epilepsy Flashcards
Epilepsy
tendency to have seizures in the absence of provocations that would cause the normal brain to have a seizure.
primary generalized seizure
a seizure that involves the entire brain at the same time. Consciousness is necessarily lost.
complex partial
a seizure of focal onset that involves areas that impair consciousness. The patient often appears dazed or confused and remembers only a part of the seizure (if at all).
myoclonic seizure
a brief generalized seizure that may be so brief as to produce a motor jerk (myoclonus) but no actual loss of consciousness.
petit mal seizure
a brief generalized seizure that interrupts consciousness but which does not result in motor symptoms (outside of, possibly, some eyelid fluttering). It may happen hundreds of times a day.
simple partial seizure
a seizure from portions of the cerebral cortex having very specific functions (i.e., motor, sensory, visual, olfactory, auditory), such that the auras are easily explained.
focal seizure
another name for a partial seizure. It arises from a specific seizure focus in the cerebral cortex. This may be a scar or an irritated area around a tumor or other cortical lesion.
secondary generalized
is the spread of a focal seizure to involve the entire brain.
status epilepticus
a medical emergency that consists of continuous or recurrent seizures over at least 30 minutes without waking up in between.
postictal period
a period of cortical depression following a seizure
interictal
the period between seizures
todd’s paralysis
a period of focal weakness after a seizure due to a prolonged postictal period in a region of cerebral cortex. This may give clues to the side and location of a seizure focus.
hippocampal sclerosis
scarring of the hippocampus. This is a common cause of temporal lobe epilepsy and occurs early in life. It is often associated with prolonged febrile convulsions in early childhood.
temporal lobe epilepsy
indicates an epilepsy with a seizure focus in the temporal lobe.
seizure focus
area of abnormal electrical excitability in the cerebral cortex.
prmary generalized seizures do not have
auras
geeralzied tonic-clonic seizures result in
autonomic upset (large pupils ,hyperthermia, tachycardia, salivation, emptying of bladder)
petit mal & post ictal period
they have none
status epilepticus
medical emergency-consists of continuous or recurrent seizures of 30 mins w/o waking up in between
status epilepticus often due to
sedative withdrawal
EEGs and seizure
2/3s of patents have abnormal activty even when not having seizure
motor cortex seizure
Jacksonian (partal simple)
complex partial are
limbic seizure
later childhood–>adolescence main type of seizures
temporal lobe epilepsy
juvenile myoclonic epilepsy
very young children main types of seizures
petit mal
metabolic defect/congenital malformations
triggers for grand mal seizures
outside of CC
- reticular formation of brainstem
- thalamus
clonic and post ictal phase
results from massive activation of inhibitory neurons in brain
what simultaneously occurs durng colonic and post ictal phase?
autonomci overload
two ways determined between grand mal and secondary generalized
secondary generalized has
- aura before hand
- repetitive movements (blinking, twtching lip smacking) beforehand
JME is due to a
mutated GABA R
petit mal seizures generally originate from
upper brainstem
todd paralysis occurs if
motor cortex is involved
how do secondary generalized seizures spread
via corpus callosum and/or reticular formation
secondary generalized seizures can be
tonic
tonic-clonic
clonic
jacksonian march
upper extremity–>face–>trunk–> lower limb
foci in primary visual cortex results in
uniformed flashes, spots, and zig-zags of light
foci in visual association cortex
hallucinations such as floating balloons, stars, polygons
more anterior in visual association area (posterior temporal or parietal lobes)
more complex sensory hallucinations (people talking, etc)
seizure near uncus of rostral medial temporal lobe
hallucinations of smell and taste
why don’t cortical seizures generalize
collateral inhibition present in normal brain to prevent excessive excitation
eplepsia partialis continua
less life threatening due to focal neuronal damage, but tendency to generalize into Major Motor Status Epilepticus, so important to terminate
