Epilepsy

Question 1

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

Answer 1

Mesial temporal sclerosis

Question 2

What causes an epileptic seizure?

Answer 2

Excessive and hypersynchronous activity of populations of neurons in the brain

Question 2

Which position of tumours in the brain is most epileptogenic?

Answer 2

Centro-tempro-parietal region

Question 3

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

Answer 3

True

Question 3

When is surgery indicated for epilepsy?

Answer 3

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

Question 4

When are the peaks of epilepsy onset?

Answer 4

Childhood and 60+

Question 5

How does focal cortical dysplasia appear on MRI?

Answer 5

Focal thickening of cerebral cortex

Blurring of grey/white interface

Gyral abnormalities

Question 6

What is the standardised mortality ratio for epileptics?

Answer 6

3.0 vs the normal population

Question 6

How do epilepsy drugs work as a treatment?

Answer 6

Prevent the symptoms by reducing excitability

Question 7

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

Answer 7

Gliomas

Question 8

Which are more readily lost, inhibitory or excitatory neurones?

Answer 8

Inhibitory

Question 9

What is epileptogenesis?

Answer 9

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

Question 9

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

Answer 9

Congenital

Perinatal insults

Question 10

What is periventricular nodular heterotopia?

Answer 10

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

Question 12

What is the rate of sudden unexplained death in epilepsy?

Answer 12

5/10000

Question 13

What are the types of causes of epilepsy?

Answer 13

Genetic

Structural/metabolic

Unknown

Question 16

T/F Seizures accelerate epileptogenesis

Answer 16

True

Question 17

What is the difference between partial and generalised seizures?

Answer 17

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

Question 18

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

Answer 18

The hippocampus

Question 19

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

Answer 19

Loss of inhibitory neurones

Gain in excitatory neurones

Aberrant sprouting

Alteration in intrinsic cellular excitability

Alternation in synaptic transmission

Alteration in extra-neuronal environment

Question 19

What is the cause of focal cortical dysplasia?

Answer 19

The aetiology is unknown - not genetic

Question 20

What is the treatment and prognosis of mesial temporal sclerosis?

Answer 20

Refractory to medical therapy but surgery has a good prognosis

Question 22

Why do you need to know the type of epilepsy?

Answer 22

Affects prognosis, treatment, and transmissibility

Question 23

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

Answer 23

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

Seizures results from identifible structural abnormalities

Question 24

What is the best imagining for epilepsy?

Answer 24

MRI

Question 25

What is the most common pathology in adults with partial epilepsy?

Answer 25

Mesial temporal sclerosis

Question 27

T/F Seizures are due to a loss of inhibition only

Answer 27

False, it is can be due to over excitability too

Question 28

What are cavernomas?

Answer 28

A tangled mass of tightly arranged abnormal vessels made of common hypocellular walls