11: Levels of Consciousness & Epilepsy Flashcards

1
Q

What is the Reticular Activating System?

A

Set of connected nuclei in the brain responsible for regulating:

  • Wakefulness
  • Sleep-wake transitions
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2
Q

Where is the Reticular Activating System located?

A

Brainstem

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3
Q

What are the 2 groups of the Reticular Activating System?

A
  1. Ascending RAS
  2. Inhibitory Area
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4
Q

What does the Activating RAS do?

A

Activates the brain to attention

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5
Q

What does the Inhibitory of the RAS do?

A

Decreases activity of higher brain → alters levels of consciousness

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6
Q

How does the RAS act?

A

By releasing these neurotransmitters into the CSF:

  1. Ach
  2. Serotonin
  3. Dopamine
  4. Noradrenaline

Changes in the levels of these hormones is seen in changes in the conscious levels in the sleep / wake cycle

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7
Q

Other than normal sleep / wake cycle changes, what can changes in the RAS hormones indicate?

A

Different diseases e.g mood disorders / cognitive ability disorders (depression / schizophrenia)

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8
Q

What is Electroencephalography (EEG)

A

Measures the activity of the cortex (and hence hormone release)

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9
Q

What is the electrical activity of REM similar to?

A

Electrical activity of the awake brain

Picture: The black bit at peak of each curve is REM

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10
Q

What are the 4 types of EEG waves in the brain?

A
  1. Alpha = @ relaxed wakefulnes (awake but eyes closed)
  2. Beta = @ mental activity + attention
  3. Theta = @ drowsy state & 1st stage of sleep
  4. Delta = @ deep sleep
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11
Q

What does RAS (aka ascending arousal system) dysfunction lead to?

A

Impaired consciousness

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12
Q

What is epilepsy an umbrella term for?

A

Umbrella term for seizures / seizure syndromes

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13
Q

What is epilepsy?

A

Brain disorder characterised by:

Periodic unpredictable seizures

Caused by rhythmic firing of groups of neurones

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14
Q

What are the signs and symptoms of epilepsy? (3 things)

A
  1. Temporary confusion
  2. Uncontrolled jerking movements
  3. Loss of consciousness / awareness
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15
Q

What are the 3 types of seizures?

A
  1. Focal (Partial) Seizures
  2. Generalised Seizures
  3. Status Epilepticus
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16
Q

What is the difference between Focal (Partial) and Generalised Seizures?

A

Focal (Partial) = affects only one hemisphere / lobe of brain

Generalised = affects both hemispheres

Generaliseddd like affect whole brain in generallll

17
Q

What are the 2 types of Focal Seizure?

A
  1. Simple Partial
  2. Complex Partial
18
Q

What are the features of a Simple Partial Seizure? (5 things)

A
  1. Affects only small part of brain
  2. Patient remains conscious
  3. Patient experiences strange sensation (hearing / smelling something)
  4. Jerking movemenets
    * 5. Can develop into a Complex Partial Seizure*

Remember them from brain to consciousness down to ears and nose down to limbs

19
Q

What are the features of Complex Partial Seizures? (1 thing)

A
  1. Impaired consciousness / awareness
20
Q

What are the 6 types of Generalised Seizures?

A
  1. Tonic
  2. Atonic
  3. Clonic
  4. Tonic-Clonic
  5. Myoclonic
  6. Absence

TACTMA (like talk to me)

21
Q

What are the features of a Tonic Generalised Seizure? (2 things)

A
  1. Muscles → stiff / flexed
  2. Patient falls backwards
22
Q

What are the features of an Atonic Generalised Seizure? (2 things)

A
  1. Muscles → Relax / Floppy
  2. Patient falls forwards
23
Q

What are the features of a Clonic Generalised Seizure? (1 thing)

A

Violent muscle contractions (convulsions)

24
Q

What are the features of a Tonic-Clonic Generalised Seizure? (1 thing)

A

Period of tonic then clonic seizures

25
What are the features of a Myoclonic Generalised Seizure? (1 thing)
Short muscle twitches
26
What are the features of an Absence Generalised Seizure (1 things)
1. Lose and regain consciousness quickly (looks like person "spaced out" momentarily) Like they were absent for a few seconds
27
What are Status Epilepticus Seizures? (3 points)
1. Seizures that last for 5 mins or more 2. Usually Tonic - Clonic 3. Medical Emergency (life threatening)
28
What is the acute management of Status Epilepticus?
Benzodiazepines
29
What is the long-term management of Epilepsy? (3 things)
1. Daily medication 2. Epilepsy surgery 3. Nerve stimulation
30
What are the Daily Medications in the long-term management of epilepsy?
Anticonvulsants (there is a wide variety of them acting on different parts of brain)
31
What is Epilepsy Surgery?
Removing the cause of the seizure (e.g tumour)
32
What is the Nerve Stimulation method of long-term management of epilepsy?
E.g stimulating vagus nerve → promotes neurotransmitter release