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Epilepsy (causes (2/3 idiopathic (familial link), cortical scarring from…
Epilepsy
causes
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non-epileptic causes: trauma, stoke, haemorrhage, alc/benzo withdrawal, metabolic disturbance
Rx
counselling (advise not to drive, swimming w/o lifeguard, heights)
sodium valproate (generalised epi, increased appetite & weight gain, teratogenic)
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elements of a seizure
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aura
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e.g. strange feeling in gut, deja vu, strange smell, flashing lights
seizure
partial (focal)
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evolving to bilateral, convulsive seizure (secondary generalised)
2/3 pts w partial, starts focal then spreads widely
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post-ictal
headache, confusion, myalgia, sore tongue, temporary weakness after a focal seizure in the motor cortex (Todd's palsy), dysphasia after a focal seizure in temporal lobe
symptoms
frontal lobe
motor features (posturing, versive movements of head/eyes)
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parietal lobe
sensory disturbance (tingling, numbness)
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temporal lobe
automatisms: complex motor phenomena w impaired awareness & no recollection afterwards (chewing, grabbing, violent acts)
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occipital lobe
visual phenomena (spots, lines, flashes)
Ix
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ECG, CT/MRI, EEG, routine bloods
recurrent tendency to spontaneous, intermittent, abnormal electrical activity in brain manifesting as seizures
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