epilepsie

Question 1

inhibition

Answer 1

GABA

Question 2

exitation

Answer 2

glutamaat

Question 3

refractory epilepsy

Answer 3

30% wordt therapie-resistent

Question 4

absence

Answer 4

afwezig zijn

Question 5

myoclonic

Answer 5

korte schok

Question 6

clonic

Answer 6

schokken van de spieren in de armen of benen

Question 7

tonic

Answer 7

opspannen

Question 8

atonic

Answer 8

verlies van tonus, in elkaar zakken

Question 9

status epilepticus

Answer 9

langer dan 5 min
medisch noodgeval
benzodiazepines geven (stimuleert GABA)

Question 10

West syndrome

Answer 10

• onset 4-10 maanden
• infantiele spasmes: flexor/ extensor
• spams followed by behavioral arrest/ regression
• occur in cluster
• developmental arrest/ regression
• behandeling: steroïden en vigabatrin

Question 11

encefalopathieën

Answer 11

epileptische activiteit verstoort de hersenontwikkeling (tussen de aanvallen door) –> negatieve invloed op cognitieve ontwikkeling
- West
- Lennox-Gastaut
- Landau-Kleffner

Question 12

Lennox Gastaut syndroom

Answer 12

• Multiple seizure types: tonic, atypical absence, atonic, non-convulsive status, myoclonus
  – Diffuse slowing
  – Slow - spike wave at <2.5Hz
  – bursts of fast rhythms at 10 to12 hertz during sleep – Tonic seizures seen on sleep EEG
• Pharmaco-resistant
• weinigen maken remissie door
• risico op vallen en kwetsuren

Question 13

Landau-Kleffner

Answer 13

• Normal early development and language
• Onset before 6 years
• Auditory agnosia
• Cognitive/behaviour/motor problems
• Seizures in 75%, but may be infrequent
• Epileptogenic activity affecting speech cortex
• Posterior temporal foci
• Seizures remit by 13-15 years of age in most
• Outcome for language less good:
  10-20% acquire normal language
• Medical treatment- steroids, sodium valproate, ethosuximide, clobazam
• Surgical treatment-multiple subpial transections

Question 14

Childhood absence epilepsy

Answer 14

• onset 4-8 jaar
• meer bij meisjes
• normaal intellect
• gegeneraliseerd
• goede prognose

Question 15

Benign Epilepsy with Centrotemporal Spikes

Answer 15

• 5-10 jaar
• aanvallen tijdens slaap
• rolandisch
• behandelen of niet behandelen

Question 16

epilepsy and cerebral palsy ‘symptomatic’

Answer 16

More frequent in
– Bilateral spastic and dyskinetic type
– In children with accompanying impairments

Question 17

onderliggende etiologie

Answer 17

• Structurele afwijkingen thv hersenen: corticale malformaties en verworven hersenletsels
• Genetische oorzaken
• Stofwisselingsziekten
• Immunologische/infectieuse oorzaken
• Ongekend

Question 18

EEG

Answer 18

• Measures electrical activity in the brain
• Abnormal electrical discharges, localisation
• Helpful in diagnosis of epilepsy syndrome

Question 19

refractory epilepsy

Answer 19

After failure of 2 appropriate drugs
30%

Question 20

Sturge-Weber

Answer 20

Port-wine stain of the face
Mild hemiplegia right-sided
Suspicion of hemianopsia
Hemispherotomy: hersenhelften loskoppelen

Question 21

factors associated with worse outcome

Answer 21

• Early onset of epilepsy
• Epilepetic encephalopathy eg Lennox-Gastaut
• Symptomatic epilepsy eg CP

Question 22

VB

Answer 22

• lower IQ
• normal IQ with learning disabilities
  -specific processes: working memory, processing speed

Question 22

Risk factor ASD

Answer 22

ID, early onset of seizures, sever seizure type IS