Epilespy Migraine And Mulitple Sclerosis Flashcards
What are paroxysmal disorders also known as?
Episodic disorders
What are paroxysmal disorders?
•Disorders where the nervous systems functions normally between attacks
What do paroxysmal disorders include?c
seizures, headaches, fainting
paroxysmal disorders have strong —– ——?
Generic components
What can paroxysmal disorders be triggered by?
Stress, fatigue and some dietary factors
What is a seizure?
–A paroxysmal hyper-synchronous abnormal activity of neurons (detected using EEG)
–Sudden and transient interruption of brain function due to disruption of electrochemical processes in transmitting information from one nerve cell to another.
What are the common causes of seizures?
- Cryptogenic (~70%)
* Vascular disease of brain (15%)
What are the less common causes of seizures?
- Head trauma
- Infections
- Alcohol
- Medication
- Drug misuse
What are the two classifications of Seizures?
1) Partial or focal seizures
2) Generalised seizures (Grand Mal)
What fraction of seizures are focal seizures?
2/3
What are the two types of focal seizures?
- Simple (conciousness preserved)
* Complex (altered conciousness)
Where do focal seizures start?
•Start in a part of the brain –Temporal lobe –Frontal lobe –Occipital lobe –Parietal lobe
What are the signs of focal seizures starting in the temporal lobe?
•Epigastric aura –Nausea –Rising epigastric sensation •Fear •Déjà vu •Staring, unresponsive •Ictal/post-ictal speech
What are the signs of focal seizures starting in the frontal lobe?
- Sudden, short, rapid recovery
- Sleep related
- Multiple events each night
- Kicking, thrashing
What are the signs of focal seizures starting in the occipital lobe?
- Visual hallucinations
- Visual field defects
- Ictal blindness
- Eye deviation
- Head deviation
What are the sign of focal seizures starting in the parietal lobe?
- Rare
- Somatosensory aura
- Contralateral numbness/tingling
- Vertigo
- Speech disturbance can occur
What do primary generalised seizures do?
•Distorts electrical activity of whole or larger portion of brain
What is tonic-clonic?
–No aura –Tonic phase •Stiffens, cries, breathing, cyanosis, incontinence –Clonic phase •Rhythmic generalised jerking
What is the post-ictal phase?
–Confusion
–Automatic behaviour
What questions do you ask when deciding what type of seizure it is?
–How does it start? –How does it evolve? –Consciousness lost or not? –How long does it last? –How does it stop? –What happens afterwards? –How long does it take to return to normal?
Why would an EEG be carried out?
–To help support diagnosis –Can be normal in epilepsy (60-70%) –Indicated in •Primary generalised epilepsy •Syndrome classification
What type of investigations will be carried out for epilepsy?
EEG and MRI
What conditions mimic epilepsy?
- Sleep disorders
- Hyperventilation
- Hypoglycaemia
- Migraine
- Panic attacks
- Syncope (fainting)
What is the most common type of headache disorder?
Migraine
What is migraine also known as?
•Paroxysmal headache disorder
What do migraines vary in?
frequency, intensity, duration, pattern of associated symptoms, and degree of disability
Can speech be affected by migraines?
Yes
What can trigger a migraine?
- Anything!
- Sleep patterns
- Foods
- Smells
- Stress
What are the 4 types of migraine?
- Migraine without aura
- Migraine with aura
- Migraine aura without headache
•Chronic migraine
What is a chronic migraine?
–Headaches on at least 15 days a month with at least 8 days on which symptoms meet criteria for migraine
What is MS?
- Complex autoimmune disease
- Life-long condition
- Repeated episodes of inflammation of nervous tissue in brain and spinal cord, causing loss of insulating myelin sheath
- Multiple areas of scar tissue - sclerosis
- Slows or blocks transmission of signals to and from brain and spinal cord impairs movement and sensation
What is relapsing-remitting MS?
•Relapsing-remitting MS: periods of good health or remission followed by sudden symptoms or relapses
What is secondary progressive MS?
- Secondary progressive MS: follows on from relapsing-remitting MS; gradually more/worsening symptoms with fewer remissions
- About 50% of those with relapsing-remitting MS develop secondary progressive MS during first 10 years of illness
What are the signs of benign multiple sclerosis?
No disability, return to normal between attacks
What are the signs of relapsing + remitting MS?
Never new disability between attacks
What are the signs of secondary progressive MS?
No new disability between attacks followed by steady increase in disability
What are the signs of primary progression MS?
Steady increase in disability without attacks
What effect can ms have on visual presentation?
–usually due to demyelination of optic nerve can cause blindness or hemianopia
–Optic neuritis: acute, sometimes painful, reduction or loss of vision in one eye
–Eye movements (nystagmus) double vision
What affect can MS have on facial weekends?
–Bell’s palsy
–trigeminal neuralgia, paroxysmal dysarthria and ataxia
–other paroxysmal symptoms: bursts of pain or paraesthesia, itching, cough, hiccup, painful spasm and gaze palsies
What are cognitive symptoms of MS?
Visual and auditory attention problems, memory loss
What are psychological symptoms of MS?
Depression
What are some unpleasant sensations caused by MS?
–Tightness, burning, twisting, tearing and pulling sensations
–Loss of thermal and pain sensation
What what is paraethesia and numbness caused by MS?
–Loss of sensation in arms and legs
–Altered sphincter function
What is the diagnostic process of MS?
No single specific diagnostic test available based on:
•Neurological examination
•MRI of brain and spinal cord
•Visual Evoked Potential Test
•Lumbar Puncture to test cerebrospinal fluid
What is the cure for MS?
Currently no cure for MS, but a number of treatments can help control condition
What are the treatments and what do they depend on?
- Treating relapses of MS symptoms
- Treatment to reduce the number of relapses
- Treating specific MS symptoms
