Clinical Epileptology - Holtkamp Flashcards
Definition of epilepsy
brain disorder characterised by enduring predisposition to generate epileptic seizures
–> defined by recurrent unprovoked seizures
what is the ictal period? what is the inter-ictal period
- ictal period- during seizure
- inter-ictal period- between seizures
definition of epileptic seizure
proximal change in behaviour sue to synchronised, rhythmic firing of population of the CNS neurons
–> different behaviours/responses depending on where in the brain the seizure occurs
what is ictogenesis?
the process of induction, propagation, and termination of seizures against the background of an inter-ictal state in established epilepsy.
T/F-
seizures are self-terminating events, but the mechanisms of termination are not well understood
T
what are the levels of epilepsy?
- symptom - epileptic seizure (focal/generalised)
- syndrome - epileptic syndrome (focal/generalised)
- disease- epilepsy (symptomatic/idiopathic)
what are the subtypes of focal seizures and their prevalence?
- focal aware- preserved consciousness (15%)
- focal impaired awareness- impaired consciousness (35%)
- focal to bilateral tonic-clonic- loss of consciousness (25%)
what are the subtypes of generalised seizures and their characteristics?
- absent seizures- very short (<5 sec), onset in early childhood
- tonic - stiffness of arms
- tonic-clonic- alternation between jerking movements and stiffness of muscles
- atonic- loss of muscle tone
- myoclonic- jerking movements after waking up
- clonic - jerking movements
which of the following statements is/are correct?
a. focal seizures are much less common than generalised seizures
b. generalised seizures usually start childhood
c. most focal seizures originate in the temporal lobe
d. seizures originating in the occipital lobe usually result in language difficulties
e. any focal seizure can spread to both hemispheres and become bilateral
b, c, e
T/F-
generalised epilepsy cannot be detected in cMRI
T
types of structural epilepsy
- hippocampus sclerosis
- malformation of cortical development (MCD)
- vascular malformation
- postnatally acquired CNS lesions
what are the stages of cortical development and what may be the causes for MCD-epilepsy at each one of these stages?
- neuronal proliferation- cortical dysplasia with balloon cells; hemimegalencephalitis
- neuronal migration- heterotopias; lissencephaly
- cortical organisation- polymicrogyra; cortical dysplasia without balloon cells
what can be potential genetic causes for epilepsy?
- ion channel mutation (Na+, K+. Cl-..)
- receptor mutation (GABA, ACh)
- ion transporter mutation (Na+/K+-ATPase)
which of the following statements is/are correct?
a. idiopathic epilepsy is usually caused by a single gene mutation whereas symptomatic epilepsy is usually caused by a combination of genetic and environmental factors or brain trauma
b. idiopathic epilepsy is usually caused by a traumatic injury whereas symptomatic epilepsy is usually caused by a mutation
c. focal epilepsy is usually caused by head trauma whereas generalised epilepsy is usually cased by mutations
c
what is syncope? what is the difference between syncope and epileptic seizure?
- Syncope is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery
- duration: syncope- <30 s; epileptic seizure- 1-2 min
- recovery: syncope- <30 s; epileptic seizure- 5-45 min
- induction- syncope can be induced on purpose (pressing on abdomen); and is more common when standing up
