Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NEURO 210 > Lecture 15: Seizures and Epilepsy > Flashcards

Lecture 15: Seizures and Epilepsy Flashcards

1
Q

What is a seizure?

A

an excessive hypersynchronous neuronal cortical discharge

a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain (usually less than 2 minutes in duration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a generalized seizure?

A

whole brain fires at the same time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a focal seizure?

A

one area is firing

focal can become generalized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the different types of focal onset seizures?

A

aware, impaired awareness

motor onset: automatisms, atonic, clonic, epileptic spasms, hyperkinetic, myoclonic, tonic

non-motor onset: autonomic, behavior arrest, cognitive, emotional, sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the different types of behavioral onset seizures?

A

motor: tonic-clonic, clonic, tonic, myoclonic, myoclonic-tonic-clonic, myoclonic-atonic, atonic, epileptic spasms

non-motor (absence): atypical, typical, myoclonic, eyelid myoclonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the different types of unknown onset seizures?

A

motor: tonic-clonic, epileptic spasms

non-motor: behavior arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is epilepsy?

A

enduring predisposition to seizures

one of these diagnoses:
1. two or more unprovoked or reflex seizures >24 hours apart
2. a single unprovoked seizure of reflex seizure + a >60% risk of having another seizure over the next 10 years
3. an epilepsy syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the different types of epilepsy?

A

focal

generalized

combined generalized and focal

unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of epilepsy?

A

structural

genetic

infectious

metabolic (low sodium)

immune (autoimmune encephalitis)

unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the differences in seizures in children compared to adults?

A

different mechanisms of epileptogenesis

different propagation of seizures

unique EEG patterns

different responses to medications

different clinical manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the definition of a seizure as seen on a electrographic?

A

a clear ictal even comprising of a sudden, repetitive, involving stereotyped waveform with a definite start, middle, and end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is ictal apnea?

A

pathophysiology unknown, likely originating in limbic system

genetic syndromes (1p36 deletion, T18, SCN8A)

mesial temporal lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are seizures with apnea?

A

apnea can be ictal especially in young children

video EEG needed for diagnosis

video EEG can identify subtle non-autonomic manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are autonomic manifestations during seizures?

A

maturation-related susceptibility of the central autonomic network

lower threshold for epileptogenic activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the key points regarding diagnosing seizures in children?

A

thorough history and event description

stereotypical brief episodes warrant further work-up

capturing the episodes on video EEG will provide the diagnostic clues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the relationship between nocturnal seizures and parasomnias?

A

differentiating nocturnal seizures from parasomnias can be challenging

ictal and interictal EEGs can be normal or non-specifically abnormal

etiology: genetic, structural (focal cortical dysplasia type IIb)

17
Q

What is frontal sleep related hypermotor epilepsy?

A

during NREM sleep

brief, highly stereotyped

occurrence in sleep, overlap with parasomnias

seizures are brief, sleep disorders are a lot longer

18
Q

What are the characteristics of parasomnias?

A

pre-school age, childhood

first 1/3 of the night

N3 sleep

5-30 minutes

single event per night

EEG normal

normal daytime behavior

respond to benzodiazepines at bedtime

19
Q

What are the characteristics of nocturnal seizures?

A

anytime infancy through adolescents

randomly through the night

N1/N2 stages of sleep

brief, less than 5 minutes

multiple events per night

EEG normal or abnormal

irritable, tired, can have daytime seizures

response to sodium channel blockers, levetiracetam

20
Q

What is a summary of the diagnosing of children with epilepsy?

A

video EEG is a valuable tool in assessment of children with suspected seizures

EEG can support the diagnosis of epilepsy, and it may assist in determining the type of or epilepsy and guide the management

child with unexplained stereotypical episodes, when seizures are a possibility, should have an EEG, ideally awake and sleeping

21
Q

How common are seizures in neonates?

A

depends on whom you ask

hard to tell actual numbers because of:
1. heterogenous groups
2. variable practices
3. variable monitoring techniques

22
Q

Why are seizures more common in neonates?

A

GABA-A receptors excitatory rather than inhibitory

developmental imbalance between excitatory and inhibitory mechanisms

delayed maturation of GABA-B, adenosine, and 5HT receptors

high density of NMDA (excitatory) receptors in hippocampus and neocortex

23
Q

What is gluatamate?

A

main excitatory neurotransmitter of the brain

24
Q

What is GABA?

A

main inhibitory neurotransmitter of the brain (except in neonates)

25
Q

Is the neonatal brain more excitable?

A

developmental imbalance between excitatory and inhibitory mechanisms

GABA-A receptors in neonates may be excitatory rather than inhibitory

high density of NMDA (excitatory) receptors in hippocampus and neocortex

delayed maturation of GABA-B, adenosine, and 5HT receptors

26
Q

What are clonic seizures?

A

easiest to diagnose, can see it even without EEG

rhythmic jerks

focal or multifocal

27
Q

What is the probability a baby is experiencing symptomatic seizures compared to epilepsy?

A

85% symptomatic seizures: abnormal brain, infections

15% epilepsy syndromes: babies more likely don’t have epilepsy

28
Q

What are the characteristics of neonatal seizures?

A

could be the first or the only sign of CNS dysfunction (because babies can’t talk and tell something is wrong)

may affect infant’s homeostasis

may contribute to neurological injury

29
Q

What are the characteristics of EEGs in neonates?

A

bedside, continuous, real time monitoring, non-invasive

assessment of cerebral function and maturation

assessment of neurological injury

seizure detection

prognosis

30
Q

What is a conventional EEG?

A

very specific placements and measurements

31
Q

What is an amplitude integrated EEG?

A

monitors over a longer period of time

32
Q

What are the pros and cons of conventional EEG?

A

pro: continuous bedside assessment of brain function, good spatial coverage

con: requires experienced technologist and reader

33
Q

What are the pros and cons of amplitude integrated EEG?

A

pro: continuous bedside assessment of brain function, limited spatial coverage, easy to apply and interpret at the bedside

con: limited spatial coverage

34
Q

What is an unusual ictal EEG?

A

background flattening and fast activity, followed by rhythmic activity

35
Q

What are the two types of KCNQ2 associated neonatal epilepsy?

A

self-limited neonatal epilepsy

developmental epileptic encephalopathy

36
Q

What is self-limited neonatal epilepsy?

A

seizures between 4-6 days of life

clonic seizures, +/- apnea

37
Q

What is developmental epileptic encephalopathy?

A

presentation depends on the pathogenic mutation (loss of function vs. gain of function)

tonic seizures and markedly abnormal EEG

38
Q

What is the effect of medications on aEEG?

A

anti-seizure medications, sedative mediations, opioids, caffeine, and surfactant cause depression of the background

39
Q

What are some abnormal paroxysmal events in neonates that aren’t seizures?

A

apnea

jitteriness

hyperekplexia

ocular signs

oral-buccal-lingual movements

complex movements

tonic posturing

abrupt change in vital signs

NEURO 210 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions