Epilepsy

Question 1

Define epilepsy

Answer 1

A conditions where a person is subject to recurrent seizures
At least 2 unprovoked seizures occurring more than 25 hours apart

Question 2

Factors predisposing a person to recurrent seizures x5

Answer 2

1. Focal seizures
2. Neurological deficits
3. Mental retardation
4. Structural brain disease
5. Psychiatric and behavioral disorders

Question 3

Define a seizure

Answer 3

Paroxysmal hypersynchronous discharge of cerebral cortical neurones without inhibition

Question 4

When is epilepsy considered to have resolved

Answer 4

Seizure free for more than 10 years, with no medication for the past 5 years

Question 5

Differential diagnosis for epilepsy x5

Answer 5

1. Syncope
2. Pseudo seizures
3. Metabolic disturbances
4. Cardiac arrhythmias
5. Mental disturbances

Question 6

Treatment of seizures- 1st and 2nd line

Answer 6

1st- carbamazepine, Na valproate
2nd- Levetiracetum, Pregabaline

Question 7

Non pharmacological treatment x2

Answer 7

1. Surgery to remove affected lobe
2. Neuro-stimulation- vagus nerve, deep brain

Question 8

Triad of partial seizures

Answer 8

1. Aura
2. Automatisms
3. Post ictal confusion

Question 9

3 methods involved in pathogenesis of epilepsy

Answer 9

1. Excessive excitability of neurons > hypersynchrony
2. Cellular processes - altered activity of voltage gated channels > altered resting potential
3. Increased central role of excitatory neurotransmitter

Question 10

Infective cause of focal lesions x5

Answer 10

1. TB
2. Brain abscess
3. Toxoplasmosis
4. Neurocysticercosis
5. Progressive multifocal leukoencephalopathy