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BB2 > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

seizure

A

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

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2
Q

epileptogenesis

A

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

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3
Q

epilepsy

A

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

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4
Q

3 classifications of epilepsy

A

focal onset
generalised onset
unknown onset

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5
Q

generalised onset seizures

A

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

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6
Q

focal onset seizures

A

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

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7
Q

unknown onset seizures

A

beginning of seizure uncertain

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8
Q

status epilepticus

A

life threatening form of epilepsy with seizures >5mins

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9
Q

premonition

A

vague sense that a seizure is imminent

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10
Q

pre tonic clonic phase

A

a few myoclonic jerks or brief clonic seizures

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11
Q

tonic phase

A

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

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12
Q

clonic phase

A

jerks of increasing amplitude followed by relaxation

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13
Q

postdictal period

A

generalized lethargy; decreased muscle tone, headaches, muscle soreness

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14
Q

epilepsy diagnosis

A

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

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15
Q

how is the hippocampus effected in temporal lobe epilepsy

A

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

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16
Q

what can cause formation of reverberant excitatory circuits

A

compensatory sprouting of mossy fibres of granule cells

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17
Q

what can neurogenesis triggered by seizures lead to

A

aberrant circuits

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18
Q

chandelier cells

A

GABAergic interneurons that control activity of cortical pyramidal cells

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19
Q

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

A

decreased

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20
Q

secondary epilepsy causes

A

craniotomy
TBI
stroke
aneurism
brain tumour
CNS infection

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21
Q

what neuronal mechanisms are linked to epilepsy

A

abnormal neuronal excitability
decreased neuronal inhibition
increased neuronal excitation

22
Q

2 major glutamate transporters on Glial cells

A

EAAT1 EAAT2

23
Q

factors in eliptogenesis

A

neuroinflammation
BBB breakdown
oxidative stress
gliosis
network and synaptic changes

24
Q

2 major signalling pathways that may be activated in epilepsy

A

mTOR pathway
REST pathway

25
Q

mTOR pathway role

A

regulates growth and homeostasis

26
Q

REST pathway role

A

negative regulation of many genes in CNS

27
Q

what cellular component issue is a major part of epilepsy

A

channelopathy

28
Q

epilepsy drugs mainly targeting sodium channels

A

phenytoin
carbamazepine
sodium valproate
lamotrigine
topiramate
lacosamide
zonisamide

29
Q

epilepsy drugs mainly targeting Ca channels

A

ethosuxinimide
gabapentin

30
Q

which epilepsy drugs are teratogenic

A

phenytoin
sodium valproate

31
Q

phamacokinetic order of phenytoin

A

0 order

32
Q

which epilepsy drugs induce liver enzyme production

A

phenytoin
carbamazepine

33
Q

which antiepileptic drugs mainly targeting sodium channels also affect other channels

A

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

34
Q

how does gabapentin affect GABA synthesis

A

increase

35
Q

how do gabapentin and pregabalin affect calcium channels

A

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

36
Q

benzodiazepines and barbituates MOA

A

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

37
Q

main action of levetiracetam

A

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

38
Q

tiagabine MOA

A

inhibits GABA reuptake by inhibiting GAT1 transporter

39
Q

vigabatrin MOA

A

inhibits GABA transaminase

40
Q

which receptors do perampanel and felbamate affect

A

perampanel - AMPA agonist
felbamate - NMDA blocker

41
Q

what type of drug is clonazepam

A

benzodiazapine

42
Q

what type of drug phenobarbitone and stiripentol

A

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

43
Q

main drugs used for focal seizures

A

carbamazepine
lamotrigine
sodium valproate

44
Q

main drugs used for tonic clonic seizures

A

carbamazepine
lamotrigine
sodium valproate

45
Q

main drugs for absence seizures

A

ethosuximide
sodium valproate

46
Q

main drugs for myoclonic seizures

A

sodium valproate
clonazepam
levetiracetam

47
Q

status elipticus treatment

A

IV lorazepam/diazepam

48
Q

surgeries for epilepsy treatment

A

lobe resection
corpus callosotomy
functional hemispherectomy

49
Q

which type of diet can be beneficial in epilepsy

A

ketogenic

50
Q

types of neuromodulation therapy that can help epilepsy

A

vagal nerve stimulation
deep brain stimulation
transcranial magnetic stimulation

BB2 (26 decks)

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