NeuroPathology - Hydrocephalus & Epilepsy Objectives Flashcards
What is Epilepsy?
Epilepsy is a chronic, noncommunicable disease of at least two or more seizures of the brain that affects all ages.
What are Seizures?
Excessive discharge of cerebral neurons resulting in transient impairment or LOC
What is the most preventable cause of epilepsy?
head trauma
What is the most common cause of seizures in adults over the age of 50?
stroke, increases risk by 17%
How does a Tonic seizure present in body movements?
muscles in the body become stiff
How does an Atonic seizure present in body movements?
muscles in the body relax
How does a Myoclonic seizure present in body movements?
Short jerking in parts of the body
How does a Clonic seizure present in body movements?
periods of shaking or jerking in parts of the body
Where do Generalized Seizures impact the brain?
Both sides of the brain
Where do Focal seizures impact the brain?
Only part of the brain
What is a secondary generalized seizure?
where a seizure begins in one part of the brain but then spreads and becomes generalized
How does a focal seizure present?
consciousness is not often depressed, twitching, change in sensation, change in taste/smell, *confused/dazed
What is an Absence Seizure (Petit Mal)
Generalized seizure begins diffusely and involves both cerebral hemispheres simultaneously
How does an Absence Seizure present?
sudden cessation of ongoing conscious activity, often staring into space, onset/termination is abrupt, minor convulsions
What are symptoms of a Tonic-Clonic (Grand Mal) seizure?
sudden LOC, fall, total loss of control, incontinence, headache, disorientation, soreness, mood changes
What structures are involved in a Grand Mal seizure?
brainstem, prefrontal cortex, and basal ganglia mechanism
What are signs of Myoclonic seizures?
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
what are signs of atonic seizures?
brief loss of consciousness but no tonic contractions. most common in children with encephalopathy
What type of seizure is Status Epilepticus?
prolonged or repeated seizures with no recovery, generalized tonic-clonic seizures, no return to consciousness between attacks, ***medical emergency
What are common causes of tonic-clonic status epiletpicus seizures?
tumors, CNS infections, drug abuse
What is the most common seizure type in young children?
febrile seizures
When would Infantile seizures occur?
neonatal period, within first 24-72 hours
What are the three phases of a seizure?
Prodome, ictal, and post-ictal
What is the Prodome phase of a seizure?
prior to the actual seizure where pt may have an aura/sense of attack but not apart of the seizure itself
What is the ictal phase of a seizure?
the actual symptoms of a seizure
What is the post-ictal phase of a seizure?
period of time from where the seizure ends to when patient returns to normal, typically between 5-30min
What are symptoms of the post-ictal phase?
confusion, drowsiness, hypertension, headache, nausea
True or False: Seizures increase mortality rates by 20%
TRUE
What is Hydrocephalus?
build up of cerebral spinal fluid (CSF) in ventricles
What are the two types of Hydrocephalus?
Communicating hydrocephalus & non-communicating hydrocephalus
What causes hydrocephalus?
chiari malformation, neural tube deficits, dandy-walker syndrome, tumors, arachnoid cysts
What are symptoms of hydrocephalus?
rapid increase in head circumference, seizures, N/V, sleepiness, irritability, eyes that constantly gaze downward, headaches, developmentally behind
What is Normal Pressure Hydrocephalus?
a type of communicating hydrocephalus
What is Communicating Hydrocephalus?
CSF is blocked after exiting ventricles but can flow between them
What is Non-Communicating Hydrocephalus?
CSF flow is blocked at one or more passages in ventricles
what is the clinical presentation of NPH?
apraxic gait, shuffling/magnetic/wide-based steps, cognitive deficits, urinary incontinence
Where are lumbar punctures accessed?
subarachnoid space in vertebral column
Why would lumbar punctures be performed?
obtain sample of CSF, measure CSF pressure, remove CSF, assessment for shunt effectiveness
What are the treatment options for hydrocephalus?
ventriculoperitoneal (VP) shunt, external ventricular drain (EVD), endoscopic third ventriculostomy (ETV)
What are factors that positively affect NPH outcomes?
early diagnosis/treatment, cognitive symptoms that develop AFTER gait issues/urinary incontinence, NPH that improves after a CSF spinal tap
What are factors that negatively affect NPH outcomes?
delays in diagnosis/treatment, cognitive symptoms that develop BEFORE gait issues/urinary incontinence
What are simple partial seizures?
preservation of consciousness and unilateral hemispheric involvement
What are minor motor seizures?
myoclonus, akinesia, and/or atonia
What are nonconvulsive status epilepticus symptoms?
change in individual’s behavior
What are complex partial seizures?
associated with alteration or loss of consciousness and bilateral hemispheric motor involvement
What is a Reflex Seizure?
triggered by specific stimuli
