Epilepsy, Migraine and Multiple Sclerosis. Flashcards
What are paroxysmal disorders also known as?
Episodic disorders.
Define- Paroxysmal disorders.
Disorders where the nervous systems functions normally between attacks.
Name some examples of paroxysmal disorders.
Seizures
Headaches
Fainting
What do paroxysmal disorders often have?
They often have a strong genetic component- starting in childhood or adolescence & improving with age.
Apart form genetics what can paroxysmal disorders be triggered by?
Stress, fatigue and some dietary factors.
It is important to know about _________ disorders as we will experience them so it is good to have an ________ of them.
paroxysmal
understanding
Define- Seizure.
A paroxysmal hyper-synchronous abnormal activity of neurons.
Explain what a seizure is.
It is a sudden and transient interruption of brain function due to disruption of electrochemical processes in transmitting information from one nerve cell to another.
Name the most common neurological disorder in Scotland.
Epilepsy.
What is epilepsy?
At least 2 unprovoked/idiopathic (no known cause) more than 24 hours apart.
70% of seizures are _______________.
cryptogenic. Meaning we don’t know what caused them!
What is another cause of seizures? (15%)
Vascular disease of brain.
Name some less common causes of seizures.
Head trauma Infection Alcohol or drug misuse Medication Acute Illness (meningitis) Tumours.
What is another word for vascular disease of the brain?
Stroke.
Stroke is most common in people aged over _____.
60.
What percentage of people who have strokes have a resulting seizure?
5-10%
Order these 1 to 3 with 1 being the highest risk of having a seizure:
- Ischaemic stroke
- Subarachnoid bleed
- Cerebral bleed
- Subarachnoid bleed
- Cerebral bleed
- Ischaemic stroke.
75% of people with ______ ____________ will have seizures within the 1st year.
Head Trauma
You have 15% chance of seizure if you have a _______ ____________ fracture.
sepressed skull
Intracranial haematoma = ___% risk of seizure.
30%
The later the the ____ of the seizure the _________ the __________________. What does it suggest?
Onset.
poorer, prognosis
That there are other underlying changes in the brain.
Name 3 infections you could possibly get seizures from.
Viral encephalitis (1-25%) Bacterial meningitis (3-10%) Viral Meningits (v. small risk in uncomplicated cases)
In terms of alcohol name the causes of seizure.
Withdrawal (mainly withdrawal)
Metabolic/ electrolyte
Toxic effects
Give a bit more information about alcohol withdrawal seizures.
They can occur 6 to 72 hours after stopping drinking
Peak at 24 hours :)
How are seizures classified?
- Partial/focal seizures
2. Generalized seizures
What should we do when someone has a seizure.
Get them on the floor
lie them in recovery position
maintain airway- make sure they can breathe
keep head safe- make sure they are not banging it on things.
What type of seizure makes up two thirds of seizures?
Focal Seizures.
Focal seizures can be simple or complex- what does this mean?
Simple- consciousness preserved
complex- altered consciousness (might not be conscious, or can’t remember seizure etc.)
What is a focal seizure?
a seizure that starts in one part of the brain eg. temporal, frontal, occipital or parietal lobe.
What is a cure to help severe seizures?
To cut the corpus callosum so the seizure can’t spread to the other hemisphere of the brain.
Describe a temporal lobe seizure.
- Epigastric aura (feel sick/nausea prior to seizure)
- Fear
- Deja vu
- Staring, unresponsive (transe like state)
- Ictal/post ictal speech affected (disturbed, slurring or repetitive speech)
What does ictal mean?
Seizure.
Describe a frontal lobe seizure.
Sudden, short, rapid recovery
Sleep related
Multiple events each night
kicking, thrashing (motor area)
Describe an occipital lobe seizure.
Visual hallucinations
Visual field defects
Ictal Blindness (lose vision during seizure)
Eye deviation
Head deviation (changes in signals going to the vestibular system)
Describe a parietal lobe seizure.
Rare Somatosensory aura (strange smell or strange sensation) Contralateral numbness/tingling Vertigo (dizziness) Speech disturbance can occur
Name a seizure that distorts electrical activity of whole or larger portions of the brain.
Primary Generalised seizures.
What happens when having a primary generalised seizure?
Tonic-clonic
tonic phase= stiffening, rigidity, cries, breathing & cyanosis (go blue)
clonic phase= rhythmic generalised jerking (fit)
Decreased consciousness
what happens post-primary generalised seizure?
Post Ictal phase- confusion and automatic behaviour (repetitive actions)
Full consciousness after 15 to 60 minutes
Generalised aches and pains
Headache
Lethargy (desire to sleep)
What’s important when deciding what kind of seizure was had?
- eye witness account
- patient account eg. how does it start and evolve, were you conscious, how long does it last, how does it stop, what happens after, how long does it take to return to normal?
What is used to investigate seizures?
EEG
MRI brain scan