Neuro 1

Question 1

Neural Mechanisms of Seizure Activity

Answer 1

Loss of GABA, increase glutamate, CNS inflamation

Question 2

Focal seizure vs Generalized seizure

Answer 2

localized in one cerebral hemisphere

involves both cerebral hemispheres

Question 3

what is the most common seizure? symptoms

Answer 3

Tonic-clonic: most common
Tonic phase: rigid extensor spasm x 10-30 seconds, respiration stops, defecation/micturition/salivation may occur
Clonic phase: rhythmic flexor spasm x 2-4 minutes, continued LOC
Alertness slowly returns

Question 4

Tonic

Answer 4

Tonic contractions, LOC, no clonic phase

Lasts a few seconds

Question 5

Clonic

Answer 5

Repetitive clonic jerks with no tonic phase

Lasts a few seconds

Question 6

Absence

Answer 6

most common in children
Less dramatic but more frequent than tonic-clonic
Abrupt stop to person’s activity, brief LOC, amnesia of event
May be some clonic movements but quick recovery

Question 7

Atonic

Answer 7

(drop attacks)

Sudden reduction in muscle tone resulting in dropping of head/limb

Question 8

Myoclonic

Answer 8

Single or multiple brief contractions of face, trunk or extremities
Last a few seconds

Question 9

treatment for eplisey

Answer 9

Daily medication: anticonvulsants
Surgery: remove cause of seizure (i.e., tumor)
Nerve stimulation: stimulate vagus nerve (influences neurotransmitter release)
Ketogenic diet: resurgence in treatment of refractory epilepsy

Question 10

what are MOA for anticonvulsants

Answer 10

1: Block Na+, Ca2+ entry
2: Block glutamate release
3: Block glutamate binding
4: Block GAT1 and GABA-T
5: Prolong opening of GABA-A channels

Question 11

common AE with anticonvulsants

Answer 11

Neurotoxicity - associated with all*
Sedation, ataxia, confusion, dizziness, blurred vision and more
Weight gain (a few cause weight loss)
Hypothyroidism
Rash 
Idiosyncratic: SJS

Question 12

Therapeutic Concerns with Epileptic Drugs

Answer 12

Referral to Physical Therapy for gait instability/difficulty: It is the medication or them
Skin rashes: PT treatments (massage, modalities) may exacerbate the condition
Bone marrow depression and Vit K deficiency: check for and report bruising/bleeding
Recognize seizures