Lecture 16 - Epilepsy

Question 1

Epilepsy definition?

Answer 1

a condition in which patients have recurrent, unprovoked epileptic seizures - abnormal and excessive discharge from neurons in the cerebral cortex

Question 2

Epilepsy and loss of consciousness?

Answer 2

epilepsy doesn’t always lose consciousness, loss of consciousness may be from other pathological processes

Question 3

Seizure types?

Answer 3

partial = neurons of one area; generalised = all neurons of the brain; simple = preserved consciousness; complex = impaired consciousness

Question 4

General physiology of a seizure?

Answer 4

imbalance between excitatory and inhibitory neurotransmitters

Question 5

NMDA receptors?

Answer 5

slow, Na, K and Ca permeable, blocked by Mg

Question 6

non-NMDA receptors?

Answer 6

AMPA and kainic; Na and K permeable, rapidly activated and inactivated

Question 7

Neonatal epilepsy?

Answer 7

mutations in voltage gated Na channels

Question 8

Absent seizures?

Answer 8

mutations in voltage gated Ca channels

Question 9

Frontal lobe seizures?

Answer 9

arms out, or full body jerks

Question 10

GABA transmission?

Answer 10

inhibitory, binds 2 molecules, opens Cl- channels

Question 11

Drugs that block GABA transmission?

Answer 11

bicuculline, picrotoxin, penicillin

Question 12

Drugs that are Glu agonists?

Answer 12

kainate, donoic acid

Question 13

Drugs that block glycine receptors?

Answer 13

strychnine

Question 14

Epileptogensis possible mechanisms?

Answer 14

anatomic rearrangements of local circuits, frequency dependent changes in synaptic efficacy (exc strengthens, inhib weakens), changes in local receptors (genes, glial changes)

Question 15

Kindling?

Answer 15

repetitive exposure to (intially) subthreshold electrical stimulation eventually produces spontaneous seizures