medical school mindmap

1. Epilepsy
Learning outcomes
• Epilepsy classification -
generalised v partial
• Definitions of each
• Symptoms and epilepsy
presentations
• Diagnosis of epilepsy
• Investigations of epilepsy
• Management of epilepsy
classification
generalised
primary
genetic
absence
JME=Juvenile Myoclonic Epilepsy
symptomatic
west syndrome
LGS=Lennox-Gastaut Syndrome
PME=Progressive myoclonic epilepsy
partial
genetic
benign rolandic
benign occipital
acquired
frontal
temporal
occipital
parietal
lesional
non-lesional
Definitions
• Epilepsy
When nerve cells in the brain fire electrical impulses at a
rate of up to four times higher than normal, this causes a
sort of electrical storm in the brain, known as a seizure
• Seizure
Uncontrolled electrical activity in the brain, which may produce a
physical convulsion, minor physical signs, thought disturbances,
or a combination of symptoms.
• Acute symptomatic seizure
• Partial versus generalised epilepsy
• Non - epileptic seizure
• Status epilepticus
evaluation(core)
general
demographics
handedness
early risk for partial epilepsy
other medical probs
psychosocial impact of epilepsy
driving
seizures
age of onset of first unprovoked seizures
types
frequency
nocturnal vs daytime
injuries
hx of status epilepticus
medication hx
current medication
all prior AEDs(and reason for
discontinuation
side effects
folic acids
comliance issues
additional assessment(honours)
multidisciplinary input
epilepsy clinical nurse specialist
education
neuropsychology
neuropsychiatry
review imaging
seizureclassification of seizure
generalised
generalised tonic clonic convulsion
• Primary Tonic Clonic seizures -They consist of
generalised tonic extension of the extremities lasting
for few seconds followed by clonic rhythmic movements
and prolonged postictal confusion.
absence
• Absence seizures are brief episodes of impaired consciousness
with no aura or postictal confusion. They typically last less than 20
seconds and are accompanied by few or no automatisms.
myoclonic
• Myoclonic seizures consist of brief, jerking, motor
movements that last less than 1 second. Myoclonic
seizures often cluster within a few minutes.
tonic
• Tonic seizures consist of tonic extension or flexion of the head, trunk,
and/or extremities for several seconds. These seizures typically occur
shortly after the person falls asleep, or just after he or she awakens.
atonic
partial(focal)
simple partial
• Simple partial: seizure with preserved consciousness,
include sensory, motor types, consists of an aura
complex partial
• Complex partial: impaired consciousness and
consists of 1 - 2 mins of starring, automatisms and
post - ictal confusion
secondarily generalised
• Secondarily generalised seizures - an aura that evolves
into a complex partial seizure and then into a
generalized tonic - clonic seizure
diagnosis
primarily clinical diagnosis
importance of eye-witness account
investigation may help to refine
diagnosis, establish aetiology
and predict prognosis
review/reconsider diagnosis in
those with uncontrolled seizures
high diagnostic error rate
- - Mindjet