Epilepsy - Types of Seizures

Question 1

What is epilepsy?

Answer 1

A tendency to recurrent, usually spontaneous seizures

Question 2

Why do seizures occur in epilepsy?

Answer 2

Due to unprovoked electrical activity in the brain

Question 3

Epileptic seizures will have stereotypical features, what does this mean?

Answer 3

The same thing will happen each time

Question 4

In epilepsy, there is interruption of normal brain activity. This can be focal - what does this mean?

Answer 4

Discharge only affects one small area of the brain

Question 5

In epilepsy, there is interruption of normal brain activity. This can be generalised - what does this mean?

Answer 5

Discharge spreads through lots of parts of the brain and involves large areas of cortex

Question 6

How long do epileptic seizures usually last? They are usually pathological seizures if they last longer than how long?

Answer 6

Seconds-minutes / 10 minutes

Question 7

When are the 2 peak onsets of epilepsy?

Answer 7

First in childhood and then a second peak in elderly age

Question 8

What are the causes for the first peak onset of epilepsy in childhood?

Answer 8

Primary idiopathic epilepsies and developmental abnormalities

Question 9

What are the causes for the second peak onset of epilepsy in elderly age?

Answer 9

Structural brain abnormalities e.g. stroke/dementia

Question 10

Which type of epilepsy is more common in a) childhood and infancy? b) old age?

Answer 10

a) generalised b) focal

Question 11

Epilepsy has a high morbidity and an increased yearly risk of mortality due to events such as what?

Answer 11

Aspiration, cardiac problems, slowing of brainwaves until they stop altogether

Question 12

What are some risk factors for epilepsy related deaths?

Answer 12

Not taking anti-convulsant medication, drugs/alcohol, not having a bed partner

Question 13

Focal structural brain lesions are most likely to produce what type of seizures?

Answer 13

Focal onset seizures

Question 14

What are the two major subtypes of epilepsy?

Answer 14

Focal and generalised

Question 15

In focal epilepsy, what causes the irritation predisposing to seizures?

Answer 15

A structural abnormality in one part of the brain

Question 16

Generally speaking, what do focal seizures cause?

Answer 16

Focal signs

Question 17

What are secondary generalised seizures?

Answer 17

A focal seizure hits pathways in the brain causing it to spread through the cortex and cause a generalised seizure

Question 18

Where is the abnormality that causes primary generalised seizures?

Answer 18

In the cortical networks

Question 19

Does a structural abnormality have to be present for a primary generalised seizure to occur?

Answer 19

No

Question 20

What type of seizures will generalised epilepsy cause?

Answer 20

Always cause primary generalised seizures

Question 21

Focal epileptic seizures can be further divided into what two subtypes?

Answer 21

Simple or complex

Question 22

What happens in a simple focal seizure?

Answer 22

The individual will not lose consciousness

Question 23

What happens in a complex focal seizure?

Answer 23

The individual will lose consciousness

Question 24

What is the pre-ictal stage of a seizure?

Answer 24

A prodrome lasting a few hours-days which can cause e.g. dizziness or mood change (irritability)

Question 25

What is the post-ictal stage of a seizure?

Answer 25

The period after the seizure ends which may cause drowsiness, confusion, headache, myalgia

Question 26

Is a seizure aura classified as pre-ictal, ictal or post-ictal?

Answer 26

Ictal

Question 27

What is a seizure aura?

Answer 27

A stereotyped abnormal sensation or perception that is experienced before more overt clinical features of a seizure e.g. loss of consciousness

Question 28

An epilepsy aura is actually what type of seizure?

Answer 28

Focal aware seizure (i.e. simple partial seizure)

Question 29

Name some examples of types of generalised seizure?

Answer 29

Absence, atonic, myoclonic, tonic-clonic

Question 30

Will an absence seizure have a warning?

Answer 30

No

Question 31

What will happen in an absence seizure?

Answer 31

The person will stop whatever they are doing and stare blankly into space while blinking (myoclonic jerks may also occur)

Question 32

What will happen after an absence seizure?

Answer 32

The person will immediately return to their previous activity with no residual symptoms

Question 33

Absence seizures are most common in who?

Answer 33

Younger people, mostly aged < 10

Question 34

Absence seizures are a common type of what kind of epilepsy?

Answer 34

Generalised idiopathic epilepsy

Question 35

What happens in a myoclonic seizure?

Answer 35

Myoclonic movements, most likely affecting muscles of the upper limb and head

Question 36

What happens in an atonic seizure?

Answer 36

A sudden loss of muscle tone causing the patient to fall to the ground (usually with no LoC)

Question 37

People having an atonic seizure will most likely fall in what direction?

Answer 37

Forwards

Question 38

What pre-ictal symptoms might someone have before a tonic-clonic seizure?

Answer 38

Dizziness or irritability

Question 39

How will a tonic-clonic seizure begin?

Answer 39

Patients will lose consciousness and fall to the ground

Question 40

Describe the tonic phase of a tonic clonic seizure?

Answer 40

Limbs will stiffen and go rigid, there may be generalised muscle spasms

Question 41

In the tonic phase of a tonic-clonic seizure, will the arms usually be flexed or extended?

Answer 41

Extended

Question 42

What usually happens to the breathing in the tonic phase of a tonic-clonic seizure?

Answer 42

It stops

Question 43

Describe the clonic phase of a tonic-clonic seizure?

Answer 43

Arms, legs and jaw rhythmically contract and relax causing repetitive muscle jerks

Question 44

Describe the pattern of shaking movements in a tonic-clonic seizure?

Answer 44

They start small and gets bigger

Question 45

What happens to the persons skin in the clonic phase of a tonic-clonic seizure?

Answer 45

Goes grey

Question 46

Describe the post-ictal symptoms of a tonic-clonc seizure?

Answer 46

Drowsiness and confusion

Question 47

It is rare for tonic-clonic seizures to occur when?

Answer 47

At night

Question 48

People having a tonic-clonic seizure tend to fall in which direction?

Answer 48

Backwards

Question 49

How long does each stage of a tonic-clonic seizure usually last? a) tonic b) clonic c) post-ictal

Answer 49

a) 5-20 secs, b) 20-60 secs, c) hours

Question 50

What happens to the person's breathing after a tonic-clonic seizure?

Answer 50

Will be stopped for a while and then noisy breathing will return quickly

Question 51

What happens if a person has a partial somatosensory seizure?

Answer 51

They will not be able to describe the feeling since it has resulted from abnormal activity which they have never experienced before

Question 52

What happens if a person has a partial seizure affecting memory?

Answer 52

They will get abnormal memories which are kind of familial but not completely