Epilepsy Flashcards

1
Q

What is Epilepsy ?

A

Epilepsy is a chronic condition of repeated seizures

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2
Q

What are Seizures ?

A

Seizures are abnormal, excessive or synchronous neuronal activity in the brain

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3
Q

Difference between seizures and epilepsy ?

A

Seizures are the event (or symptom), epilepsy is the disorder

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4
Q

What is Status epilepticus?

A

Status epilepticus is a prolonged seizure or when seizures recur frequently enough to prevent recovery between episodes (duration 20-30 minutes) – a medical emergency

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5
Q

What is the fraction of people with epilepsy that have a family member with it?

A

Around 1/3 people

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6
Q

70 % of epilepsy cases arise due to ?

A

Genetic factors but often with complex inheritance

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7
Q

Only 1 % of all epilepsy cases are ?

A

Single-gene epilepsies (with simple genetic inheritance)

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8
Q

The remaining 30% of epilepsy cases are due to?

A
  • Injury
  • Stroke
  • Tumor
  • Birth defects
  • Infection and autoimmune diseases
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9
Q

Examples of epilepsy syndromes ?

A
  • Dravet syndrome
  • Benign Rolandic Epilepsy (i.e. w/ centrotemporal spikes)
  • Landau Kleffner syndrome (LKS)
  • Rasmussen’s syndrome
  • West syndrome
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10
Q

What could be triggers of seizures ?

A
  • Lack of sleep
  • Drugs/alcohol
  • Missing meals
  • Fever
  • Not taking medications
  • Flashing lights
  • Stress
  • Monthly periods
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11
Q

What seizure types are not considered part of epilepsy according to the International
League against Epilepsy (ILAE)?

A
  • Febrile seizures (0.5 – 6 years old)
  • Alcohol-withdrawal seziures
  • Metabolic seizures (e.g. glucose)
  • Toxic seizures (e.g. drug withdrawal)
  • Convulsive syncope
  • Acute concussive convulsion
  • Seizures within first week after brain trauma, infection or stroke
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12
Q

What is Electroencephalography (EGG) ?

A

An EEG is a test that detects abnormalities in your brain waves, or in the electrical activity of your brain

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13
Q

Explain the seizure type - Partial ?

A
  • Simple – patient remains
    conscious. Also known as ‘auras’
  • Complex – patient has impaired consciousness
    if the seizure spreads to the
    reticular formation (in the brainstem)
  • Partial seizures are also known as focal seizures
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14
Q

Explain the seizure type - Generalised (tonic-clonic) ?

A
  1. Normal record
  2. Tonic (contractions; lose
    consciousness)
  3. Clonic (jerks)
  4. Coma
    - Lasts 3-5 min
    - Also known as grand mal seizures
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15
Q

Explain the seizure type - Generalised (absence) ?

A
  1. Occur in children
  2. Patient stops, stares
    and is unaware; no
    motor disturbance
  3. Rhythmic discharge;
    Spike-and-wave
    - Also known as petit mal seizures
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16
Q

What are some other generalised seizures ?

A

Myotonic seizures and atonic (or drop) seizures

17
Q

Types of wave on a normal EEG ?

A
  • Delta waves (0.5–4 Hz). Sleep and in children < 1 year old.
  • Theta waves (4–7 Hz). Sleep and in young children.
  • Alpha waves (8–13 Hz): Awake relaxation w/eyes closed
  • Beta waves (13–30 Hz). Conscious thought (frontal lobes)
  • Gamma waves (30–100 Hz). Working memory and attention
18
Q

What is the typical amplitude ?

A

About 25–100 mV

19
Q

As neuronal ensembles become more synchronised, voltage changes in the
EEG become ?

A

Larger and prominent over normal EEG waves

20
Q

What are sudden changes in activity referred to as ?

A

Paroxysmal activity

21
Q

Briefly explain abnormal waves on an EEG ?

A
  • Sharp waves: Last 80-200 milliseconds.
  • Spikes: very large, fast waves. Last < 80 ms.
  • Spike & wave: >1 brief spikes followed by a slow wave (3 Hz) - typical of absence seizures
  • Polyspikes: burst of spikes
  • Polyspike & waves
22
Q

What does Ictal activity refer to ?

A
  • Ictal refers to a sudden physiological attack (e.g. stroke, seizure, headache)
  • In the context of epilepsy, ictal refers to the seizure event.
23
Q

During the interictal period abnormal activity is confined to the seizure focus by?

A

Inhibitory surround, but this breaks down and/or is overcome at the onset of a focal seizure, leading to synchronisation

24
Q

Explain seizure spread in a partial seizure ?

A

Spread locally via:

  1. Intrahemispheric fibres
  2. Corpus callosum
  3. Subcortical centers
25
Q

Explain seizure spread in a generalised seizure ?

A

Spread locally via:

- Thalamus