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Neuroscience and NeuroAnatomy > 42 - Cerebral Cortex and Epilepsy > Flashcards

42 - Cerebral Cortex and Epilepsy Flashcards

1
Q

Grand Mal Seizure

A

Generalized Compulsive Seizure

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2
Q

Paleocortex

A

Hippocampus & Olfactory Regions

3 Layers

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3
Q

Neocortex

A

6 Layers

Majority of the cortex

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4
Q

Layers

A

Organize inputs of cortical neurons

Organize the outputs

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5
Q

Excitatory Neurons

A

Spiny

Glutamatergic

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6
Q

Inhibitory Neurons

A

Smooth or Sparesly Spiny
GABAergic (Glycinergic rare in neocortex)
Biophysical properties differ from excitatory cells

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7
Q

Pyramidal Neurons

A

Main excitatory neurons

Polarized (Apical dendrite extending to pial surface)
Large - Layers 3 & 5
Small - Layers 2, 3, 4 & 6
Long-range axons projecting to other cortical regions

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8
Q

Spiny Stellate Cells

A

Excitatory interneurons

Small
Multipolar
Layer 4
Axons usually project only to local cortical region

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9
Q

Basket Cells

A

Inhibitory interneurons

Layers 3 & 4

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10
Q

Chandelier Cells

A

Inhibitory interneurons
Layer 3
Synapse on axon initial segment of pyramidal cells

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11
Q

Double Bouquet Cells

A

Inhibitory Interneurons

Layers 2, 3 & 4

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12
Q

Three molecular markers that account for nearly all neocortical inhibitory cells

A

PV
SST
5HT3aR

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13
Q

Alpha Rhythm

A

The first wave observed

Most dominant rhythm in humans

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14
Q

Beta Rhythm

A

Higher frequencies

Signify alert, working, thinking

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15
Q

Theta Rhythm

A

Drowzy

Relaxed

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16
Q

Delta Rhythm

A

Sleeping

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17
Q

Factors influencing whether or not you can MEASURE cortical potentials with an EEG

A

Voltage of cortical discharge
Area of cortex involved in synchronous activity
Degree of synchrony

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18
Q

Complications in measuring an EEG

A

Complex geometry of brain & head
Emphasis on radially-orientated pyramidal neurons
Many cytoarchitectural differences reflected in cortical layering
Conductivity varies in different directions
Not all cells behave in the same manner

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19
Q

Normal

A

Excitation and inhibition balance each other out

20
Q

Seizure

A

Excitation outweighs inhibition

21
Q

Cellular changes contributing to seizure

A 
Membrane properties
Synaptic strength
Connectivity
Glia (ionic homeostasis, NT uptake)
Metaboloic changes
Cell death
Trauma, infection, dysplasia, infarcts
22
Q

Epilepsy

A

Not a single disorder, but a group
All contain seizures
Definition: >1 unprovoked seizure (3% of US population)
Some acquired
Some idiopathic
Genetic factors sometimes but not always
Seizure semiology is highly variable
Extent/duration vary
Different brain areas involved in different manifestations
Seizures are intermittent
Brain immaturity modifies clinical and EEG expressions of seizures

23
Q

Seizure

A

Paroxysmal change in behavior due to abnormal electrical brain activity
10% of the US population

24
Q

Interictal EEG abnormalities

A

Marker of seizure susceptibility

25
Q

Generalized onset seizures

A

Tonic-clonic (convulsive)
Absence (non-convulsive)
Myoclonic (muscle jerks, +/- loss of consciousness)

26
Q

Focal (partial) seizures

A

Simple partial seizures (no loss of consciousness)
Complex partial seizures (consciousness altered or lost)
Focal seizures with secondary generalization

27
Q

Focal epilepsy - Idiopathic

A

Benign focal epilepsy of childhood
Central midtemporal spikes (rolandic)
Occipital spikes

28
Q

Focal epilepsy - Symptomatic

A

Epilepsia partialis continua (Rasmussen’s Syndrome)
Temoral lobe epilepsy
AD frontal lobe epilepsy

29
Q

Generalized onset seizures - Idiopathic

A

Childhood absence epilepsy
Juvenile myoclonic epilepsy
Other generalized idiopathic epilepsies

30
Q

Generalized onset seizures - Symptomatic

A

West syndrome (infantile spasms)
Lennox-Gastaut syndrome
Landau Kleffner syndrome

31
Q

Interictal

A

Phenomenon happening between seizures
Spikes and hsarp waves (epileptiform discharges)
Focal vs. generalized
Sometimes multifocal

32
Q

Ictal

A

Seizures event, itself

33
Q

Cellular basis of EEG epileptiform discharges

A

Paroxysmal Depolarizing Shift (PDS)

34
Q

Interictal PDS

A

AMPA and NMDA excite
GABA inhibits

Excitatory signals are encased in an “inhibitory surround”
When this breaks down, we have an ictal event.

35
Q

Cortical Circuit

A

Excitatory input coupled to tandem inhibitory input.
There is also autoinhibition coupled to the nerve’s output
All this helps to refine the signal

36
Q

Cellular Events during a seizure

A

Tonic Phase:
AMPA and NMDA are ON ON ON ON ON ON ONNNNN
GABA is on.

Clonic Phase:
AMPA and GABA alternate which one is dominant
Leads to rhythmic bursts

37
Q

Untreated Recurrent Seizures

A

Hippocampal Sclerosis:
Granule Cell Layer ragged and deformed
Pyramidal cells missing

38
Q

Hippocampal Sclerosis

A

Profound loss of CA1 and CA3 pyramidal cells
Profound loss of neurons in the dentate hilus
Relative survival of CA2 pyramidal cells and dentate granule cells

39
Q

Untreated Recurrent Seizures - Cellular Effects

A

Cell death, initially selective
Synaptic reorganization
Structural remodeling
Neurogenesis (?!)
Changes in intrinsic protective or trophic mechanisms
Effects on future seizure susceptibility
Interference with normal neuronal development

40
Q

Untreated Recurrent Seizures - Outcomes

A 
Developmental delays (infancy & early childhood)
Failure to acquire interpersonal and vocational skills (adolescence and young adulthood)
Specific cognitive dysfunction
Memory deficits (temporal lobe epilepsy)
Language deficits (Landau-Kleffner syndrome)
Other cognitive defects (CSWS)
Psychiatric disturbances, especially depression
Higher mortality rate
41
Q

Absence Seizure

A

3Hz spike wave running through entire brain
Often misdiagnosed for ADD
Kid just zones out for a sec

42
Q

3 Key Elements of Thalamocortical Circuitry that contribute to an Absence Seizure

A

Reciprocal connectivity
Specific synaptic mechanisms
Intrinsic burst-firing capability in key neurons

43
Q

Thalamocortical Neurons

A

Relay neurons in the thalamus
Intertwined with reticular neurons
Low threshold Ca2+ channels
Burst when inhibited strongly

44
Q

Reticular Neurons

A

Inhibitory regulators of thalamocortical neurons

STRONG

45
Q

Epilepsy

A

IT IS A CHANNELOPATHY
Too much sodium influx
OR
Not enough potassium efflux

46
Q

Twins

A

Um not always paired with epilepsy
Maybe environment
Maybe de novo mutations

Neuroscience and NeuroAnatomy (41 decks)

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