NP: Chapter 16 Epilepsy

Question 1

wat voor soort disease is epilepsie

Answer 1

heeeeel breed, veel symptomen! en veel underlying mechanisms

Question 2

wat is de definitie van epilepsie

Answer 2

recurring episodes of electrical discharges called seizures.

hoewel er ook cognitive and physiological problems kunnen zijn, is niet alleen seizures!

Question 3

hoeveel mensen hebben een seizure in lifetime

Answer 3

10%

Question 4

hoeveel mensen epilepsie

Answer 4

50 mil

Question 5

wanneer komt het het meeste voor

Answer 5

voor 10 jaar age en na 65 jaar age

Question 6

in 50% van de patients, epilepsy occurs before the age of…

Answer 6

18

Question 7

the seizure symptoms depend on the ..

Answer 7

localization of the epileptic discharges

Question 8

4 symptoms van epileptische aanval

Answer 8

1. altered consciousness
2. involuntary movements
3. experiencing perceptual or autonomous changes
4. behavioural changes

Question 9

2 soorten seizures

Answer 9

focal seizures vs generalized seizures

Question 10

verschil focal seizures en generalised seizures

Answer 10

focal: beginnen in een specifiek, klein deel van het brein (but may spread)
generalised: affects both hemispheres

Question 11

focal onset seizures kenmerk of hoe ziet het er uit

Answer 11

These seizures can often be subtle or unusual and may go unnoticed or be mistaken for anything from being intoxicated to daydreaming. dus is redelijk mild vergeleken met generalised

Question 12

hoeveel mensen met epilepsie hebben focal seizures

Answer 12

60%

Question 13

3 types of focal seizures

Answer 13

• focal aware: person is aware, but may not be able to talk or respond. usually brief, called a warning or aura that a more intense seizure may develop (although these are already part of the seizure!)
• focal impaired awareness: awareness is affected, appears confused/vague/disoriented
• evolving to bilateral convulsive seizures

Question 14

generalised onset seizures algemeen

Answer 14

Generalised onset means the seizure affects both hemispheres (sides) of the brain from the onset. Because of this, a person may lose consciousness at the start of the seizure. Generalised onset seizures almost always affect awareness in some way

Question 15

6 types of generalised onset seizures

Answer 15

tonic-clonic
absence
myoclinic
atonic
clonic
tonic

Question 16

tonic-clonic seizure

Answer 16

tonic = stiffening, clonic =rhythmical jerking

bij tonic-clonic is er complete loss of consciousness for several minutes, muscles on both sides of the body are contracted (tonic). after 30 seconds, bilateral rhythmic jerks start to occur for several minutes (clonic). the seizures end when a person falls asleep or wakes up confused.

Question 17

status epilepticus

Answer 17

(vgm bij tonic-clonic)

als een seizure immediately follwed by another seizure. requires medical attention.

Question 18

absence

Answer 18

generalized seizure, meestal during childhood.

blank out or stare into space for a few seconds. usually unaware of the seizure

Question 19

symptomatic seizures =

Answer 19

type epilepsie waarvan de oorzaak waarschijnlijk bekend is.

• cryptogenic epilepsy: stron suspicion of neurological cause based on the severity

Question 20

ideopathic generalized epilepsy=

Answer 20

no cause can be determined, probably cellular abnormality

Question 21

waardoor worden seizures veroorzaakt

Answer 21

door disruption of ion channels in cell membrane or imbalance in neurotransmitters. enough synchronous epileptic discharges = seizure

Question 22

wat voor drugs voor seizures

Answer 22

inhibit the excitatory effect of glutamate, or increase the effect of GABA

Question 23

childhood absence should be treated with…

Answer 23

valproate
lamotrigine
ethosuximide

Question 24

partial/focal seizures treated with…

Answer 24

carmazepine and levetiracetam

Question 25

likelihood of a patient becoming seizure free

Answer 25

65%

Question 26

hoe heten mensen die niet van hun symptomen afkomen

Answer 26

refractory epilepsy patients

Question 27

4 treatments for refractory epilepsy patients

Answer 27

1. neurosurgical treatment for focal epilepsy 2. vagus nerve stimulation VNS, in chest to vagus nerve in neck. --> EEG desynchronisation 3. deep brain stimulation in thalamus -> interrupt or prevent discharges 4. ketogenic diet (high in fat, low in protein, starch and sugar_

Question 28

epilepsy leads to increased risk of...

Answer 28

cognitive impairments and psychosocial problems. related to: 1. stable factors: brain anomaly, age of onset, type of seizures 2. dynamic clinical factors: frequency, years, duration of discharges 3. the treatment

Question 29

ideopathic epilepsiesare..

Answer 29

associated with less severe neuropsych. disorders, and easier to treat.

Question 30

wat voor symptoms bij ideopathic epilepsie

Answer 30

attention deficits information processing slower psychomotor visuospatial skills executive functions mood fluctuations mental speed & flexibility limited self control no intellectual decline!

Question 31

which 3 forms of ideopathic epilepsy are the most common

Answer 31

childhood absence, juvenile absence, juvenile myoclonic

Question 32

10% of idiopathic epilepsy begins with centrotemporal spikes BECTS

Answer 32

oke

Question 33

symptomatic epilepsy: wat voor symptomen

Answer 33

ligt aan de localization

Question 34

syndrome of temporal love epilepsy

Answer 34

70% van de chronic symptomatic epilepsies, loss of memory

Question 35

frontal lobe epilepsy hoeveel mensen

Answer 35

20% of partial/focal seizures structural anomalities are not consistent, therefore less specific disabilities

Question 36

early onset =

Answer 36

meer last van cognitive impairments

Question 37

the incidence of psychological disorders is higher for people with epilepsy, welke vooral

Answer 37

depression and anxiety (40-60%!) ook psychosis

Question 38

personality changes in... epilepsy

Answer 38

both generalised and focal