Epilepsy Flashcards
(52 cards)
What characteristics could be seen in a temporal focal onset seizure?
Auras: smell/taste, emotional changes
Oral automatisms: gestures
What characteristics could be seen in a frontal focal onset seizure?
Motor seizures: often bilateral, commonly on waking up from sleep
What characteristics could be seen in a parietal focal onset seizure?
Sensory seizures: tingling/warmth
Auras: nausea, choking, sinking sensations, body distortion
What characteristics could be seen in a occipital focal onset seizure?
Visual hallucinations
Vision blackout
Headturning/headaches/nausea
What is a focal aware seizure? How is it characterised?
No loss of consciousness or post-ictal confusion
Symptoms depend on focal site (usually temporal lobe in origin)
What is a focal with impaired awareness seizure?
How is it characterised?
Altered consciousness, possibly post-ictal confusion
Symptoms depend of focal site (usually temporal lobe)
Name the 2 types of Jacksonian seizures
Focal aware motor
Focal aware sensory
Describe a focal aware motor (Jacksonian seizure)
Short lasting
Ripple of muscle activity
Localised but usually ripples distal to proximal
Describe a focal aware sensory (Jacksonian seizure)
Short lasting
Sensory changes
Localised or progressing sensory changes distal to proximal
What is a focal to bilateral tonic clonic seizure?
How is it characterised?
Focal seizure progressing to generalised (tonic clonic)
Can experience auras
Can have unilateral motor effects
What is a generalised tonic clonic seizure?
How is it characterised?
No warning of onset, but may have ‘triggers’
Whole brain involved
Tonic phase: body stiffness, breathing may stop, loss of bladder control
Clonic phase: muscle jerks
Followed by unconsciousness, muscle relaxation, confusion, sleepy
No recall of episode
Large amplitude, syncronised activity on EEG
What is a generalised absence seizure?
How is it characterised?
Usually starts between 6-12 yrs
‘Switch off’ - can not be alerted or woken up
Whole brain involved, low level activity
Responds well to anti-epileptics
Focal point tends to be thalamus
What is status epilepticus?
How is it characterised?
Generalised tonic clonic, ictal period >5 minutes
Whole brain involved
Repeated seizures with no recovery between >30 mins
MEDICAL EMERGENCY
What is NEAD?
Non-epileptic attach disorder
No physical reason or changes in brain activity, but has similar symptoms
Diagnosis through EEG
Name some differences between NEAD and generalised tonic-clonic seizures
No changes in EEG brain activity
NEAD - eyes closed, bite tip of tongue
Tonic-clonic - eyes open, bite side of tongue
What are some advantages of electroencephalogram (EEG)
Useful for investigations/research
Non-invasive
Painless
Used over long periods
Cost effective
Can pick up coma/brain-dead patients
How is an EEG taken?
What does it record?
24-158 plate electrodes
Voltage deflections measured relative to ‘ground’ electrode (ear)
Records activity patterns of populations of neurons by recording changes in gross current flow
Looking at changes in synchrony
Name the 5 types of rhythms seen in an EEG
Alpha
Beta
Gamma
Theta
Delta
Describe alpha waves
8-13Hz
Mainly occipital
Eyes shut, meditation
Describe beta waves
> 14Hz
Parietal and frontal
Sleep spindles
Describe gamma waves
40Hz
Binding
Learning and memory
Describe theta waves
4-7Hz
Parietal and temporal
Alertness - replayed activity in sleep
Learning and memory
Describe delta waves
<3.5Hz
Cortical
Deep sleep
Coma
What 4 things change in seizures (transmitters etc.)
Reduction in GABA
Increase in ACh transmission
Increase in Na+ channel activity
Decrease in K+ channel activity
