medical school mindmap

1. Epilepsy 2
optimal use of
investigations(core)
EEG studies
MRI
for partial(focal)epilepsy or suspected partial epilepsy
auxillary tests
e.g. ECG,tilt-table testing, lumbar
puncture if patient is obtunded and
suspected meningitis
what is adequate control of seizure?
pts and family usually the best
judge of adequacy of seizure
control
aim for no side effect
freedom from convulsions
and/or drop attacks maybe
worthwhile goal in some with
severe epilepsy syndromes
aetiology
witdrawing therapy
individualise/discuss
underlying epilepsy diagnosis?
are there troublesome side
effectsof therapy?
consequences of sezure
recurrence?
driving issues
try early in adolescence
the single seizure
look and define cause
driving issues
risk of recurrence
50%
decision to is individualised
is there underlying lesion on imaging
is there epileptogenic pattern on EEG
what are the potential consequences of
a further seizure
non-epileptic seizure
common in neurological practice
diff. to diagnose
no single feature is diagnostic
beware frontal lobe seizure
video EEG monitoring
a cry for hep-needs intervention
intratable epilepsy
continued seizure despite
treatmetn with two or more
appropriate AEDs at tolerated
and adequate doses
~10% chacne of remission with
next AED in this situation
consider epilepsy surgery if
partial epilepsy
management options
lifestyle/education
attention to other medical conditions
anti-epileptic drugs
treatment of co-morbidity e.g. depression
epilepsy surgery(honours)
for refractory partial epilepsy(most
commonly temporal)
consider early
evaluation
video EEG monitoring
epilepsy protocol MRI
neuropsychology
neuropsychiatry
functional imaging
vagal nerve stimulation
30-40% response: increases with time
AED burdernmaybe reducelater
ketogenic diet
- - Mindjet