Epilepsy

Question 1

Prevalence of epilepsy in Canada

Answer 1

Epilepsy affects about 1% of the Canadian population and about 50 million persons worldwide

Question 2

About ___ of cases enter long-term remission with treatment

Answer 2

65-85%

Question 3

Causes of epilepsy

Answer 3

• May be genetic
• May be secondary to tumors, infection, head injury, lack of oxygen (for example, at birth), metabolic factors, alcohol abuse and stroke
• In >50% of cases, the cause is unknown

Question 4

Tonic

Answer 4

stiffening of muscles

Question 5

atonic

Answer 5

limp

Question 6

Clonic

Answer 6

repeated jerking movements

Question 7

Absence

Answer 7

interruption of consciousness, with blank stare, possibly with some motor symptoms

Question 8

What is the focal onset of seizure types

Answer 8

Focal onset

Motor Non-motor
Focal to bilateral tonic-clonic

Question 9

Motor symptoms

Answer 9

may be tonic, clonic or aclonic, or brief muscle twitching

Question 10

automatisms

Answer 10

like clapping or rubbing of hands, lipsmacking or chewing, pacing in circles

Question 11

Non-motor symptoms of seizures

Answer 11

changes in sensation, emotions, thinking or cognition, autonomic functions (such as gastrointestinal sensations, waves of heat or cold, goosebumps, heart racing, etc.), or lack of movement (behavior arrest).

Question 12

What do frontal lobe seizures generally do?

Answer 12

Cause loss of motor control and changes in behavior or change language expression

Question 13

What do Occipital lobe seizures generally do?

Answer 13

Multi shapes, loss of vision

Question 14

What do Parietal lobe seizures do?

Answer 14

Numbness or tingling

Question 15

What do Temporal lobe seizures do?

Answer 15

Odd smell tase buzzing or ringing in the ear

Question 16

Excessive Excitation What is a seizure?

Answer 16

• Inward sodium and calcium currents
• Excitatory neurotransmitters: glutamate , spartate

Question 17

Not enough inhibition What is a seizure?

Answer 17

• Inward chloride and outward potassium curents * Inhibitory neurotransmitters: GABA (A, B)

Question 18

Sodium channel blockers

Answer 18

They slow the rate of recovery so it extends the period of absolute refractive period.

Question 19

What are High-voltage activated calcium channel used for?

Answer 19

Focal seizures usually

Question 20

What are T-type slow calcium channels
used for?

Answer 20

Use for absence seizures

Question 21

Calcium channel blockers (Two types)

Answer 21

T-type slow calcium channels
High-voltage activated calcium channel
Focal seizures usually

Question 22

Drugs that inhibit glutamate receptors and SV2A

Answer 22

AMPA: glutamate receptor (excitatory), also ion channel for sodium and potassium

NMDA: glutamate receptor (excitatory), also ion channel for calcium, sodium and potassium

Question 23

Drugs that enhance GABA-mediated inhibition

Answer 23

Benzodiazepines (diazepam, lorazepam, midazolam, clonazepam), barbiturates (phenobarbital), vigabatrin

Question 24

What are myoclonus motor symptoms?

Answer 24

Brief muscle twitching common

Question 25

What is surround inhibition?

Answer 25

Gabaergic neurons block the signal to surrounding neurons so we don’t have massive movements (Moving a finger vs a hand)

Question 26

Sodium channel blockers work how?

Answer 26

They slow the rate of Sodium moving into the neuron