Epilepsy

Question 1 of 29

1

Fill the blank space to complete the text.

A seizure whereby there is rapid contraction and relaxation of muscles causing an uncontrollable shaking of the body is called a seizure.

Explanation

Question 2 of 29

1

❌ affect both brain hemispheres
❌ affect only one brain hemisphere

Drag and drop to complete the text.

Generalised seizures

Focal seizures

Explanation

Question 3 of 29

1

Types of Generalised Seizure:
❌ - Contraction of limbs followed by their extension & arching of back lasting 10-30s, followed by a shaking of the limbs.
❌ - Constant contraction of the muscles. Person often turns blue as breathing is stopped.
❌ - Shaking of the limbs in unison.
❌ - Brief, shock-like jerks of a muscle or a group of muscles.

Drag and drop to complete the text.

Myoclonic

Clonic

Tonic

Tonic-clonic

Explanation

Question 4 of 29

1

During tonic-clonic seizures, bites to which part of the tongue are more common?

Select one of the following:

Bites to tip of tongue
Bites to side of tongue

Explanation

Question 5 of 29

1

If a patient presents after a fall/seizure, it is mandatory to rule out a cardiovascular cause via which investigation?

Select one of the following:

ECG
Echocardiogram
Ultrasound
Blood Pressure Measurement

Explanation

Question 6 of 29

1

DVLA Rules Regarding Seizures - car:

You’ve had a one-off seizure while awake and lost consciousness:

Select one of the following:

Licence suspended, can reapply after 6 months seizure free
Licence suspended, can reapply after 12 months seizure free
Licence only suspended after 2nd seizure

Explanation

Question 7 of 29

1

DVLA Rules Regarding Seizures - HGV:

You’ve had a one-off seizure while awake and lost consciousness:

Select one of the following:

Licence suspended, can reapply after 12 months
Licence suspended, can reapply after 3 years
Licence suspended, can reapply after 5 years

Explanation

Question 8 of 29

1

DVLA Rules Regarding Seizures - car:

Diagnosed with epilepsy:

Select one of the following:

Licence suspended, can reapply after 5 years seizure free
Licence suspended, can reapply after 1 year seizure free
Licence suspended, can reapply after 3 years seizure free

Explanation

Question 9 of 29

1

DVLA Rules Regarding Seizures - HGV:

Diagnosed with epilepsy:

Select one of the following:

Licence suspended, can reapply after 5 years off medication & seizure free
Licence suspended, can reapply after 7 years off medication & seizure free
Licence suspended, can reapply after 10 years off medication & seizure free

Explanation

Question 10 of 29

1

Primary Generalised Epilepsy often presents ...

Select one of the following:

In childhood/teenage years
In late 20s/early 30s
In those over 50

Explanation

Question 11 of 29

1

Fill the blank space to complete the text.

The treatment of choice for primary generalised epilepsy is

Explanation

Question 12 of 29

1

If a primary generalised epilepsy patient is unresponsive to Sodium Valproate, which of the following second line treatments is most common?

Select one of the following:

Lamotrigine
Clobazam
Gabapentin
Pregabalin

Explanation

Question 13 of 29

1

Due to the adverse side effects, sodium valproate is not recommended for focal onset epilepsy. Instead, what is the first line treatment for this condition?

Select one of the following:

Carbamazepine
Clobazam
Levetiracetam
Oxcarbazepine

Explanation

Question 14 of 29

1

Sodium Valproate is teratogenic and should not be prescribed to pregnant women

Select one of the following:

True
False

Explanation

Question 15 of 29

1

A 17 year old girl is taken to A&E after having had a generalized seizure.
She had been out partying the night before. No past Hx of note, although her mother reported that she had been a bit clumsy and jerky in the mornings recently, e.g. dropping her hairbrush or coffee cup. Which of the following statements is correct?

Select one of the following:

The history is suggestive of a secondary generalized fit. The patient
needs urgent brain scanning.
The history suggests a primary generalized epilepsy, and either Sodium
Valproate or Lamotrigine would be treatment of choice.
Treatment of choice for this type of epilepsy is Carbamazepine
Juvenile myoclonic epilepsy is associated with hippocampal sclerosis
This is probably just an alcohol induced seizure. No further
investigations or treatment required

Explanation

Question 16 of 29

1

What is status epilepticus?

Select one of the following:

Recurrent epileptic seizures without full recovery of consciousness. Continuous seizures lasting >30 minutes
Recurrent epileptic seizures without full recovery of consciousness. Continuous seizures lasting >60 minutes
A seizure that can only be halted by high loading with an acute anti-convulsant

Explanation

Question 17 of 29

1

Status Epilepticus is a clinical emergency. Whilst they tend to stop by themselves, to prevent further damage anticonvulsants should be given. Which of the following anticonvulsants should be given in an acute situation such as this?

Select one of the following:

Phenytoin
Lamotrigine
Sodium Valproate
Carbamazepine

Explanation

Question 18 of 29

1

A patient in status epilepticus is considered an emergency case. Therefore, urgent blood tests and CT to identify the cause are required.

Select one of the following:

True
False

Explanation

Question 19 of 29

1

What means of investigation is used to differentiate generalised from focal epilepsy?

Select one of the following:

Electroencephalogram (EEG)
Electrocardiogram (ECG)
Electroneurogram (ENG)
Electrical Seizure Test (EST)

Explanation

Question 20 of 29

1

Women on anti-convulsants seeking the contraceptive pill should not use the ❌ and should instead be switched to the ❌

Drag and drop to complete the text.

combined pill (estrogen + progesterone)

progesterone only pill

Explanation

Question 21 of 29

1

The morning after pill is more effective in women taking anti-convulsants and the dose should be titred down accordingly.

Select one of the following:

True
False

Explanation

Question 22 of 29

1

Fill the blank space to complete the text.

Which anti-convulsant can be given to patients who are obese/have sleep problems due to its weight reducing and sedative effects?

Explanation

Question 23 of 29

1

Carbamazepine typically makes Primary Generalised Epilepsy worse

Select one of the following:

True
False

Explanation

Question 24 of 29

1

Fill the blank spaces to complete the text.

In the case of Status Epilepticus, patients are generally given benzodiazepines first line to attempt to halt the seizures. Such medications include IV , Buccal and Rectal .
If benzodiazepines fail to halt the seizures, then the anti-convulsant called should be given IV.

Explanation

Question 25 of 29

1

Which type of seizure typically causes the patient to experience odd smells?
e.g. every time they drive they experience a "metallic smell"

Select one of the following:

Focal Seizure
Generalised Seizure

Explanation

Question 26 of 29

1

Is an absence feature focal or generalised?

Select one of the following:

Focal Seizure
Generalised Seizure

Explanation

Question 27 of 29

1

Fill the blank space to complete the text.

Following a seizure patients typically enter what is known as a state where they feel drowsy and tired for around 15 minutes before they are back to feeling normal again.

Explanation

Question 28 of 29

1

Which of the following anticonvulsants is known to induce alopecia?

Select one of the following:

Sodium Valproate
Lamotrigine
Carbamazepine
Phenytoin

Explanation

Question 29 of 29

1

	Created by Matthew Coulson over 6 years ago

Epilepsy given on 14th September 2018

Question 1 of 29

Fill the blank space to complete the text.

A seizure whereby there is rapid contraction and relaxation of muscles causing an uncontrollable shaking of the body is called a seizure.

Explanation

Question 2 of 29

❌ affect both brain hemispheres ❌ affect only one brain hemisphere

Drag and drop to complete the text.

Explanation

Question 3 of 29

Drag and drop to complete the text.

Explanation

Question 4 of 29

During tonic-clonic seizures, bites to which part of the tongue are more common?

Select one of the following:

Explanation

Question 5 of 29

If a patient presents after a fall/seizure, it is mandatory to rule out a cardiovascular cause via which investigation?

Select one of the following:

Explanation

Question 6 of 29

DVLA Rules Regarding Seizures - car: You’ve had a one-off seizure while awake and lost consciousness:

Select one of the following:

Explanation

Question 7 of 29

DVLA Rules Regarding Seizures - HGV: You’ve had a one-off seizure while awake and lost consciousness:

Select one of the following:

Explanation

Question 8 of 29

DVLA Rules Regarding Seizures - car: Diagnosed with epilepsy:

Select one of the following:

Explanation

Question 9 of 29

DVLA Rules Regarding Seizures - HGV: Diagnosed with epilepsy:

Select one of the following:

Explanation

Question 10 of 29

Primary Generalised Epilepsy often presents ...

Select one of the following:

Explanation

Question 11 of 29

Fill the blank space to complete the text.

The treatment of choice for primary generalised epilepsy is

Explanation

Question 12 of 29

If a primary generalised epilepsy patient is unresponsive to Sodium Valproate, which of the following second line treatments is most common?

Select one of the following:

Explanation

Question 13 of 29

Due to the adverse side effects, sodium valproate is not recommended for focal onset epilepsy. Instead, what is the first line treatment for this condition?

Select one of the following:

Explanation

Question 14 of 29

Sodium Valproate is teratogenic and should not be prescribed to pregnant women

Select one of the following:

Explanation

Question 15 of 29

Select one of the following:

Explanation

Question 16 of 29

What is status epilepticus?

Select one of the following:

Explanation

Question 17 of 29

Status Epilepticus is a clinical emergency. Whilst they tend to stop by themselves, to prevent further damage anticonvulsants should be given. Which of the following anticonvulsants should be given in an acute situation such as this?

Select one of the following:

Explanation

Question 18 of 29

A patient in status epilepticus is considered an emergency case. Therefore, urgent blood tests and CT to identify the cause are required.

Select one of the following:

Explanation

Question 19 of 29

What means of investigation is used to differentiate generalised from focal epilepsy?

Select one of the following:

Explanation

Question 20 of 29

Women on anti-convulsants seeking the contraceptive pill should not use the ❌ and should instead be switched to the ❌

Drag and drop to complete the text.

Explanation

❌ affect both brain hemispheres
❌ affect only one brain hemisphere

DVLA Rules Regarding Seizures - car:

You’ve had a one-off seizure while awake and lost consciousness:

DVLA Rules Regarding Seizures - HGV:

You’ve had a one-off seizure while awake and lost consciousness:

DVLA Rules Regarding Seizures - car:

Diagnosed with epilepsy:

DVLA Rules Regarding Seizures - HGV:

Diagnosed with epilepsy:

In the case of Status Epilepticus, patients are generally given benzodiazepines first line to attempt to halt the seizures. Such medications include IV , Buccal and Rectal .
If benzodiazepines fail to halt the seizures, then the anti-convulsant called should be given IV.

Which type of seizure typically causes the patient to experience odd smells?
e.g. every time they drive they experience a "metallic smell"