ch. 10: epilepsy

Question 1

What are convulsions?

Answer 1

Sudden, violent, irregular muscle contractions; a symptom of some seizures.

Question 2

What are seizures?

Answer 2

Uncontrolled electrical disturbance in the brain; may or may not cause convulsions.

Question 3

What is epilepsy?

Answer 3

Neurological disorder characterized by recurrent, unprovoked seizures.

Question 4

A 17-year-old male has a second seizure, both associated with methamphetamine use. Does he have epilepsy?

Answer 4

No. He has recurrent seizures, but they are provoked by drug use, not unprovoked, so it is not epilepsy.

Question 5

How reliable is lateral tongue biting as an indicator of seizure activity?

Answer 5

Sensitivity: 24%, Specificity: 99%. Lateral tongue biting is highly specific (99% of non-seizure individuals do not experience it), but not very sensitive.

Question 6

Name some risk factors for seizure activity.

Answer 6

• Subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, CNS infections, traumatic brain injury
• Medication, illicit drugs, metabolic/electrolyte disorders

Question 7

What factors can lower seizure thresholds and trigger seizures?

Answer 7

• Lack of sleep
• Stress
• Menstrual cycle
• Other external triggers

Question 8

A 17-year-old male has his second seizure, unrelated to drug use. MRI is normal, but EEG is abnormal. Does he have epilepsy?

Answer 8

Yes. Recurrent, unprovoked seizures and abnormal EEG suggest epilepsy.

Question 9

What are the three main classifications of epilepsy?

Answer 9

• partial (focal)
• generalized
• mixed

Question 10

Partial (focal) epilepsy

Answer 10

Structural cause, localized, may need surgery

Question 11

Generalized epilepsy

Answer 11

Ion-channel/metabolic cause, affects whole brain

Question 12

Mixed epilepsy

Answer 12

Starts focal, then spreads

Question 13

What are the major types of epileptic seizures?

Answer 13

• Generalized tonic-clonic seizure: Stiffening (tonic) → Jerking (clonic)
• Atonic seizure: Sudden loss of muscle tone
• Myoclonic seizure: Brief jerking
• Tonic seizure: Stiffening
• Clonic seizure: Jerking
• Absence seizure: Brief loss of consciousness, blank stare

Question 14

What distinguishes simple vs. complex focal seizures?

Answer 14

• Simple: Consciousness not affected
• Complex: Altered awareness, zoning out, odd behaviors

Question 15

What is unique about temporal lobe epilepsy (TLE)?

Answer 15

• Most common focal seizure
• Associated with experiential hallucinations (déjà vu, jamais vu, out-of-body experiences)
• Personality traits: paranoia, hyper-morality, religiosity, obsession, guilt

Question 16

What are the phases of a temporal lobe seizure?

Answer 16

1. Pre-ictal phase: Prodrome (hours to days before) & aura (seconds before)
2. Ictal phase: Seizure event (1-2 minutes)
3. Post-ictal phase: After seizure (1-30 minutes), confusion and fatigue

Question 17

What are the main causes of epilepsy?

Answer 17

• Structural (brain lesions, injury)
• Genetic
• Metabolic (not epilepsy but can cause seizures)
• Infectious (not epilepsy but can cause seizures)
• Immune-related
• Unknown causes

Question 18

What is the “river of epilepsy” concept?

Answer 18

Epilepsy results from a mix of genetic and acquired factors:
- Micro: Synaptic and ion channel changes
- Meso: Cell birth/death, neural sprouting
- Macro: Previous seizures, trauma, stroke, tumors

Question 19

What are the primary goals of epilepsy treatment?

Answer 19

1. Significant seizure reduction
2. Seizure freedom
3. Minimal side effects
4. Improved quality of life

Question 20

How does neuropsychology contribute to epilepsy management?

Answer 20

It helps localize affected brain areas but is not typically used for diagnosis.