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#passmed 2022 > 11: Levels of Consciousness & Epilepsy > Flashcards

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
Q

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

A

Short muscle twitches

26
Q

What are the features of an Absence Generalised Seizure (1 things)

A
  1. Lose and regain consciousness quickly (looks like person “spaced out” momentarily)

Like they were absent for a few seconds

27
Q

What are Status Epilepticus Seizures? (3 points)

A
  1. Seizures that last for 5 mins or more
  2. Usually Tonic - Clonic
  3. Medical Emergency (life threatening)
28
Q

What is the acute management of Status Epilepticus?

A

Benzodiazepines

29
Q

What is the long-term management of Epilepsy? (3 things)

A
  1. Daily medication
  2. Epilepsy surgery
  3. Nerve stimulation
30
Q

What are the Daily Medications in the long-term management of epilepsy?

A

Anticonvulsants (there is a wide variety of them acting on different parts of brain)

31
Q

What is Epilepsy Surgery?

A

Removing the cause of the seizure (e.g tumour)

32
Q

What is the Nerve Stimulation method of long-term management of epilepsy?

A

E.g stimulating vagus nerve → promotes neurotransmitter release

#passmed 2022 (27 decks)

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