Ch 16: What is epilepsy Flashcards
Epilepsy: clinical picture
1/10 people get a seizure
<10, >65
four categories:
- altered consciousness
- involuntary movements
- perceptual or autonomous changes
- behavioral changes
tonic-clonic seizure
generalised attack
loses consciousness for a few minutes
tonic: contraction of all muscles (30 secs)
clonic: rhythmic contractions (spasms)
Partial epilepsy: types of causes
- idiopathic: no cause can be determined
- symptomatic: the cause is known (e.g. brain tumor)
- cryptogenic: there is a strong suspicion of a neurological cause based on the severity of the epilepsy, but for the time being at least it is impossible to establish this by means of a neurological examination
Epilepsy: pathophysiology
unclear
- dysfunctional ion channel in the cell membrane?
- imbalance in neurotransmitters?
Anti-epileptica
- inhibit exciting effect (glutamate)
- enhance inhibiting effect (GABA)
Refractory patients
Do not respond to anti-epileptica
Epilepsy: treatment
Lobotomy (focal)
Vagus nerve stimulation
Deep brain stimulation
Ketogenic diet
Ideopathic Epilepsy: neuropsychological consequences
less severe neuropsychological disorders
easier to treat
information processing low
Symptomatic epilepsies: neuropsychological consequences
memory disorders
Side effects of anti-epileptica
influence quality of life strongly
mild to severe side effects, particular attention to memory disorders and mental slowness
Psychiatric disorders in patients with epilepsy
more common than in healthy controls
involvement of amygdala + sensitivity of the temporal brain structures to seizures ==> anxiety disorders, depression, personality changes, psychoses
50% anxiety or depression
Epilepsy: psychosocial consequences
due to unpredictability of attacks
- low self-esteem
- low social support
- negative attitude towards epilepsy patients
- lower expectations of their own cognitive performance
