Epilepst Co-morbidities

Question 1

What may modulate depression in human TLE?

Answer 1

Chronic hippocampus hyperexcitability on the limbic network

Question 2

What is the possible mechanism of TLE induced depression?

Answer 2

Persistent hyperexcitability of hippocample neurons activating prefrontal regions that influence depression symptoms.

Question 3

What region of the prefrontal cortex is thought to have antidepressant effects?

Answer 3

Stimulation of the subgenual cingulate (Broadman area 25) has antidepressant effects.

Question 4

What is the most common serious psychosocial issue facing a person with epilepsy?

Answer 4

33% have experienced depression, often with anxiety symptoms

Question 5

The Americans with Disability Act of 1990 prohibits employers from discriminating based on disability. What are potential employers permitted to ask?

Answer 5

The ability to perform specific functions required for the job.

Question 6

Under the ADA act, what are employers not permitted to ask about?

Answer 6

1- if the person has a disability

2- asking this parties regarding applicant’s disability status

Question 7

Under the ADA, can the employer ask the person to describe or demonstrate how they would perform specific job duties.

Answer 7

1- Yes
2- can also ask if the employee can comply with an attendance policy
3- request to indicate any accommodations needed for pre-employment test

Question 8

Under the ADA can an employer offer an applicant a job on the condition of a medical exam?

Answer 8

Yes

Question 9

Under the ADA an employer can ask an employee once he has been offered a job any condition believed relevant to the ability to peer form the job.

Answer 9

Yes

Question 10

Under the ADA who can the the employer discuss confidential information?

Answer 10

A supervisor, medical departments, safety personnel, government officials who investigate complaints

Question 11

Under the ADA a conditional job offer be withdrawn due to:

Answer 11

Job related, employee safety, safety of others, or no reasonable accommodation available

Question 12

Under Title 1 of the ADA is limited to businesses of what size?

Answer 12

> 15

Question 13

What are the driving laws concerning driving non-commercial vehicles?

Answer 13

Varies from state to state.

Question 14

What are the most liberal laws concerning driving?

Answer 14

Leaving the decision up to the physician.

Question 15

Do most states require the physician to report seizures-?

Answer 15

No

Question 16

What is the concern of adult neurologist taking over care of young adults with pediatric onset epilepsies?

Answer 16

Insufficient information about past medical history received from pediatric neurologist and patient does not know his past medical history.

Question 17

In patients having SUDEP or near SUDEP experience had this common feature

Answer 17

A rapid pattern of breathing - over 15breaths per minute- occurring after a generalized convulsion. Often this is followed by cardiorespiratory dysfunction

Question 18

What is the the seizure type at highest risk for SUDEP?

Answer 18

Generalized tonic clones seizures

Question 19

What population of ethnic population has adverse effects to CBZ?

Answer 19

Han Chinese

Question 20

What is the approximate incidence of SUDEP?

Answer 20

1.16 - 1.6 deaths per 1000 people with epilepsy per year

Question 21

What is the most suggestive clinical finding atypical language dominance in patients with left hemispheric epilepsy?

Answer 21

Left-handed was

Question 22

What is the atypical language dominance in patients with left hemisphere epilepsy?

Answer 22

17-38% who underwent WADA testing

Question 23

What percentage of patients who are left-handed with left hemisphere epilepsy, who have atypical language dominance?

Answer 23

91% versus 31% of righted patients

Question 24

Is there a difference in atypical language dominance in age of onset in left hemisphere epilepsy?

Answer 24

Yes, atypical language dominance is seen in 51% in patients with onset under 14 years and 28% with later onset.

Question 25

In add on AED trials, the incidence of SUDEP in the placebo arm is altered compared to general epilepsy?

Answer 25

SUDEP was up to 7-fold higher in the placebo arm than those receiving drug.

Question 26

What is hypothesized to cause SUDEP?

Answer 26

Sympathies hyperactivation, parasympathetic suppression and parasympathic overdrive, abnormal heart rate variability, and respiratory suppression.

Question 27

What co-morbidity is associated with worse outcomes for both medical and surgical outcomes?

Answer 27

Depression

Question 28

What psychiatric condition is most predictive of PNES in veterans?

Answer 28

Post traumatic stress disorder