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Pathophysiology: Part 2 > 6) Epilepsy > Flashcards

6) Epilepsy Flashcards

1
Q

What is epilepsy?

A

Chronic, CNS, neurological disorder causing recurrent seizures with no known causes.

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2
Q

What is the key difference between epilepsy and seizures?

A

A person must have two or more unprovoked seizures of unknown etiology to be epilepsy.

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3
Q

What are three diagnostic tests for epilepsy?

A

Brain imaging
Blood tests
Lumbar puncture

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4
Q

What would blood tests determine in regards to epilepsy?

A

It can check for infection, anemia or poisons that may have caused the seizure (secondary cause)

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5
Q

What are the four different types of brain scans that can be done for epilepsy diagnosing?

A

Electroencephalograph (EEG)
Computerized tomography (CT)
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)

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6
Q

This type of testing is noninvasive in locating the irregular cortical firing, which can help determine the severity and type of seizure

A

EEG

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7
Q

A balanced neuron has inhibitory signals (Cl-, GABA, and K+, leaving) affecting it in balance with excitatory signals (Na, Ca and glutamate). What occurs when these are no longer balanced with excitatory dominating?

A

Hyper excitability causing synchronization in the burst of action potentials from the cortical neuron clusters.

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8
Q

What causes an imbalanced neuron?

A

Defective voltage-gated ion channel allowing:
- Na and Ca excessive influx
- K insufficient effluent
-Cl insufficient influx
Excessive excitatory (glutamate and aspartate) and insufficient inhibitory (GABA)

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9
Q

The crying babies analogy refers to what in regards to propagation?

A

Excitability of the one recruits surrounding cortical neurons, causing them to lose surrounding inhibition.

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10
Q

What is the mechanism in how a seizure is terminated

A

No known mechanism

Spontaneous

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11
Q

What is an aura in relation to seizures?

A

Physiological warning signs of an approaching seizure

Ex) scents, anxiousness, déjà vu, fear

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12
Q

At the beginning of this type of seizure you will experience aura, followed by motor, sensory, autonomic or psychic symptoms with no loss in consciousness and a full memory of the occurrence.

A

Simple Partial Seizure.

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13
Q

Describe the symptoms during a simple partial seizure.

A

Motor: jerky movements, stiffness
Sensory: tingling, numbness
Autonomic: abdominal discomfort
Psychic: hallucination, fear, sadness

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14
Q

This type of seizure can start with an aura, but is followed by impaired consciousness involving automatisms like picking at clothes and mumbling.
It can progress to a general seizure and is followed by no memory of the event and tiredness

A

Complex partial

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15
Q

A partial seizure which progresses into a generalized seizure with tonic-clonic convulsions is called what?

A

Secondarily generalized

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16
Q

This type of seizure occurs more commonly in children with no aura and the child experiences a brief lapse of consciousness with prompt recovery.
This can occur several times throughout the day

A

Absence (Petit mal)

17
Q

This type of seizure has no warning signs and is characterized by loss of muscle tone and consciousness, with a regain in consciousness a few seconds later

A

Atonic

18
Q

This type of seizure has no warns and is characterized by muscle jerks and spasms with the consciousness and memory intact.

A

Myoclonic

19
Q

During this seizure, the body stiffens (tonic) and jerks (clonic) with epileptic crying and tongue biting
There is no recollection afterwards, just confusion and fatigue.

A

Tonic-Clonic (Grand mal)

20
Q

What is the name for a seizure that lasts a long time and may repeat without reccovering

A

Status epilepticus

21
Q

What can secondary seizures be triggered by?

A 
Head trauma
Stress
Lack of sleep
Drug use
Alcohol withdrawal
Disease/ infection
22
Q

Heavy consumption of alcohol does what to the seizure threshold?

A

It decreases it.

Chronic consumers can also experience seizures upon withdrawal

23
Q

Define a seizure.

A

Sudden excessive, electrical excitation in the cortical neurons creates a loss of awareness, consciousness, movement/sensation disturbances

24
Q

What is a febrile seizure and what causes it?

A

It is common in children, convulsions brought on by fever.

25
Q

Why are children not considered to have epilepsy?

A

Because recurring seizures can be brought on by fever.

26
Q

What are the treatment goals for epilepsy?

A

There is no cure.

The goal is to decrease the frequency and severity of the attacks.

27
Q

What are the four possible treatments for epilepsy?

A

Anti-epileptic drugs
Surgery
Vagal nerve stimulation
Ketogenic diet

28
Q

How does vagal nerve stimulation decrease the frequency and duration of seizures?

A

Brief jolts of electrical activity sent from an impulse generator implanted in the skin to the vagal nerve interrupt or prevent electrical disturbances in the brain.

29
Q

The ketone if diet is high in fat and low in carbs for children, how does this affect the body?

A

Tricks body in to thinking its starving and the body burns fat for energy instead of glucose.

30
Q

Hat are the three mechanisms of action for Anti-Epileptic Drugs (AEDs)

A

Modify voltage-gated ion channel
Increase GABA-mediated inhibitory neurotransmission
Decrease glutamate-mediated excitatory neurotransmission

31
Q

Name the two most common AED’s.

A

Voltage-gated Na channel blockers

Voltage-gated Ca channel blockers

32
Q

What are the two mechanisms that the enhancement of GABA activity acts through.

A

1) Activation of GABA receptors to enhance and prolong their response
2) Decrease GABA turnover by blocking their reuptake or reducing their metabolism

33
Q

What are 5 common side effects of AEDs?

A 
Drowsiness
Irritability
Nausea
Skin rash
Lack of coordination
34
Q

Surgery can involve resection(removal of brain piece) or disconnection and is considered when seizures are not responsive to pharmaceutical treatment. What is its two goals?

A

Maximize seizure control and minimize disruption of normal brain functioning.

35
Q

As seizures and AEDs can put both mother and fetus at risk, what is the solution?

A

Use lowest dose of medication (decrease toxicity to which fetus is exposed)

Pathophysiology: Part 2 (7 decks)

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