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CNSLF Med - Epilepsy (i) (Intro (may have significant consequences in…
CNSLF Med - Epilepsy (i)
Intro
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recurrent unprovoked seizures, or 1 unprovoked seizure with an "enduring predisposition" to further seizures (hyper excitable state)
not provoked seizures (e.g. trauma, cocaine)
may have significant consequences in terms of adverse education, vocational + psychosocial functioning + physical morbidity + potentially mortality (e.g. increases suicide rates)
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Classification
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focal (aka partial, localised)
frontal, temporal, occipital, parietal
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Automatisms
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lip smacking, repetitive swallowing
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Dx
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importance of collat hx, eye witness account, videotaping
investigations may help refine dx, establish aetiology, guide tx + predict prognosis
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dDx
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some drugs can lower the seizure threshold - e.g. alcohol, cough medicine
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Medication hx
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if pregnant
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avoid Na valproate - a/w birth defects, autism, low IQ
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Adequate seizure control
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freedom from convulsions +/or drop attacks may be a worthwhile goal in some with severe epilepsy syndromes