Lecture 45: Epilepsy Flashcards

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1
Q

Seizure

A

Uncontrolled release of electrical activity

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2
Q

Epilepsy

A

Seizure disorder: two or more unprovoked seizures

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3
Q

How often does a seizure have a found cause?

A

25%

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4
Q

Kindling

A

Epilepsy isn’t good for you, the more you have the more you get

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5
Q

Main categories of epilepsy (2)

A

Primary Generalized; Focal/Partial

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6
Q

Most generalized epilepsy has what cause?

A

Genetic

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7
Q

Types of generalized epilepsy (6)

A

Absence, myoclonic, primary generalized tonic-clonic, tonic, clonic, atonic

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8
Q

Focal epilepsy in two categories. Also categorized by…

A

Simple and complex; brain region (i.e. temporal)

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9
Q

Reflex epilepsy

A

Triggered by stimuli (i.e. photosensitive by particular Hz)

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10
Q

Epilepsy differential (7)

A

Syncope, cardiac arrhythmias, migraine, hypoglycemia, narcolepsy, panic attacks, psychogenic non-epileptic seizures

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11
Q

What do you look for when testing epilepsy?

A

Lesion!

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12
Q

Epileptic regions

A

Hippocampus, enterorhinal cortex and amygdala (medial temporal lobe)

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13
Q

Why do you record EEG near the ear?

A

Amplifies EEG

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14
Q

Delta

A
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15
Q

Theta

A

4-8Hz

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16
Q

Alpha

A

8-13Hz: awake, alert but relaxed, eye closed

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17
Q

Beta

A

> 13Hz: awake/alert in anterior head regions, large numbers associated w/ benzo use

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18
Q

Epilepsy auras differ from migraine in that they…Can include (4)

A

Are part of (don’t precede) seizure; sudden intense fear, deja/jamais vu, olfactory/gustatory hallucinations, visual/motor

19
Q

Frontal lobe seizures are common/rare. Only seizure that can be…Symptoms?

A

Fairly rare; bilateral w/out LOC; vocalizations, shaking, head turn

20
Q

Generalized tonic-clonic seizure: aura, length, consciousness, post-ictal state

A

Must be generalized from onset, no aura (no focal areas involved), LOC, 2-3 minutes, amnesia/confused after

21
Q

Tonic

A

Freeze

22
Q

Clonic

A

Moving

23
Q

Absence seizures. Another name?

A

Sudden behavioral arrest, staring/unresponsive, sudden return to normal w/out pre-event amnesia but doesn’t recognize seizure; also called petit-mal seizures

24
Q

Absence/petit mal common trigger…describe. Common wave pattern?

A

Triggered by hyperventialation, regular generalized, 3/second spike and slow wave

25
Q

Absence seizures are common in?

A

Children

26
Q

Myoclonic seizure. Common trigger? Always epilepsy?

A

Brief, quick movements in body; light/startle; no

27
Q

Todd’s post-ictal paralysis

A

Post-seizure paralysis due to seizure in motor region of the brain

28
Q

What is the most common abnormality underlying temporal lobe epilepsy?

A

Medial temporal sclerosis

29
Q

Describe temporal seizure symptoms

A

Epigastric rising feeling, intense fear, deja vu, olfactory hallucinations, automatisms (lip smacking)

30
Q

Frontal lobe seizures are common/rare. Only seizure that can be…Symptoms?

A

Fairly rare; bilateral w/out LOC; vocalizations, shaking, head turn

31
Q

Occipital lobe seizures are common/rare. Symptoms

A

Rare; poorly formed colored lights across visual field

32
Q

Juvenile myoclonic epilepsy; associated with? Prognosis?

A

Myoclonus early in day; positive family history; benign but may last for life

33
Q

Benign epilepsy with centrotemporal spikes (Rolandic seizure) symptoms. Prognosis?

A

Parethesiae involving mouth –> unilateral clonic activity of face; often occurs shortly after falling asleep; benign, resolve by adolescence

34
Q

Infantile spasms (West syndrome) age of onset, symptoms, prognosis. Treatment?

A

3-12 months of age; jerk followed by stiffening; NOT benign, associated w/ retardation; give high doses ACTH

35
Q

Lennox-Gaustat Syndrome triad. Prognosis?

A

Mental retardation, slow spike and wave, multiple seizure types; difficult to treat

36
Q

Atonic seizures are dangerous because?

A

Sudden loss of tone can lead to falling –> injury

37
Q

Febrile seizures definition and prognosis

A

Occurs w/ high fever in young child, less than 15 min; generally benign and don’t require treatment

38
Q

Seizures are the _______ most common presentation of brain tumor

A

Second

39
Q

Drug treatment response rate and rules

A

70%; first try monotherapy: “start slow, increase slowly”

40
Q

How long seizure-free when medication will be often be stopped?

A

Three years

41
Q

Surgical treatment is primarily for…

A

Focal seizures

42
Q

Status Epilepticus definition

A

Condition w/ seizures lasting for more than 30 minutes or multiple seizures lasting 30 minutes w/out recovery

43
Q

Why is Status Eplipeticus serious

A

Death in 5-10% due to circulatory collapse

44
Q

Psychogenic Non-Epileptic seizures are associated with (3). What do they look like?

A

True seizure disorder, sexual abuse, bereavement; non-stereotyped thrusting, eyes closed, face not involved, feels normal afterward