Neurology Flashcards
What is neurodivergency?
Individuals who’s neurology differs substantially from what is considered typical or normal.
What is a seizure?
A sudden alteration of neurological function.
What is epilepsy?
2 unprovoked seizures at least 24 hours apart.
Is epilepsy an investigation based diagnosis or a clinical diagnosis?
Clinical
There is no diagnostic test, it is history based. An EEG is the gold standard SUPPORTIVE test, but only if it is during a seizure.
What elements to a history are specific and crucial to form an epilepsy diagnosis?
Eye witness account
Circumstances around the episode
Onset
Evolution of episode
Post ictal period
Aura?
Are the episodes always the same? - if not, not epilepsy
What test is over-interperated, causing misdiagnoses of epilepsy?
EEG
Minor EEG abnormalities are common in the general population, often with no symptoms or any issues.
Give 3 overarching causes of non-epileptic seizures.
Organic,
- CVS/neuro/etc causes
Psychogenic,
- Psychiatric disorders
Malingering,
- Not real seizures, patients have some or all control
Give 2 examples of CVS causes of non-epileptic seizures.
Syncope
Reflex Anoxic Seizures (RAS)
What is syncope + seizure-like activity called?
Convulsive syncope. Not the same as syncope-induced seizures, these are anoxic epileptic seizures.
What are some differentials for night time episodes?
Parasomnias (Night terrors)
Nocturnal seizures/Epilepsy (usually frontal/temporal lobe)
Psychogenic
Cardiogenic
Benign monoclonus jerk - commonly missed in infants and diagnosed as epilepsy
What are parasomnias?
Night terrors or similar events.
They usually occur before 12am and are common in early childhood (~3% of children)
After the episode they return to normal but have no recollection of it occurring.
Parents often got woken by young children crying/screaming at night, go to see whats wrong only to find the child has gone back to sleep.
They can also include sleep walking/talking.
What are nocturnal seizures/epilepsy?
Usually frontal lobe epilepsy that can occur at any age. They are normally short episodes and can happen multiple times per night.
They can also occur if sleeping in the day.
Stereotypically, frontal lobe seizures are characterised by initial hyper-motor arm posturing. (I think it kinda looks like drawing a bow) (extending one arm whilst flexing the other).
What are benign monoclonus (myoclonus) jerks?
Twitching or random movements of a single muscle or group of muscles that can occur whilst sleeping. Affects many people in their sleep, a lot of which don’t know it happens, and is harmless.
Certain BMJs can also occur as nonREM sleep-wake transition disorders.
What are nonREM sleep-wake transition disorders?
Events/episodes that can occur whilst the body transitions from being awake to nonREM sleep. Normally harmless, although they can be distressing if they are severe.
Give 4 examples of nonREM sleep-wake transition disorders.
Nocturnal cramps (commonly in the leg - calf)
Rhythmic movement disorders (head bobbing whilst asleep)
‘Sleep starts’
Sleep talking