Epilepsy Flashcards

1
Q

Where is the most common place for a structural lesion in drug resistant epilepsy?

A

Mesial temporal sclerosis

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2
Q

What causes an epileptic seizure?

A

Excessive and hypersynchronous activity of populations of neurons in the brain

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2
Q

Which position of tumours in the brain is most epileptogenic?

A

Centro-tempro-parietal region

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3
Q

T/F Epilepsy is the most common chronic neurological disease in the world

A

True

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3
Q

When is surgery indicated for epilepsy?

A

Focal epilepsy - where the origin of the seizures can be localised to a brain region

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4
Q

When are the peaks of epilepsy onset?

A

Childhood and 60+

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5
Q

How does focal cortical dysplasia appear on MRI?

A

Focal thickening of cerebral cortex

Blurring of grey/white interface

Gyral abnormalities

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6
Q

What is the standardised mortality ratio for epileptics?

A

3.0 vs the normal population

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6
Q

How do epilepsy drugs work as a treatment?

A

Prevent the symptoms by reducing excitability

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7
Q

What is the most common type of tumour that causes epilepsy?

A

Gliomas

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8
Q

Which are more readily lost, inhibitory or excitatory neurones?

A

Inhibitory

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9
Q

What is epileptogenesis?

A

The changes that occur in the brain during the development of epilepsy

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9
Q

What are the most common causes of epilepsy onset in post-natal and early infancy?

A

Congenital

Perinatal insults

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10
Q

What is periventricular nodular heterotopia?

A

A generalised malformation due to abnormal neuronal migration leaving nodular masses of grey matter diffusely lining the ventricular walls

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12
Q

What is the rate of sudden unexplained death in epilepsy?

A

5/10000

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13
Q

What are the types of causes of epilepsy?

A

Genetic

Structural/metabolic

Unknown

16
Q

T/F Seizures accelerate epileptogenesis

17
Q

What is the difference between partial and generalised seizures?

A

Partial seizures arise in a limited number of neurones in one hemispheres whereas generalised seizures arise simultaneously in the both hemispheres

18
Q

What is the most sensitive structure to induce seizures in human models?

A

The hippocampus

19
Q

What are some changes that occur in neuronal networks that causes epilepsy

A

Loss of inhibitory neurones

Gain in excitatory neurones

Aberrant sprouting

Alteration in intrinsic cellular excitability

Alternation in synaptic transmission

Alteration in extra-neuronal environment

19
Q

What is the cause of focal cortical dysplasia?

A

The aetiology is unknown - not genetic

20
Q

What is the treatment and prognosis of mesial temporal sclerosis?

A

Refractory to medical therapy but surgery has a good prognosis

22
Q

Why do you need to know the type of epilepsy?

A

Affects prognosis, treatment, and transmissibility

23
Q

What is the difference between the brain in genetic and structural epileptics?

A

In genetic caused epilepsy the brain is structurely normal but likely due to ion channel

Seizures results from identifible structural abnormalities

24
What is the best imagining for epilepsy?
MRI
25
What is the most common pathology in adults with partial epilepsy?
Mesial temporal sclerosis
27
T/F Seizures are due to a loss of inhibition only
False, it is can be due to over excitability too
28
What are cavernomas?
A tangled mass of tightly arranged abnormal vessels made of common hypocellular walls