Epilepsy

Question 1

seizure

Answer 1

abnormal, paroxysmal changes in the electrical activity of the brain; they reflect large scale synchronous discharges of neuronal networks

Question 2

epileptogenesis

Answer 2

the process by which normal brain function progresses towards generation of abnormal electrical activity

Question 3

epilepsy

Answer 3

a neurological disorder that represents a brain state that supports recurrent, unprovoked seizures

Question 4

3 classifications of epilepsy

Answer 4

focal onset
generalised onset
unknown onset

Question 5

generalised onset seizures

Answer 5

affect both sides of the brain from the onset
cortical or subcortical.

Question 6

focal onset seizures

Answer 6

start in an area or network in one of the brain hemispheres
cortical or subcortical
remain localized or spread to large areas

Question 7

unknown onset seizures

Answer 7

beginning of seizure uncertain

Question 8

status epilepticus

Answer 8

life threatening form of epilepsy with seizures >5mins

Question 9

premonition

Answer 9

vague sense that a seizure is imminent

Question 10

pre tonic clonic phase

Answer 10

a few myoclonic jerks or brief clonic seizures

Question 11

tonic phase

Answer 11

tonic contraction of the axial musculature; upward eye deviation and pupillary dilatation; tonic contraction of the limbs; cyanosis; respiratory muscle contraction - “epileptic cry”; tonic contraction of jaw muscles

Question 12

clonic phase

Answer 12

jerks of increasing amplitude followed by relaxation

Question 13

postdictal period

Answer 13

generalized lethargy; decreased muscle tone, headaches, muscle soreness

Question 14

epilepsy diagnosis

Answer 14

2+ seizures >24hrs apart
witness accounts
EEG MRI fMRI PET MRS

Question 15

how is the hippocampus effected in temporal lobe epilepsy

Answer 15

reorganisation and loss of cells
sclerosis
distortion and compression of layers
gliosis
differential tract organisation

Question 16

what can cause formation of reverberant excitatory circuits

Answer 16

compensatory sprouting of mossy fibres of granule cells

Question 17

what can neurogenesis triggered by seizures lead to

Answer 17

aberrant circuits

Question 18

chandelier cells

Answer 18

GABAergic interneurons that control activity of cortical pyramidal cells

Question 19

do decreased or increased numbers of chandelier cells lead to abnormal excitatory activity

Answer 19

decreased

Question 20

secondary epilepsy causes

Answer 20

craniotomy
TBI
stroke
aneurism
brain tumour
CNS infection

Question 21

what neuronal mechanisms are linked to epilepsy

Answer 21

abnormal neuronal excitability
decreased neuronal inhibition
increased neuronal excitation

Question 22

2 major glutamate transporters on Glial cells

Answer 22

EAAT1 EAAT2

Question 23

factors in eliptogenesis

Answer 23

neuroinflammation
BBB breakdown
oxidative stress
gliosis
network and synaptic changes

Question 24

2 major signalling pathways that may be activated in epilepsy

Answer 24

mTOR pathway
REST pathway

Question 25

mTOR pathway role

Answer 25

regulates growth and homeostasis

Question 26

REST pathway role

Answer 26

negative regulation of many genes in CNS

Question 27

what cellular component issue is a major part of epilepsy

Answer 27

channelopathy

Question 28

epilepsy drugs mainly targeting sodium channels

Answer 28

phenytoin carbamazepine sodium valproate lamotrigine topiramate lacosamide zonisamide

Question 29

epilepsy drugs mainly targeting Ca channels

Answer 29

ethosuxinimide gabapentin

Question 30

which epilepsy drugs are teratogenic

Answer 30

phenytoin sodium valproate

Question 31

phamacokinetic order of phenytoin

Answer 31

0 order

Question 32

which epilepsy drugs induce liver enzyme production

Answer 32

phenytoin carbamazepine

Question 33

which antiepileptic drugs mainly targeting sodium channels also affect other channels

Answer 33

lamotrigine - calcium, inhibit glutamate release topiramate - augment GABAa receptors, inhibit glutamate AMPA signalling zonisamide - blocks calcium channels

Question 34

how does gabapentin affect GABA synthesis

Answer 34

increase

Question 35

how do gabapentin and pregabalin affect calcium channels

Answer 35

Target alpha2delta subunit to disrupt delivery of VG calcium channels to cell membrane

Question 36

benzodiazepines and barbituates MOA

Answer 36

GABAa positive allosteric modulator Ben incr opening freq Barb incr opening duration

Question 37

main action of levetiracetam

Answer 37

modulates NT release by binding to synaptic vesicle protein SV2A inhibiting presynaptic calcium channels

Question 38

tiagabine MOA

Answer 38

inhibits GABA reuptake by inhibiting GAT1 transporter

Question 39

vigabatrin MOA

Answer 39

inhibits GABA transaminase

Question 40

which receptors do perampanel and felbamate affect

Answer 40

perampanel - AMPA agonist felbamate - NMDA blocker

Question 41

what type of drug is clonazepam

Answer 41

benzodiazapine

Question 42

what type of drug phenobarbitone and stiripentol

Answer 42

barbituates - pheno Stiri is new drug w similar action to barbituates

Question 43

main drugs used for focal seizures

Answer 43

carbamazepine lamotrigine sodium valproate

Question 44

main drugs used for tonic clonic seizures

Answer 44

carbamazepine lamotrigine sodium valproate

Question 45

main drugs for absence seizures

Answer 45

ethosuximide sodium valproate

Question 46

main drugs for myoclonic seizures

Answer 46

sodium valproate clonazepam levetiracetam

Question 47

status elipticus treatment

Answer 47

IV lorazepam/diazepam

Question 48

surgeries for epilepsy treatment

Answer 48

lobe resection corpus callosotomy functional hemispherectomy

Question 49

which type of diet can be beneficial in epilepsy

Answer 49

ketogenic

Question 50

types of neuromodulation therapy that can help epilepsy

Answer 50

vagal nerve stimulation deep brain stimulation transcranial magnetic stimulation