NeuroPathology - Hydrocephalus & Epilepsy Objectives

Question 1

What is Epilepsy?

Answer 1

Epilepsy is a chronic, noncommunicable disease of at least two or more seizures of the brain that affects all ages.

Question 2

What are Seizures?

Answer 2

Excessive discharge of cerebral neurons resulting in transient impairment or LOC

Question 3

What is the most preventable cause of epilepsy?

Answer 3

head trauma

Question 4

What is the most common cause of seizures in adults over the age of 50?

Answer 4

stroke, increases risk by 17%

Question 5

How does a Tonic seizure present in body movements?

Answer 5

muscles in the body become stiff

Question 6

How does an Atonic seizure present in body movements?

Answer 6

muscles in the body relax

Question 7

How does a Myoclonic seizure present in body movements?

Answer 7

Short jerking in parts of the body

Question 8

How does a Clonic seizure present in body movements?

Answer 8

periods of shaking or jerking in parts of the body

Question 9

Where do Generalized Seizures impact the brain?

Answer 9

Both sides of the brain

Question 10

Where do Focal seizures impact the brain?

Answer 10

Only part of the brain

Question 11

What is a secondary generalized seizure?

Answer 11

where a seizure begins in one part of the brain but then spreads and becomes generalized

Question 12

How does a focal seizure present?

Answer 12

consciousness is not often depressed, twitching, change in sensation, change in taste/smell, *confused/dazed

Question 13

What is an Absence Seizure (Petit Mal)

Answer 13

Generalized seizure begins diffusely and involves both cerebral hemispheres simultaneously

Question 14

How does an Absence Seizure present?

Answer 14

sudden cessation of ongoing conscious activity, often staring into space, onset/termination is abrupt, minor convulsions

Question 15

What are symptoms of a Tonic-Clonic (Grand Mal) seizure?

Answer 15

sudden LOC, fall, total loss of control, incontinence, headache, disorientation, soreness, mood changes

Question 16

What structures are involved in a Grand Mal seizure?

Answer 16

brainstem, prefrontal cortex, and basal ganglia mechanism

Question 17

What are signs of Myoclonic seizures?

Answer 17

typically no loss of consciousness, often cluster shortly after waking or falling asleep, repeated seizures may seem to increase and end in generalized tonic-clonic convulsion

Question 18

what are signs of atonic seizures?

Answer 18

brief loss of consciousness but no tonic contractions. most common in children with encephalopathy

Question 19

What type of seizure is Status Epilepticus?

Answer 19

prolonged or repeated seizures with no recovery, generalized tonic-clonic seizures, no return to consciousness between attacks, ***medical emergency

Question 20

What are common causes of tonic-clonic status epiletpicus seizures?

Answer 20

tumors, CNS infections, drug abuse

Question 21

What is the most common seizure type in young children?

Answer 21

febrile seizures

Question 22

When would Infantile seizures occur?

Answer 22

neonatal period, within first 24-72 hours

Question 23

What are the three phases of a seizure?

Answer 23

Prodome, ictal, and post-ictal

Question 24

What is the Prodome phase of a seizure?

Answer 24

prior to the actual seizure where pt may have an aura/sense of attack but not apart of the seizure itself

Question 25

What is the ictal phase of a seizure?

Answer 25

the actual symptoms of a seizure

Question 26

What is the post-ictal phase of a seizure?

Answer 26

period of time from where the seizure ends to when patient returns to normal, typically between 5-30min

Question 27

What are symptoms of the post-ictal phase?

Answer 27

confusion, drowsiness, hypertension, headache, nausea

Question 28

True or False: Seizures increase mortality rates by 20%

Answer 28

TRUE

Question 29

What is Hydrocephalus?

Answer 29

build up of cerebral spinal fluid (CSF) in ventricles

Question 30

What are the two types of Hydrocephalus?

Answer 30

Communicating hydrocephalus & non-communicating hydrocephalus

Question 31

What causes hydrocephalus?

Answer 31

chiari malformation, neural tube deficits, dandy-walker syndrome, tumors, arachnoid cysts

Question 32

What are symptoms of hydrocephalus?

Answer 32

rapid increase in head circumference, seizures, N/V, sleepiness, irritability, eyes that constantly gaze downward, headaches, developmentally behind

Question 33

What is Normal Pressure Hydrocephalus?

Answer 33

a type of communicating hydrocephalus

Question 34

What is Communicating Hydrocephalus?

Answer 34

CSF is blocked after exiting ventricles but can flow between them

Question 35

What is Non-Communicating Hydrocephalus?

Answer 35

CSF flow is blocked at one or more passages in ventricles

Question 36

what is the clinical presentation of NPH?

Answer 36

apraxic gait, shuffling/magnetic/wide-based steps, cognitive deficits, urinary incontinence

Question 37

Where are lumbar punctures accessed?

Answer 37

subarachnoid space in vertebral column

Question 38

Why would lumbar punctures be performed?

Answer 38

obtain sample of CSF, measure CSF pressure, remove CSF, assessment for shunt effectiveness

Question 39

What are the treatment options for hydrocephalus?

Answer 39

ventriculoperitoneal (VP) shunt, external ventricular drain (EVD), endoscopic third ventriculostomy (ETV)

Question 40

What are factors that positively affect NPH outcomes?

Answer 40

early diagnosis/treatment, cognitive symptoms that develop AFTER gait issues/urinary incontinence, NPH that improves after a CSF spinal tap

Question 41

What are factors that negatively affect NPH outcomes?

Answer 41

delays in diagnosis/treatment, cognitive symptoms that develop BEFORE gait issues/urinary incontinence

Question 42

What are simple partial seizures?

Answer 42

preservation of consciousness and unilateral hemispheric involvement

Question 43

What are minor motor seizures?

Answer 43

myoclonus, akinesia, and/or atonia

Question 44

What are nonconvulsive status epilepticus symptoms?

Answer 44

change in individual's behavior

Question 45

What are complex partial seizures?

Answer 45

associated with alteration or loss of consciousness and bilateral hemispheric motor involvement

Question 46

What is a Reflex Seizure?

Answer 46

triggered by specific stimuli