Epilepsy and Dementia Flashcards
what is dementia
a progressive decline in higher cortical function leading to global impairment of memory, intellect and personality
name 3 types of dementia
alzheimers, vascular, lewy body and fronto-temporal
what is seen microscopically in alzheimers disease
- amyloid-beta plaque
- neurofibrally tangles
what drugs can be given to patients with alzheimers
cholinesterase inhibitors
what is vascular dementia
this is where you get arteriosclerosis affecting the blood vessels to the brain resulting in ischaemia and infarction
what is the pattern of decline in Alzheimers disease
steady decline
what is the pattern of decline in vascular dementia
step wise decline: their cognitive state remains the same until another vascular event occurs and then it drops suddenly
what is the pattern of decline in lewy body dementia
state of cognitive varies as there are points of improvement, however overall there is a downwards decline
what is Lewy body dementia
where Lewy bodies are deposited all over the brain
why does Lewy body dementia have parkinsons features
as both disease have Lewy bodies deposited in the substania nigra
what is fronto-temporal disease
where tau proteins build up in the frontal and temporal lobes
what are some of the reversible causes of dementia
depression, trauma, vitamin deficiency, thyroid dysfunction, alcohol
what are the presentations of dementia
- memory loss
- behavioural changes e.g. personality
- physical changes e.g. incontinence and difficultly swallowing
- language disorders
- apraxia = difficultly carrying out learned motor skills
what is used to determine the diagnosis between dementia and delirium
CAM score looking at acute changes in mental state, altered consciousness, inattention and disorganised thinking
what investigations are carried out to help diagnose dementia
full history
mini mental state examination
MRI/CT
blood tests to rule out reversible causes
define seizure
a sudden discharge of electrical activity in the brain
define epilepsy
neurological disorder marked by sudden recurrent episodes of seizures
define aura
disturbance experienced prior to a seizure e.g. lighting or smells
define status epilepticus
when seizures occur without a recovery period in-between meaning the patient may become cyanotic
what is a partial seizure
where the electrical discharge only affects a small part of the brain
what are the 2 types of partial seizure
simple = patient remains conscious complex = patient loses consciousness
what are the 5 types of generalised seizure
tonic-clonic atonic absence myotonic tonic
what is a tonic-clonic seizure
where the muscles are tense and the patient has convulsions
what are convulsions
uncontrolled shaking movements due to repeated contractions and relaxations of the muscles
what are generalised seizures
where the electrical discharge spreads throughout the whole brain
what is a tonic seizure
where the muscles become tense
what is an atonic seizure
where the muscle lose their tone e.g. the neck drops briefly
what is a myotonic seizure
where you get a sudden jerking movement
what is an absence seizure
where it seems as if youre day dreaming
what medication would you give to someone having a seizure
lorazepam or midazolam
what are the differential diagnoses for a seizure
Vascular Infection Trauma Autoimmune Metabolic Iatrogenic Neoplastic
