Epilepsy

Question 1

Describe the symptoms of an epileptic seizure?

Answer 1

paroxysmal, inappropriate, hypersynchronous, self-sustained neuronal network activity

Question 2

disease modifying epilepsy requires?

Answer 2

multifaceted approaches

Question 3

what is a partial/focal seizure?

Answer 3

seizure that arises in a limited number of cortical neurons within one hemisphere

Question 4

where in the world is there more cases of epilepsy?

Answer 4

developing countries

lowersocioeconomics

Question 5

consequences of epilepsy? 5 classes:

Answer 5

physical injury
psychiatric
social
medication side effects
mortality

Question 6

people with epilepsy mortality ratio?

Answer 6

3 to 1

Question 7

epilepsy is most common cause of death in who?

Answer 7

young people

sudden unexplained death in epilepsy

Question 8

ECG in epilepsy shows?

Answer 8

discharge loops, hyper synchronous

Question 9

how long do seizures normally last?

Answer 9

60-90 seconds

Question 10

epilepsy vs. seizures?

Answer 10

epilepsy means you’re more predisposed to seizures, having a seizure does not mean you have epilepsy

Question 11

3 main causes of epilepsy?

Answer 11

genetic
structural/metabolic
unknown

Question 12

what is a generalised seizure?

Answer 12

arises simultaneously in both hemispheres

Question 13

what kind of epilepsy is it where the underlying brain structure and function is normal? who normally get these.

Answer 13

genetic

usually kids

Question 14

Genetic epilepsy in kids, how to treat? what is the underlying problem likely?

Answer 14

1. respond well to meds

2. usually ion channel defect

Question 15

what kind of epilepsy can you get normally as you get older?

Answer 15

structural/metabolic

Question 16

structural/metabolic epilepsy course? treatment?

Answer 16

1. uncommonly remit

2. incompletely controlled with meds

Question 17

why important to get proper detailed epilepsy dx?

Answer 17

treatment options differ widely

Question 18

Thomas Willis postulated that epilepsy source was?

Answer 18

within the brain

Question 19

Hughlings Jackson said seizures result from?

Answer 19

focal grey matter pathology

Question 20

what would cause the uncontrolled firing of neurons in seizures?

Answer 20

no balance between inhibition and excitation of neurons and networks

Question 21

imbalance in neurons can be caused by what in the connections? 4 things:

Answer 21

1. aberrant sprouting
2. altered excitability
3. altered transmission
4. altered glial environment

Question 22

what is the most sensitive structure to induce seizures? where is it?

Answer 22

Hippocampus

medial temporal lobe structure

Question 23

what are the 4 main subregions of hippocampus?

Answer 23

dentate gyrus

CA 1,2,3

Question 24

Hippocampus is important in?

Answer 24

learning and memory

Question 25

Histopathology of epilepsy shows what? where?

Answer 25

1. Mesial Temporal sclerosis(MTS)

Question 26

Mesial Temporal sclerosis(MTS) consists of 3 features?

Answer 26

1. cell loss in CA1,3, dentate
2. mossy fibre sprouting
3. gliosis

Question 27

uncertain about the progression of seizures of epilepsies and if?

Answer 27

seizures beget seizures

Question 28

Age and epilepsy?

Answer 28

bimodal peak, increased risk young and elderly

Question 29

childhood onset of epilepsy most likely because of?

Answer 29

congenital/perinatal CNS insults

Question 30

reason for late childhood/early adulthood onset epilepsy?

Answer 30

idiopathic/genetic

Question 31

reason for adult/elderly epilepsy?

Answer 31

acquired/trauma/structural

Question 32

what increases you chances of having epilepsy 60x?

Answer 32

Alzheimer’s

Question 33

most ppl with idiopathic generalized epilepsies have?

Answer 33

genetic inheritance

Question 34

MRI epilepsy usually find focal lesions of what kind in epilepsy?

Answer 34

70% medically refractory

20% new onset seizures

Question 35

mesial temporal sclerosis means what for treatment?

Answer 35

drug resistance

Question 36

mesial temporal sclerosis good candidates for what treatment?

Answer 36

surgery

Question 37

mesial temporal sclerosis most common cause of?

Answer 37

adults with partial epilepsy

Question 38

2 most common cause of drug resistant epilepsy?

Answer 38

malformation of cortical development

Question 39

aetiology of focal cortical dysplasia?

Answer 39

unknown

Question 40

what is the condition of inherited generalized malformation due to abnormal neuronal migration causing epilepsy?

Answer 40

periventricular nodular heterotopia

Question 41

most common cause of new onset partial seizures?

Answer 41

low grade tumours

Question 42

most common type of low grade tumour causing epilepsy?

Answer 42

gliomas affecting cortial>subcortical

Question 43

10% of patients with drug resistant partial epilepsy have? what two major ones?

Answer 43

vascular lesions: blood in brain can cause seizures

1. cavernoma
2. ateriovenous malformations

Question 44

what is a cavernoma?

Answer 44

tangled mass of vessels slowing blood flow causing seizures

Question 45

anti-epileptic drugs treat what?

Answer 45

symptoms only not underlying condition

Question 46

how long take epilepsy drugs for?

Answer 46

years/lifetime

Question 47

3 non med epilepsy Rx?

Answer 47

surgery
neurostim
dietary

Question 48

when do epilepsy surgery?

Answer 48

focal localized drug-resistance epilepsy