Epilepsy, concussions, and MS

Question 1

Seizures

Answer 1

brief, sudden, excessive discharge of electrical activity in the brain

Question 2

Provoked seizure

Answer 2

have a direct cause (head injury, non-epileptic infection, drugs)

Question 3

Epileptic seizure

Answer 3

does not have an immediate cause

Question 4

Psychogenic Non-epileptic seizures (PNES)

Answer 4

resemble seizures, but without abnormal brain electrical activity; caused by stress

Question 5

Focal seizure

Answer 5

onset is localized to a specific region of the brain

Question 6

Simple seizure

Answer 6

does not impair consciousness

Question 7

Complex seizure

Answer 7

alters consciousness

Question 8

Generalized tonic clonic “grand mal” seizure

Answer 8

tonic extension of extremities and trunk (20 seconds) clonic synchronous rhythmic muscle movements (45 seconds)

Question 9

EEG

Answer 9

measures brain electrical activity to identify seizures
- has poor sensitivity for location, but high specificity for seizures when interictal epileptiform activity is present

Question 10

epilepsy

Answer 10

a disorder characterized by at least 2 unprovoked seizures 24 hours apart.
-can start @young age or in adulthood
-when starting in adulthood, more PNES

Question 11

Anti-epileptic drugs (AEDS)

Answer 11

effective in 70% of individuals
-side effects may impact cognition and mood
-if 3 fail, likelihood of control is low (called intractable/refractory epilepsy)

Question 12

Resection surgery for epilepsy

Answer 12

removal source of seizures
-most common surgery for intractable
-PNES would not improve w/surgery

Question 13

Disconnection surgery for epilepsy

Answer 13

disrupt pathways allowing seizure to spread

Question 14

Implantation of medical devices for epilepsy

Answer 14

vagal nerve stimulator (VNS) or deep brain stimulation (DBS)

Question 15

Status epilepticus

Answer 15

condition in which patient undergoes series of seizures without regaining consciousness
-damage caused by excessive glutamate release during seizure
-seizures last more than 5 mins

Question 16

Traumatic Brain Injury (TBI)

Answer 16

alteration in brain function or other evidence of brain pathology caused by an external force

Question 17

Closed injury

Answer 17

non-penetrative, outside force impacts head, skull is not broken

Question 18

open injury

Answer 18

penetrative injury, results when skill is broken or fractured

Question 19

Primary injury

Answer 19

what we think of as the brain injury or the immediate cause (Fall or car accident)
-diffuse injury

Question 20

Secondary injury

Answer 20

occurs in the hours/days following the injury as the injury evolves
-intracranial pressure from hemorrhage, iatrogenic effects from treatment
-could be focused or diffuse

Question 21

Glasgow coma scale

Answer 21

used to rate how traumatic an injury is
-monitors eye opening responses, verbal responses, and motor responses

Question 22

GCS mild

Answer 22

13-15, less than one day of posttraumatic confusion, loss of con for less than 30 mins

Question 23

GCS moderate

Answer 23

9-12, 1-7days of posttraumatic confusion, loss of con for 30mins to less than 24 hours

Question 24

GCS severe

Answer 24

<9, more than 7 days of posttraumatic confusion, loss of con for more than 24 hours

Question 25

Mild TBI (concussion)

Answer 25

70-90% -neurons dysfunctional, not destroyed -full recovery w/in 7-39 days less than 3% less than a month

Question 26

moderate/severe injury

Answer 26

destruction and sheering of white matter (diffuse axonal injury) -most recovery occurs in 1st year, most rapidly in first 3-6 months -plateau in 2 years

Question 27

Post concussion syndrome

Answer 27

presence of persistent subjective cognitive/emotional complaints more than 3 months after injury -commonly occurs with comorbid psych distress -does not correlate with injury severity variables -can be ass w/ inadequate pain symptom management

Question 28

What predicts recovery from a moderate to severe TBI

Answer 28

force of trauma, brain functions affected, areas that aren't affected, age and time of injury, other bodily injuries

Question 29

Multiple sclerosis

Answer 29

Progressive autoimmune disorder where immune system attacks oligodendrocytes in CNS -degradation of myelin that occurs in MS leads to a breakdown in communication between neurons -can form at any site w/in CNS -symptoms depend on lesion location

Question 30

MS epidemology

Answer 30

peak onset b/t 20 and 40 -more common in women -genetic factors contribute

Question 31

MS causes

Answer 31

Hypothesis: a viral infection primes a susceptible immune system for an abnormal reaction later in life -may be a response to a chronic infection

Question 32

MS symptoms

Answer 32

vision loss, weakness, double vision, vertigo, fatigue, etc.

Question 33

MS characteristic (course)

Answer 33

defined by experiences of relapses and disease progression

Question 34

MS relapses

Answer 34

worse periods of neurological symptoms caused by acute inflammatory demyelination

Question 35

MS disease progression

Answer 35

individuals will experience progressive disability due to chronic demyelination, gliosis, and axonal loss overtime

Question 36

MS cognitive impairment

Answer 36

40-65% -related do damaged or destroyed white matter tracks resulting in diffuse white matter changes -Most often affected (processing speed, attention, learning, memory, exec functioning)

Question 37

MS psychosocial

Answer 37

unemployment, functional impairment (decreased participation in activities), mental illness