Epilepsy Flashcards
Where is the most common place for a structural lesion in drug resistant epilepsy?
Mesial temporal sclerosis
What causes an epileptic seizure?
Excessive and hypersynchronous activity of populations of neurons in the brain
Which position of tumours in the brain is most epileptogenic?
Centro-tempro-parietal region
T/F Epilepsy is the most common chronic neurological disease in the world
True
When is surgery indicated for epilepsy?
Focal epilepsy - where the origin of the seizures can be localised to a brain region
When are the peaks of epilepsy onset?
Childhood and 60+
How does focal cortical dysplasia appear on MRI?
Focal thickening of cerebral cortex
Blurring of grey/white interface
Gyral abnormalities
What is the standardised mortality ratio for epileptics?
3.0 vs the normal population
How do epilepsy drugs work as a treatment?
Prevent the symptoms by reducing excitability
What is the most common type of tumour that causes epilepsy?
Gliomas
Which are more readily lost, inhibitory or excitatory neurones?
Inhibitory
What is epileptogenesis?
The changes that occur in the brain during the development of epilepsy
What are the most common causes of epilepsy onset in post-natal and early infancy?
Congenital
Perinatal insults
What is periventricular nodular heterotopia?
A generalised malformation due to abnormal neuronal migration leaving nodular masses of grey matter diffusely lining the ventricular walls
What is the rate of sudden unexplained death in epilepsy?
5/10000
What are the types of causes of epilepsy?
Genetic
Structural/metabolic
Unknown
T/F Seizures accelerate epileptogenesis
True
What is the difference between partial and generalised seizures?
Partial seizures arise in a limited number of neurones in one hemispheres whereas generalised seizures arise simultaneously in the both hemispheres
What is the most sensitive structure to induce seizures in human models?
The hippocampus
What are some changes that occur in neuronal networks that causes epilepsy
Loss of inhibitory neurones
Gain in excitatory neurones
Aberrant sprouting
Alteration in intrinsic cellular excitability
Alternation in synaptic transmission
Alteration in extra-neuronal environment
What is the cause of focal cortical dysplasia?
The aetiology is unknown - not genetic
What is the treatment and prognosis of mesial temporal sclerosis?
Refractory to medical therapy but surgery has a good prognosis
Why do you need to know the type of epilepsy?
Affects prognosis, treatment, and transmissibility
What is the difference between the brain in genetic and structural epileptics?
In genetic caused epilepsy the brain is structurely normal but likely due to ion channel
Seizures results from identifible structural abnormalities
What is the best imagining for epilepsy?
MRI
What is the most common pathology in adults with partial epilepsy?
Mesial temporal sclerosis
T/F Seizures are due to a loss of inhibition only
False, it is can be due to over excitability too
What are cavernomas?
A tangled mass of tightly arranged abnormal vessels made of common hypocellular walls
