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2a Neurology > MS and Epilepsy > Flashcards

MS and Epilepsy Flashcards

1
Q

What is Multiple Sclerosis?

A

A chronic AI progressive neuroinflammatory disease where there is demyelination of axons (Schwann Cells and Oligodendrocytes)

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2
Q

What is the epidemiology, aetiology and PP of MS?

A

E: 20-40y/o, Rarer in tropics and males
A: Environment, Chance and Genetic predisposition
PP: Genetic susceptibility and environmental trigger -> T cell activated –> B cell and macrophage activated release cytokines IL-1, IL-6 etc and inflammation, demyelination and gradual destruction

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3
Q

Where is an MS plaque found and what are the 3 main features?

A

1) Inflammation
2) Demyelination
3) Axon Loss
Around blood vessels

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4
Q

Does myelin regenerate with someone with MS?

A

Yes, but will regenerate thinner and overtime become thinner to point of destruction

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5
Q

What is RRMS?

A

Recurrent attacks over years at random intervals of MS but no progression in severity

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6
Q

What can affect MS symptoms?

A

Heat exacerbates symptoms

Cold relieves symptoms

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7
Q

What is chronic MS?

A

Slow decline in function of symptoms from gradual onset

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8
Q

What are the main S/S of MS?

A

1) Nystagmus
2) Spasticity
3) Rigidity
4) Bladder and Sex dysfunction
5) Paraesthesia
6) Sensory symptoms
7) Weakness
8) Optic neuritis

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9
Q

What are the 3 general symptoms of MS?

A

1) Aphasia
2) Hemianopia
3) Muscle wasting

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10
Q

What is the diagnostic criteria of MS?

A
  1. > 2 CNS lesions disseminated in time and space.

2. Exclusion of conditions that may give a similar clinical presentation.

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11
Q

What investigations and treatment are used in MS?

A

I: MRI brain and spinal cord
Lumbar Puncture

T: (Short course steroids to V inflammation)
- Beta Interferon, Natalizumab, Stem Cell transplant, Muscle relaxants for spasticity and other symptom relief
Therapy: Physio, Counselling and Speech

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12
Q

Define epilepsy and seizures?

A

E: Tendency to have seizures
S: Convulsion caused by discharge of cerebral neurones (Abnormal and excessive excitability of neurones)

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13
Q

What are the main causes of epilepsy?

A

1) Flashing lights
2) Cerebrovascular events
3) CNS infection
4) Trauma
5) Genetic Predisposition

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14
Q

What is the definition for an epileptic seizure?

A

Excessive, unsynchronised neuronal discharges in brain causing paroxysmal changes in behaviour, sensation or cognitive processes

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15
Q

What are 5 signs of an epileptic seizure?

A

1) 30-120s in duration
2) Positive symptoms e.g. Tingling and Movement
3) Tongue biting
4) Head turning
5) Muscle pain

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16
Q

How does a non-epileptic seizure differ?

A

Mental processes associated with psychological distress cause paroxysmal changes in behaviour, sensation and cognitive processes.

  1. Situational.
  2. 1-20 minutes in duration (longer than epileptic).
  3. Eyes closed.
  4. Crying or speaking.
  5. Pelvic thrusting.
  6. History of psychiatric illness.
17
Q

What is focal epilepsy?

A

Seizure/Epilepsy with only one region of the brain involved

  • Simple partial seizures with consciousness
  • Complex partial seizures without consciousness
  • Secondary generalised seizures
18
Q

What is general epilepsy?

A

Epilepsy with all regions of the brain

  • Tonic
  • Clonic
  • Tonic-Clonic
19
Q

What happens in a Tonic-Clonic seizure?

A
  • Sudden onset rigid tonic phase followed by convulsion (Clonic) so muscles jerk rhythmically
  • Episode lasts up to 120s and associated with tongue biting and incontinence
20
Q

What are the main features of an absence seizure?

A
  • Child ceases activity and lasts for few seconds

- Present in childhood

21
Q

How does carbamazepine work as an AED?

A
  • Inhibits Na+ pre-synaptic channels so prevents pre-axonal firing
22
Q

What is the treatment for generalised vocalised seizure?

A
  • Sodium Valproate

Teratogenic –> Lamotrigine

23
Q

What are 4 potential side effects of AED?

A

1) Cognitive disturbances
2) Teratogenic
3) Heart disease
4) Drug interactions

24
Q

How are focal seizures treated?

A

Carbamazepine

2a Neurology (8 decks)

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