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BAB > L13: Brain Rhytms Epilepsy > Flashcards

L13: Brain Rhytms Epilepsy Flashcards

1
Q

What is a seizure as a result of

A

Excessive asynchronous neuronal discharge

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2
Q

What is an epilepsy

A

A tendency to recurrent seizures (2+ seizures over 24 hours apart)

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3
Q

What are the risk factors for epilepsy

A

Underlying CNS problem
Family history
Prolonged atypical febrile convulsion

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4
Q

What are the 2 seizure types

A 
Focal (partial)
Bilateral convulsive (generalised)
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5
Q

Wha is focal (partial seizure)

A

When the network is confined to one area of the brain

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6
Q

What is bilateral (generalised) seizure

A

Network starts in both sides of the brain simultaneously

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7
Q

What are the symptoms of focal seizures

A

depends on where the seizure originates and spreads to:
Somatosensory symptoms of one side of the body e.g tingling
Motor symptoms of jerking of body and head
Autonomic symptoms of sweating, flushing, pallor, tightness of throat and epigastric sensation (butterfly stomach)
Visual symptoms of flashes of light
Auditory (hearing) symptoms of ringing or hissing noises

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8
Q

What are the generalised seizures types

A 
Absence 
Myoclonic 
Tonic 
Tonic clonic 
Atonic
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9
Q

What is a tonic clonic (convulsion) seizure

A

A seizure that has 2 phases of:
Tonic: stiffness of muscles
Clonic: jerking phase

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10
Q

What is a absence seizure

A

Sudden alteration of awareness person may seem like they are daydreaming and this can be unnoticed by other and are followed by normal activity later

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11
Q

What is myoclonic seizures

A

Sudden jerk of both of the upper limbs

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12
Q

What is tonic seizure

A

Sudden stiffening of the body

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13
Q

What is atonic seizure

A

Loss of muscle tone

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14
Q

What are the types of partial seizures

A

Simple: person is aware but cannot control function or behaviour

Complex: impaired conscious with no control over functions and behaviour

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15
Q

What has to happen for a diagnosis of epilepsy

A

2 or more stereotyped seizure attacks

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16
Q

What phases can a seizure have

A

Ictal phase

Post ictal phase

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17
Q

What is the ictal phase

A

Seizure itself

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18
Q

What is the post ictal phase

A

Phase after the seizure with confusion, fatigue or muscle pain

19
Q

What is the ictal phase associated with

A 
Warning smell 
Vocalisation 
Frothing of mouth 
Incontinence 
Lateral tongue biting
20
Q

What are the post ictal symtoms

A

Headache

Myalgia (muscle pain)

21
Q

If the seizure occurs in the frontal lobe what can appear

A

Minimal post ictal confusion

Bizarre behaviours

22
Q

How can we examine someone with a seizure

A

ECG
Blood test
Imaging MRI
EEG

23
Q

Why is an ECG essential

A

A change in heart rhythm can lead to a seizure or vice versa

24
Q

With a blood test what do we look for

A

Kidney and liver function
Infective screen for meningitis illness- inflammation indicators
Drug levels of cocaine, alcohol and anti-psychotics

25
Q

What increases the risk of seizures

A

Excessive alcohol intake

26
Q

What is an ECG used for

A

Establish localisation

27
Q

What are the causes of seizures

A 
Genetic 
Previous febrile convulsion 
Infection 
Autoimmune 
Metabolic 
Toxic 
Tumours
28
Q

What can previous febrile convulsions lead to

A

Scarring in the hippocampus

29
Q

What type of infection can lead to seizures

A

Meningitis

Encephalitis

30
Q

What are the metabolic factors that can lead to seizures

A

Hypocalcaemia
Hyponatriemia
Hypoglycaemia

31
Q

What are the toxic factors that can lead to seizures

A

Alcohol
Cocaine
Amphetamine
Anti depressants

32
Q

What are the common structural lesions that can cause seizures

A

Diseases of small vessels
Intracranial tumour
Hippocampus sclerosis

33
Q

What are the advantages of using a EEG

A

Painless

Non invasive

34
Q

What are the disadvantages for using an eeg

A

Seizures can be deep enough to record it

35
Q

When does treatment with medication for epilepsy start

A

After the second seizure

36
Q

What medication is used to treat epilepsy

A

Anti epileptic drugs

37
Q

When we start anti-epileptic drug treatment how long does it last

A

At least 2 years from the last seizure

38
Q

What are the factors we have to consider before starting anti epileptic drugs

A

1) drugs can bring side effects so the doses have to be titrated very slowly
2) valproate can be teratogenic for a fetus

39
Q

What are the surgical options for epilepsy

A
  • resection i.e take out the tumour
  • vagal nerve stimulation
  • deep brain stimulation
40
Q

What is vagal nerve stimulation

A

1) Implantation of a pacemaker into the chest wall that has a lead going up to the vagus nerve in the neck
2) when there is a increase in heart rate the lead delivers an electrical impulse to shorten the seizure

41
Q

What are the lifestyle advices that we can give for epilepsy

A

Minimise alcohol and drugs
Regular sleep
Ketogenic diet

42
Q

What is a status epilepticus

A

A convulsive seizure that lasts for over 5 minutes without recovery (emergency situation)

43
Q

What are the anti-epileptic drugs used in focal epilepsy

A

Carbamazepine
Lamotrigine
Oxcarbazepine

44
Q

What are the anti-epileptic drugs used in generalised seizures

A

Sodium valproate (teratogenic)
Lamatrigine
Levetiracetam

BAB (21 decks)

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