Disease, Cognition, Aging Flashcards
1
Q
Non-Inflicted Brain Injury
A
- Seizure Activity
- Infection – Viral, Bacterial, Parasitic
- Inflammatory – Auto-immune
- Neoplasms - Cancer
- damage can lead to lasting impairment b/c brain regenerates VERY slowly if at all
2
Q
Seizures and cause
A
=Uncontrolled extra electrical activity in the brain causing a paroxysm (sudden attack)
be caused by any brain insult
- most seizure/epileptic disorders are Idiopathic – Cause is unknown
- rest are a combo of:
Genetic (though unknown mechanism)
Hypoxia
Infection
TBI
Neoplasms
3
Q
Types of Seizures
A
-
Generalized Seizure
* electrical activity in deep cortical structures (thalamus)–> spreads throughout the brain. - Simple-Partial
- start in cortical area, don’t spread through brain (Localized). 2/3 of seizures
- no Alteration of Consciousness
-
Complex-Partial
* Alteration of Consciousness (Usually either losing consciousness, or losing responsiveness) 2/3
Seizure activity=ictal activity
4
Q
Absence (petit mal)
A
- 5-30 seconds of unresponsiveness,
- secession of activity
- loss of awareness
- generalized
5
Q
Tonic-Clonic (grand mal)
A
- Stiffening of body followed by clonic muscle jerks.
- associated with incontinence and followed by post-ictal sleep.
- “Classic” seizure, not necessarily dangerous if rare and individual is cared for during seizure
- bad prognosis if repetitive and long (>5 minutes)
- generalized
6
Q
Simple Partial
A
- no loss or alteration of consciousness (aware of seizure)
- Tactile hallucinations (sensory symptom)
- Olfactory hallucinations (usually unpleasant)
- Intense feelings – fear, euphoria, deja or jamais vu (psychic symptom)
- Myclonus (usually unilateral bc localized)
- Dysphasia or schizophasia (psychic)
Sweating, horripilation, hyperventilation (autonomic)
7
Q
Complex Partial
A
- loss of awareness/consciousness
- Similar symptoms:
- Automatisms – random, purposeless movements
- Individual usually does not remember the seizure, and is tired afterwards
8
Q
Aura
A
If a Partial seizure (esp simple one) turns into Generalized seizure, the partial symptoms are called the Aura, much like the aura before a migraine
9
Q
Temporal Lobe Epilepsy
A
- Most common form of epilepsy
- most resistant to meds (surgery)
- simple-to-complex partial seizure,
- olfactory hallucinations, intense psychic sensations (religious hallucinations and delusions), then period of altered consciousness, occasionally with tonic-clonic seizure
- Seizure starts in (and is usually limited to) either the hippocampus or the temporal cortex
10
Q
Seizure Sequelae
A
- TLE associated with increasing memory and attention deficits
- Seizure while doing attention required activity (driving)
- Inc freq + severity of seizures predict inc neural damage and impairment, more seizures
11
Q
Status Epilepticus
A
- seizure activity lasting >30 minutes.
- medical emergency with a 20% mortality rate.
- Associated with epilepsy, stroke, TBI, drug withdrawal or overdose, high fever, or poor compliance with seizure medication
12
Q
Seizure Dx
A
- MRI and CT particularly for TLE, bc possibility of identifying hippocampal atrophy
- observation and EEG.
- Types of seizures have specific look.
- EEGs used to Dx area of brain seizure activity, type of seizure, and differentially diagnose absence seizures from things like daydreaming or ADHD.
13
Q
Seizure Tx
A
Acute
- injection of a CNS depressant, typically benzodiazepine (Valium) or barbituate (phenobarbital), + anti-convulsant
Long-term/prophylactic treatment
anti-convulsants
- lots of neurological side effects
- Easy to OD
- Dosage carefully monitored
- Avoiding Seizure triggers
- Nerve Stimulation – under trial (vagus and DBS)
14
Q
Surgery for Seizure & Prog
A
Partial:
- Attempt to locate area of seizure activity using CT, MRI, Angio, and EEG
- Do Wada test to make sure you won’t affect dominant brain hemisphere
- Cut it out (often the hippocampus in TLE)
General:
- Cut corp cal – seizure cannot generalize to other half of the brain
- Lobectomy/Hemispherectomy – very rare, but still used if no other recourse danger of mortality
Prog good esp if young (flexibility)
15
Q
Multiple Sclerosis (MS)
A
- Neurodegenerative disease
- demyelinating autoimmune disorder,
- inflammation of the brain cause immune functions to kill oligodentrocytes (the cells that make myelin)
- Females more likely
- Symptoms include weakness and incontinence.
- “flare-up,” then remit (each flare-up getting worse)
- Etiology is unknown
25
Q
Causes for Age-Related Cognitive Impairment
A
- Brain cells do not replace themselves at the rate that others do. When brain cells die, many are never replaced. Result is evident as enhanced sulci.
- Normal” Brain Injury – cognitive decline is gradual/continuous from ~25 on. Alcohol, drugs, environmental toxins, brain injury, fevers, infections, all slowly affecting brain functioning, (particularly gray matter)
- Result: cortical enhancement
