Epilepsy Flashcards
When was epilepsy first described?
In Babylon 1500 BCE
Was known as Miqtu (the falling sickness)
Who identified symptoms of epilepsy in 450-350 BCE?
Hippocrates
Who started a definition for epilepsy based on physiology?
Huhglings Jackson 1870
What did Hughlings Jackson identify in epilepsy?
He noticed the focal nature of it
& realised damage than area of the brain could cause epileptic seizures
Who was the first to record electrical activity on the scalp of epilepsy?
Hans Berger performed the first EEG in absence epilepsy 1931
What did Hans Berger notice in his EEG?
He noticed sudden changes in electrical rhythms in the brain
These would now be recognised as absence seizures
What did Wilder Penfield do to study epilepsy?
He used neurosurgery & brain stimulation to study epilepsy
What was a focus of Wilder Penfield’s studies & what did he discover
- He did lots of work on temporal lobe epilepsy
- He could stimulate temporal lobe & this could evoke memories in a patient (e.g. familiar memory to patient & they feel like they are apt to have an attack)
Define a seizure:
A transient occurence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain
Define epilepsy:
“A pathologic & during tendency to have recurrent seizures”
AND
“by the neuro-biologic, cognitive, psychological & social consequences of this condition”
What do all seizure types share?
Abnormal neuronal firing in a particular brain network which trigger clinical symptoms:
- May alter consciousness
- May have external signs
- Will often have an EEG signature
How do the types of seizures differ?
- Brain networks involved
- Signs & symptoms
- Causes
- Drug therapy (need to be specific to type of seizure)
- Prognosis (final outcome)
What are the 2 main types of seizures?
- Generalised seizures
- Focal seizures
What is a generalised seizure:
A seizure that starts simultaneously in both hemispheres
It spreads from there
What is a focal seizure:
Seizure starts in a focus (on one side of the brain) & then spreads across the brain
(Can spread from one hemisphere to another)
How can a focal onset seizure be classified?
- Does the patient have awareness?
- Is there motor onset or not?
- If it progresses from focal to bilateral tonic-clonic (not all will do this but it is good to classify with)
How can generalised onset seizures be classified?
Motor and non-motor symptoms
Is there tonic-clonic or other motor symptoms present
What is the definition of a generalised seizure?
“Originating at some point within, and rapidly engaging, bilaterally distributed networks”
What are the 3 types of generalised seizures?
- Typical absence
- Myoclonic
- Tonic-clonic
What is the usual onset of typical absence seizures?
Mainly childhood in onset
How long do typical absence seizures last?
Frequent brief attacks (1-30s)
(In video patient was briefly unaware w little face movements but quickly comes back around)
What happens during an typical absence seizure to the patient?
- Sudden loss & return of consciousness
- No aura (warning signs) & no post-ictal state (period after seizure where brain is recovering)
- Some involuntary movements
When an EEG is taken of an absence seizure, what does it look like?
There is a 3Hz spike and wave (electroclinical syndrome)
(Pretty sure this is seen at the start of the seizure)
What are the physical symptoms of a patient suffering a myoclonic seizure?
- Sudden, brief, shock-like muscle contractions
- Usually bilateral arm jerks (can also be legs)
