Epilepsy and Dementia

Question 1

what is dementia

Answer 1

a progressive decline in higher cortical function leading to global impairment of memory, intellect and personality

Question 2

name 3 types of dementia

Answer 2

alzheimers, vascular, lewy body and fronto-temporal

Question 3

what is seen microscopically in alzheimers disease

Answer 3

• amyloid-beta plaque

- neurofibrally tangles

Question 4

what drugs can be given to patients with alzheimers

Answer 4

cholinesterase inhibitors

Question 5

what is vascular dementia

Answer 5

this is where you get arteriosclerosis affecting the blood vessels to the brain resulting in ischaemia and infarction

Question 6

what is the pattern of decline in Alzheimers disease

Answer 6

steady decline

Question 7

what is the pattern of decline in vascular dementia

Answer 7

step wise decline: their cognitive state remains the same until another vascular event occurs and then it drops suddenly

Question 8

what is the pattern of decline in lewy body dementia

Answer 8

state of cognitive varies as there are points of improvement, however overall there is a downwards decline

Question 9

what is Lewy body dementia

Answer 9

where Lewy bodies are deposited all over the brain

Question 10

why does Lewy body dementia have parkinsons features

Answer 10

as both disease have Lewy bodies deposited in the substania nigra

Question 11

what is fronto-temporal disease

Answer 11

where tau proteins build up in the frontal and temporal lobes

Question 12

what are some of the reversible causes of dementia

Answer 12

depression, trauma, vitamin deficiency, thyroid dysfunction, alcohol

Question 13

what are the presentations of dementia

Answer 13

• memory loss
• behavioural changes e.g. personality
• physical changes e.g. incontinence and difficultly swallowing
• language disorders
• apraxia = difficultly carrying out learned motor skills

Question 14

what is used to determine the diagnosis between dementia and delirium

Answer 14

CAM score looking at acute changes in mental state, altered consciousness, inattention and disorganised thinking

Question 15

what investigations are carried out to help diagnose dementia

Answer 15

full history
mini mental state examination
MRI/CT
blood tests to rule out reversible causes

Question 16

define seizure

Answer 16

a sudden discharge of electrical activity in the brain

Question 17

define epilepsy

Answer 17

neurological disorder marked by sudden recurrent episodes of seizures

Question 18

define aura

Answer 18

disturbance experienced prior to a seizure e.g. lighting or smells

Question 19

define status epilepticus

Answer 19

when seizures occur without a recovery period in-between meaning the patient may become cyanotic

Question 20

what is a partial seizure

Answer 20

where the electrical discharge only affects a small part of the brain

Question 21

what are the 2 types of partial seizure

Answer 21

simple = patient remains conscious 
complex = patient loses consciousness

Question 22

what are the 5 types of generalised seizure

Answer 22

tonic-clonic 
atonic 
absence 
myotonic 
tonic

Question 23

what is a tonic-clonic seizure

Answer 23

where the muscles are tense and the patient has convulsions

Question 24

what are convulsions

Answer 24

uncontrolled shaking movements due to repeated contractions and relaxations of the muscles

Question 25

what are generalised seizures

Answer 25

where the electrical discharge spreads throughout the whole brain

Question 26

what is a tonic seizure

Answer 26

where the muscles become tense

Question 27

what is an atonic seizure

Answer 27

where the muscle lose their tone e.g. the neck drops briefly

Question 28

what is a myotonic seizure

Answer 28

where you get a sudden jerking movement

Question 29

what is an absence seizure

Answer 29

where it seems as if youre day dreaming

Question 30

what medication would you give to someone having a seizure

Answer 30

lorazepam or midazolam

Question 31

what are the differential diagnoses for a seizure

Answer 31

Vascular 
Infection
Trauma 
Autoimmune 
Metabolic 
Iatrogenic 
Neoplastic