Epilepsy - Types of Seizures Flashcards
What is epilepsy?
A tendency to recurrent, usually spontaneous seizures
Why do seizures occur in epilepsy?
Due to unprovoked electrical activity in the brain
Epileptic seizures will have stereotypical features, what does this mean?
The same thing will happen each time
In epilepsy, there is interruption of normal brain activity. This can be focal - what does this mean?
Discharge only affects one small area of the brain
In epilepsy, there is interruption of normal brain activity. This can be generalised - what does this mean?
Discharge spreads through lots of parts of the brain and involves large areas of cortex
How long do epileptic seizures usually last? They are usually pathological seizures if they last longer than how long?
Seconds-minutes / 10 minutes
When are the 2 peak onsets of epilepsy?
First in childhood and then a second peak in elderly age
What are the causes for the first peak onset of epilepsy in childhood?
Primary idiopathic epilepsies and developmental abnormalities
What are the causes for the second peak onset of epilepsy in elderly age?
Structural brain abnormalities e.g. stroke/dementia
Which type of epilepsy is more common in a) childhood and infancy? b) old age?
a) generalised b) focal
Epilepsy has a high morbidity and an increased yearly risk of mortality due to events such as what?
Aspiration, cardiac problems, slowing of brainwaves until they stop altogether
What are some risk factors for epilepsy related deaths?
Not taking anti-convulsant medication, drugs/alcohol, not having a bed partner
Focal structural brain lesions are most likely to produce what type of seizures?
Focal onset seizures
What are the two major subtypes of epilepsy?
Focal and generalised
In focal epilepsy, what causes the irritation predisposing to seizures?
A structural abnormality in one part of the brain
Generally speaking, what do focal seizures cause?
Focal signs
What are secondary generalised seizures?
A focal seizure hits pathways in the brain causing it to spread through the cortex and cause a generalised seizure
Where is the abnormality that causes primary generalised seizures?
In the cortical networks
Does a structural abnormality have to be present for a primary generalised seizure to occur?
No
What type of seizures will generalised epilepsy cause?
Always cause primary generalised seizures
Focal epileptic seizures can be further divided into what two subtypes?
Simple or complex
What happens in a simple focal seizure?
The individual will not lose consciousness
What happens in a complex focal seizure?
The individual will lose consciousness
What is the pre-ictal stage of a seizure?
A prodrome lasting a few hours-days which can cause e.g. dizziness or mood change (irritability)
What is the post-ictal stage of a seizure?
The period after the seizure ends which may cause drowsiness, confusion, headache, myalgia
Is a seizure aura classified as pre-ictal, ictal or post-ictal?
Ictal
What is a seizure aura?
A stereotyped abnormal sensation or perception that is experienced before more overt clinical features of a seizure e.g. loss of consciousness
An epilepsy aura is actually what type of seizure?
Focal aware seizure (i.e. simple partial seizure)
Name some examples of types of generalised seizure?
Absence, atonic, myoclonic, tonic-clonic
Will an absence seizure have a warning?
No
What will happen in an absence seizure?
The person will stop whatever they are doing and stare blankly into space while blinking (myoclonic jerks may also occur)
What will happen after an absence seizure?
The person will immediately return to their previous activity with no residual symptoms
Absence seizures are most common in who?
Younger people, mostly aged < 10
Absence seizures are a common type of what kind of epilepsy?
Generalised idiopathic epilepsy
What happens in a myoclonic seizure?
Myoclonic movements, most likely affecting muscles of the upper limb and head
What happens in an atonic seizure?
A sudden loss of muscle tone causing the patient to fall to the ground (usually with no LoC)
People having an atonic seizure will most likely fall in what direction?
Forwards
What pre-ictal symptoms might someone have before a tonic-clonic seizure?
Dizziness or irritability
How will a tonic-clonic seizure begin?
Patients will lose consciousness and fall to the ground
Describe the tonic phase of a tonic clonic seizure?
Limbs will stiffen and go rigid, there may be generalised muscle spasms
In the tonic phase of a tonic-clonic seizure, will the arms usually be flexed or extended?
Extended
What usually happens to the breathing in the tonic phase of a tonic-clonic seizure?
It stops
Describe the clonic phase of a tonic-clonic seizure?
Arms, legs and jaw rhythmically contract and relax causing repetitive muscle jerks
Describe the pattern of shaking movements in a tonic-clonic seizure?
They start small and gets bigger
What happens to the persons skin in the clonic phase of a tonic-clonic seizure?
Goes grey
Describe the post-ictal symptoms of a tonic-clonc seizure?
Drowsiness and confusion
It is rare for tonic-clonic seizures to occur when?
At night
People having a tonic-clonic seizure tend to fall in which direction?
Backwards
How long does each stage of a tonic-clonic seizure usually last? a) tonic b) clonic c) post-ictal
a) 5-20 secs, b) 20-60 secs, c) hours
What happens to the person’s breathing after a tonic-clonic seizure?
Will be stopped for a while and then noisy breathing will return quickly
What happens if a person has a partial somatosensory seizure?
They will not be able to describe the feeling since it has resulted from abnormal activity which they have never experienced before
What happens if a person has a partial seizure affecting memory?
They will get abnormal memories which are kind of familial but not completely
