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PSY 246 > Epilepsy and Seizures > Flashcards

Epilepsy and Seizures Flashcards

1
Q

what are the characteristics of benign childhood epilepsy? (3)

A
  • occurs in 3-13 year olds
  • accounts for ~1/4 of childhood epilepsy
  • seizures occur during sleep or shortly after awakening
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2
Q

what are the characteristics of childhood absence epilepsy? (6)

A
  • accounts for 10-15% of childhood epilepsies
  • blank stare during seizure
  • longer seizures can have automatisms (blinking or mouth movements)
  • can have dozens of seizures per day
  • no post-ictal changed
  • certain anti-epileptic drugs can make it worse (hard to tell apart from complex partial seizures)
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3
Q

what is the progression of childhood absence seizures? (3)

A
  • majority remit in later adolescents or adulthood
  • if they also have generalized tonic-clonic seizures it is more likely to persist
  • prognosis is good, with some data suggesting lower vocational attainment, poor social adjustment, or increased psychiatric diagnoses as adults
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4
Q

what are the characteristics of juvenile myoclonic epilepsy? (3)

A
  • onset in adolescents (~14 years)
  • inherited (dominant but not perfect penetrance)
  • accounts for 3-12% of epilepsies
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5
Q

what are the 3 types of seizures that are usually seen in juvenile myoclonic epilepsy?

A
  • myoclonic
  • generalized tonic clonic
  • absence
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6
Q

what is the prognosis of juvenile myoclonic epilepsy?

A

good, but it is a lifelong condition

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7
Q

how is juvenile myoclonic epilepsy treated?

A

AEDs

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8
Q

what are the neuropsychological deficits that occur in juvenile myoclonic epilepsy? (5)

A
  • processing speed
  • working memory
  • fluency
  • naming
  • executive functioning
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9
Q

what are the characteristics of West’s Syndrome? (4)

A
  • onset at 6-18 months
  • high mortality rate
  • infantile spasms, developmental arrest, and chaotic EEG patterns
  • poor prognosis, intellectual delay, develop a second type of seizure syndrome
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10
Q

what are the characteristics of Lennox-Gastaut Syndrome? (4)

A
  • onset 27 months to 6 years
  • rare; pathological genesis for many (meningitis, trauma, etc)
  • severe and difficult to control
  • intellectual delay; autistic features; behavioural problems
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11
Q

what are the characteristics of Landau-Kleffner Syndrome? (5)

A
  • acquired epileptic aphasia
  • rare
  • present after normal development
  • behaviours on the autism spectrum
  • variable prognosis (depends on age of onset)
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12
Q

what are the characteristics of focal (partial) epilepsies? (2)

A
  • focal onset

- present with simple partial seizures (may or may not have motor symptoms)

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13
Q

what are the characteristics of temporal lobe epilepsy (TLE)? (4)

A
  • most common type of epilepsy
  • mesial temporal sclerosis
  • many have a history of febrile seizures
  • most have hippocampal sclerosis (stiffening of tissue)
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14
Q

what do temporal lobe seizures usually involve?

A
  • non-motor simple partial (auras) but with oral related automatisms or upper extremities; then lose consciousness
  • can have the usual sensations: rising gastric, auditory hallucinations, deja-vu, post-ictal paraphasias
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15
Q

what are the neuropsychological deficits associated with temporal lobe epilepsy? (5)

A
  • intellectual delay
  • language
  • memory
  • attention/executive function
  • visuospatial impairments
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16
Q

what are the characteristics of frontal lobe epilepsy (FLE)? (4)

A
  • short clusters of seizures with no clear loss of consciousness, but more motor activity
  • jacksonian march (if in primary motor cortex)
  • hypermotor behaviour
  • variable neuropsychological deficits
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17
Q

what are the characteristics of parietal lobe epilepsy? (3)

A
  • rare
  • vertigo is common
  • neuropsychological deficits in language and/or apraxia
18
Q

what are the characteristics of occipital lobe epilepsy? (3)

A
  • very rare
  • visual auras, flashing colours, and blindness can occur
  • visuospatial deficits
19
Q

what are the characteristics of refractory epilepsy? (5)

A
  • most commonly partial complex seizures (medial temporal sclerosis is very common)
  • at risk for sudden unexplained death in epilepsy (SUDEP)
  • progressive neuropsychological deficits
  • psychiatric dysfunction
  • lower quality of life; poorer educational and vocational attainment
20
Q

what are the types of neurosurgery? (5)

A
  • anterior temporal lobectomy
  • hemispherectomy (for patients with hemiparesis)
  • corpus callosotomy (for patients with drop attacks)
  • multiple supial transection (for patients with motor, sensor, or language involvement)
  • implants
21
Q

what is a non-drug/non-surgical intervention for epilepsy?

A

initiating ketosis

22
Q

what percentage of patients experience declines after neurosurgery?

A

18-50%

23
Q

what is a double loser?

A

someone who is not seizure free and has new onset memory/language impairments after neurosurgery

24
Q

what makes a patient more likely to avoid being a double loser? (5)

A
  • lesion likely causing seizures close to the seizure focus
  • unilateral EEG abnormalities
  • memory is laterally impaired for the hemisphere where the lesion/seizure focus is (ipsilateral)
  • higher general cognitive ability
  • Wada’s test on contralat says memory and language is good
25
Q

ictal

A

physiological state - such as during a seizure

26
Q

refractory

A

not modified by any known treatment

27
Q

what is a seizure?

A

hyper-synchronous discharge of neurons with behavioural change

28
Q

what are the characteristics of seizures? (3)

A
  • can be provoked or unprovoked
  • anyone can have a provoked seizure (TBI, hypoglycaemia)
  • more than one unprovoked seizure is considered epilepsy
29
Q

what are the different classifications of seizures? (3)

A
  • focal (focal read of brain) associated with abnormality
  • epileptogenic focus (part of the brain that is damaged)
  • generalized (both hemispheres involved)
30
Q

what are the aspects of seizure classification? (2)

A

we have to think:

  • is the onset focal or generalized?
  • do you lose consciousness or not?
31
Q

partial vs complex seizures

A

partial: do not lose consciousness (only part of brain)
complex: lose consciousness (multiple parts of brain)

32
Q

what are the characteristics of simple partial seizures? (5)

A
  • one focal area
  • does not impair consciousness
  • sensory, motor, autonomic, or psychic (deja-vu, jamais-vu)
  • lasts from a few seconds to minutes
  • sometimes non-motor simple partial seizures are referred to as auras
33
Q

what are the characteristics of complex partial seizures? (6)

A
  • one focal area
  • impairs consciousness
  • typically starts as simple partial and moves to complex partial
  • no response to environment
  • lasts a few seconds to a few minutes
  • blank stare with repeated motor movements
34
Q

what are the characteristics of absence seizures? (4)

A
  • onset involves both hemispheres (generalized)
  • impairs consciousness
  • brief (less than 20 seconds)
  • blank stare
35
Q

what are the characteristics of atonic seizures? (3)

A
  • onset involves both hemispheres (generalized)
  • sudden loss of muscle tone
  • falling seizures
36
Q

what are the characteristics of clonic seizures? (3)

A
  • onset involves both hemispheres (generalized)
  • impairs consciousness
  • jerking movements
37
Q

what are the characteristics of tonic seizures? (4)

A
  • onset involves both hemispheres (generalized)
  • bilateral tonic extension of arm or flexion of the head and neck
  • impairs consciousness
  • lasts several seconds
38
Q

what are the characteristics of myoclonic seizures? (4)

A
  • onset involves both hemispheres (generalized)
  • impairs consciousness
  • fast jerks of the head, limbs, etc
  • might evolve to generalized tonic-clonic seizures
39
Q

what are the characteristics of tonic-clonic seizures? (5)

A
  • onset involves both hemispheres (generalized)
  • impairs consciousness
  • tonic extension of extremities for about 20 seconds
  • clonic synchronous muscle movements lasting about 45 seconds
  • patient tends to be confused and exhausted after the seizure has ended
40
Q

what is status epilepticus?

A
  • a seizure lasting more than 5 minutes
  • the longer the seizure the less likely it will stop on its own
  • dangerous and can increase chances of death
41
Q

what are the common post-ictal behaviours? (3)

A
  • after a complex partial or generalized tonic-clonic seizure the person is confused
  • mood disorders
  • psychosis

PSY 246 (14 decks)

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