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Neuropsychiatry and Psychopharmacology > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Tonic?

A

1st phase
muscles contract and subject falls to ground
can grunt or cry from respiratory muscles contraction
incontinence
can get cyanosed from lack of o2

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2
Q

clonic

A

usually second phase

rhythmic contractions

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3
Q

What can epilepsy be categorised by

A
  • content of attack
  • presumed aetiology
  • EEG
  • presumed site of origin in brain
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4
Q

What is a myoclonic seizure?

A

hypnic jerk

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5
Q

what is an atonic seizure

A

loss of tone cross the cortex… perseon has no tone

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6
Q

what causes deja vu

A

mesial temporal lobe - recognition phenomena

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7
Q

What is a partial seizure

A

`when a person does not lose consciousnes. There is no disruption to the RAS

e.g. focal seizure in the frontal lobes will not cause LOC

  • simple partial seizures
  • complex partial seizures
    simple or complex partial seizures evolving into secondary generalised seizures.
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8
Q

What are some times of generalised seizures?

A
  • absense seizures (petit mal)
  • myoclonic seizures
  • clonic seizures
  • tonic seizures
  • atonic seizures
  • tonic-clonic seizures
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9
Q

What are some location-related epilepsies

A

focal

  • idiopathic with an age-related onset
  • symptomatic - e.g. temporal lobe or frontal lobe epilepsies
  • cryptogenic - no etiology
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10
Q

What are some generalised epilepsies

A
  • idiopathic
  • symptomatic - early myoclonic encepalopathy, speicifc syndromes which have epilepsy as a predominant feature
  • cryptogenic - rare with a resumed but undefined etiology.
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11
Q

What are generalised seizures also known as?

A

petit mal

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12
Q

What are generalised seizures?

A
  • LOC
  • petit mal
  • simple absence type or complex absence type.
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13
Q

What are simple absence seizures?

A

without waring, the patient loses contact with environment for 4-5 seconds.

appears dazed and LOC

may occur 5-10 times a day but can go as high as 100s.

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14
Q

what are complex absence seizures??

A

duration is longer than simple absence

LOC

may include compelx movements i.e. lip smacking.. due to being low on the motor strip.

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15
Q

What are tonic-clonic seizures?

A

grand mal

  • subcortical in origin
  • display an abrupt loss of consciousness
  • no aura
  • all body parts symmetrically involved
  • patient is disoriented after confusion
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16
Q

What is an akinetic seizure

A

these affect the mechanisms which govern posture producing profound muscle relaxation - drop attacks

17
Q

What are generalised myoclonic jerks?

A

sudden shock-like movements of a fraction of a second mainly affecting the neck arms and shoulders.

18
Q

What is the course of progression for partial seizures?

A
  • begin focally often with an aura
  • sometimes leads to generalised
  • simple partial - no LOC
  • complex partial - often shows LOC
  • curios - triggered by an enviornmental event like a light flicker.
  • gelastic epilepsy (laughing)
19
Q

Which type of seizures usually have aura?

A

partial

less common with generalised

20
Q

Some causes of epilepsy?

A

unknown etiology

  • birth injury or congenital malformation
  • CVA
  • post infection
  • post trauma
  • tumour
  • degernative disorders
  • drugs and toxins
  • metabolic causes
21
Q

What is seen in the brain of epilepsy

A
  • increased gliosis - effectively cells are dead and there is proliferation for glia…

loss of grey matter
mesiotemporal sclerosis

22
Q

What is a limitation of EEG

A

it’s on the surface and we’re trying to measure deep structions

23
Q

What are the modes of treatment for epilepsy?

A
  • anti-epileptic drugs - 25-30% unresponsive
  • epilepsy surgery - need to have focal epileptogenic zone that is not in functional area
  • electrical stimulation (vagus nerve stimulator)
  • seizure prediction
24
Q

What drug is best for generalised tonic clonic seizures?

A

Phytoin or carbamazepine (benzo)

carbamazepine is favoured due to higher dosability.

25
Q

What drug is best for petit mal seizures?

A

valproate (epilim)

26
Q

What are some new AEDs?

A 
gabapentin 
topamax
keppra
vigabantrin
lamotrigin
27
Q

Psychogenic non-epileptic seizures?

A

aka pseudoseizures

usually longer in duration,
starts and stops, arrhythmic, non-physiologic evolution
not stereotyped
can appear like a real seizure

patient is awake on EEG.. normal EEG rhythms.

28
Q

Physical treatments for epilepsy?

A
  • anterior temporal lobectomy, and anterior callosal section.

Neuropsychiatry and Psychopharmacology (12 decks)

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