes Imaging: Structural- if focal/neuro signs- tumour Imaging: functional- abnormal metabolism seizure foci/ epileptogenic lesions
Treatment: AEDs Recurrence, type, monotherapy, side effects Generalised: Tonic clonic: Valproate Absence:________ Focal: Carbamazepine
Common side effects: Drowsiness and sedation, rash Diplopia, headache, tremor Depression, suicidal thoughts Ataxia, confusion, slurred speech
Specific Carbamazepine: Hyponatraemia/ SIADH Valproate: weight gain Phenytoin: acne/ hirsustism Teratogenic Reproductive age: lamotrogine
Hypsarrhythmia
Case Miss RG, 13yrs, F BG: Reflex anoxic seizures, Absence seizures Paeds neurology 2010 EEG + treated epilepsy Intractable Epilepsy MRI scan indicated Previous resection DH: carbamazepine (Tegretol) 200mg BD, levetiracetam (Keppra) 750mg BD
MRI- 2010 Lesion in left occipitotemporal region
Brain Tumours Most common form solid childhood cancer Most common cause childhood cancer death Astrocytoma- 40% Treatment: Surgery, Chemo, Radio