Chap 16 Epilepsy & Seizure Disorders

Question 1

Common age of onset seizures?

Answer 1

Childhood (2/3 of cases) ; >60 years old (p 318)

Question 2

Term “Seizure”?

Answer 2

All paroxysmal electrical discharges of the brain (p 318)

Question 3

Secondary damage caused by seizures?

Answer 3

Excitotoxicity, prolonged tonic seizures, systemic hypoxia (p319)

Question 4

ILEA is based on…

Answer 4

clinical form & EEG features

Question 5

Primary generalized epilepsies is characterised by

Answer 5

1. age-dependent phenotypes
2. EEG: 2.5-4 Hz bifrontal predominant spikes, poly-spikes, and slow wave discharges (in a normal background)
3. WITHOUT structural abnormalities USUALLY genetic
4. NORMAL intelligence

Question 6

Etiologies of secondary generalised seizure:

Answer 6

1. Acquired (post-stroke, post-infectious, trauma)
2. CONGENITAL
3. METABOLIC

Question 7

Common focal seizure patterns

Answer 7

Clinical type: Localization
Somatic motor
>Jacksonian (focal motor) : Prerolandic gyrus
>Masticatory, salivation, speech arrest : Amygdaloid nuclei, opercular
>Simple contraversive: Frontal
>Head and eye turning associated with arm movement or athetoid-dystonic postures : Supplementary motor cortex

Somatic and special sensory (auras)
> Somatosensory : Contralateral postrolandic
> Unformed images, lights, patterns: Occipital
Auditory : Heschl gyri
Vertiginous : Superior temporal
Olfactory : Mesial temporal
Gustatory : Insula
Visceral - autonomic : Insular-orbital-frontal cortex

Focal seizure with altered consciousness
> Formed hallucinations : Temporal neocortex or amygdaloid-hippocampal
> Illusions : -
> Dyscognitive experiences (deja vu, dreamy states,
depersonalization) : -
Affective states (fear, depression, or elation): Temporal
Automatism (ictal and postictal): Temporal & Frontal
Staring : Frontal cortex, amygdaloid-ltippocampal complex, reticularcortical system

Question 8

2010 Classification by Berg et al

Answer 8

Figure 16-1 (p320)

Question 9

Electroclinical syndromes

Answer 9

Figure 16-2 (p321) based on onset of age

Question 10

Phases of Generalized type of seizure

Answer 10

Tonic Phase
Clonic Phase
Post-ictal Phase