202 Symposia

Question 1

Define Epilepsy

Answer 1

Recurring, unprovoked (spontaneous seizures)

Question 2

What provokes acute symptomatic seizures?

Answer 2

acute insults such as stroke, alcohol withdrawal, metabolic disturbance

Question 3

What are the causes of epilepsy?

Answer 3

Ideopathic 61%, CVD 15%, Alcohol 7%, Tumour 6%, Post-traumatic 3%, Other 8%

Question 4

What are generalized onset seizure?

Answer 4

electrical discharges appear to start over the whole brain at the same time on EEG

Question 5

What are partial/focal onset seizures?

Answer 5

electrical discharge appears to start in one cortical region and then may remain localized or spread over the whole brain - secondary generalized

Question 6

Describe generalized seizures/

Answer 6

onset in childhood or adolescence
usually no focal symptoms/signs
often a number of seizure types cluster
a polygenic cause is presumed with no identifiable structural lesion on imaging
generalized (all leads) spike and wave discharges on EEG, photosensitivity may be present

Question 7

Define Juvenile Myoclonic epilepsy.

Answer 7

commonest form of primary generalized epilepsy 		
3-12% all epilepsy
juvenile onset, probably lifelong
early morning myoclonic jerks (ask)
photosensitive, sleep deprivation triggers
\+/- absences 
generalized tonic clonic seizures –
occur without warning

Question 8

Desrcibe Tonic Clonic “Grand Mal” Seizures.

Answer 8

Occurs without warning- risk of injury
1- tonic phase
continuous muscle spasm, fall, cyanosis, tongue biting, incontinence
2- clonic phase
rhythmic jerking slows and gets larger in amplitude as attack ends
3- post-ictal (post-seizure) phase
coma, drowsiness, confusion, headache
muscle aching

Question 9

Describe “Petit Mal” Seizures/Absences

Answer 9

abrupt
short, 5-20 seconds
multiple times/day, can lead to learning difficulties
unresponsive, amnesia for the gap, rapid recovery
tone preserved (or mildly reduced)
eyelid flickering
absences only, tend to remit in adulthood (childhood absence epilepsy)

Question 10

Describe “Petit Mal” Seizures/Absences

Answer 10

abrupt
short, 5-20 seconds
multiple times/day, can lead to learning difficulties
unresponsive, amnesia for the gap, rapid recovery
tone preserved (or mildly reduced)
eyelid flickering
absences only, tend to remit in adulthood (childhood absence epilepsy)

Question 11

Describe Absences/ Petit Mal on EEG

Answer 11

3Hz Spike and Wave