Epilepsy Matt Beaumont.

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Presentation transcript:

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