Epilepsy

Question 1

What is Epilepsy?

Answer 1

• A brain disorder caused by seizures (spontaneous, abnormal activity)
• Seizures are recurrent
• Symptomatic Seizures: specific cause
• Idiopathic Seizures: appear spontaneously
• Most epileptogenic when inactive

Question 2

List of causes (Table 26.3)?

Answer 2

• Drugs: alcohol, analeptics, excessive anticonvulsants, tricyclic antidepressants
• Emotional stress
• Fever
• Hormonal changes: adrenal steroids, menses, puberty
• Hyperventilation
• Sensory stimuli: flashing lights, laughing, reading, speaking, coughing, sounds
• Sleep
• Sleep deprivation
• Trauma
• Neurological disorder

Question 3

What are the three common symptoms?

Answer 3

1) Onset of aura - warning of an impending seizure
2) Loss of consciousness
3) Motor component
* Diagnose confirmed by EEG

Question 4

Type of Epilepsy: Focal Seizures?

Answer 4

• Begins in one place (a focus point) and spreads
• Jacksonian focal seizures: begins with movement in one part of the body and spreads
• Complex partial seizures: originates in temporal or frontal lobes; characterized by subjective experiences preceding attack, automatisms (automatic behaviors), postural changes

Question 5

Type of Epilepsy: Generalized Seizures?

Answer 5

• Bilaterally symmetrical (no focal origin)
• Loss of awareness or consciousness
• 50% are preceded by an aura

Question 6

Types of Generalized Seizures: Grand Mal and Petit Mal?

Answer 6

• Grand Mal Attack: tonic stage, clonic stage, post-seizure depression
• Petit Mal Attack: no motor activity, except blinking or rolling eyes or turning the head; brief duration

Question 7

Treatment of Epilepsy?

Answer 7

1) Anti-convulsants: Diphenylhydantoin (DPH, Dilantin), Phenobarbital (barbiturate)
2) Surgery
3) Deep Brain Stimulation (DBS): invasive; requires further assessment with long-term trials