Lecture 98 - Seizures and Epilepsy

Question 1

There are a few subclasses of Generalized seizures (discharge bilaterally throughout the brain).

1. _____-_____(grand mal) –> these patients exhibit convulsions.
2. _______ (petit mal) –> these patients often just look like they’re staring into space, maybe with rapid blinking.
3. _______ –> these patients just collapse
4. ________ spasms –> brief atonia followed by stiffness in extremities.

Answer 1

Tonic-clonic

Absence

Atonic

Infantile spasms

Question 2

Absence seizures tend to occur in Children with a family ______. EEG will show a “_____ and _____” pattern. They are treated with _______.

Answer 2

Family Hx

Spike and wave pattern

Ethosuximide

Question 3

Partial seizures differ from generalized in that they are ______ (unilateral or bilateral?). They are considered ______ (simple or complex?) when there is no loss/impairment of consciousness.

Answer 3

Unilateral

Simple

Question 4

Epilepsy is a disease state of recurrent ______.

Answer 4

Seizures

Question 5

Lennox-Gastaut syndrome is associated with Atonic seizures resultant from brain injury. One of the diseases that can lead to this is _______ ______, which may also cause “Ash leaf” spots on the skin.

Answer 5

Tuberous Sclerosis

Question 6

The same areas of the brain that are most susceptible to anoxic injury are also most likely to be involved with Epilepsy, as they have high Inherent Burst-generating properties. Which areas are they?

Answer 6

CA3 of hippocampus and Cortical layers IV and V

Question 7

When the Hippocampus is damaged from seizures (particularly febrile seizures in children), it reorganizes to a _______ (hyper or hypoexcitable?) state, triggering a depolarizing shift that leads to auras like deja vu, fear, etc.

Answer 7

Hyperexcitable (particularly CA3, CA1, and Dentate gyrus)

Question 8

In Generalized seizures, the _______ acts as the “pacemaker” of the bilateral cortical firing.

Answer 8

Thalamus (essentially the seizure starts here and propagates to the cortex.)