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Clinical & Neuropsychology > NP: Lecture 7 Epilepsy + > Flashcards

NP: Lecture 7 Epilepsy + Flashcards

1
Q

epilepsy=

A

continuous tendency for sudden recurring episodes of electrical discharges

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2
Q

epilepsy op 3 levels

A

electrical discharge - brain level
behavioural manifestations - behaviour level
epileptic seizures - terminology

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3
Q

hoeveel mensen ooit een seizure in hun leven

A

10%

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4
Q

prevalence epilepsy

A

4%

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5
Q

bij wie komen seizures het vaakste voor

A

< 10 en > 65 jaar

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6
Q

hoeveel epilepsy start voor 18 yr

A

50%

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7
Q

seizure types based on onset

A

focal
generalised
unknown

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8
Q

epilepsy types

A

focal
generalised
combined generalised and focal
unknown

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9
Q

hoe gaat het vanaf seizure

A

seizure types -> epilepsy types -> epilepsy syndrome

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10
Q

ethiology

A

structural
genetic
infectious
metabolic
immune
unknown

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11
Q

4 dingen waarop epilepsy classifications gebaseerd zijn

A
  1. altered consciousness
  2. involuntary movements
  3. perceptual and autonomous changes
  4. behavioural changes
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12
Q

2 ways you can classify epilepsy

A

A. seizure classification: focus on symptoms
B. epilepsy syndrome classification: seizure symptoms + additional clinical factors

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13
Q

focal/partial

A

starts in one area

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14
Q

generalised

A

whole brain

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15
Q

vanaf focal verdeeld in

A

simple - retains awareness
complex - altered awareness and behaviour

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16
Q

vanaf simple kan hij naar

A

complex, of secondary generalised

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17
Q

generalised naar…

A

Absences
Myoclonic seizures
Tonic-clonic seizures
Tonic seizures
Clonic seizures
Atonic seizures

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18
Q

tonic =

A

sudden tension in muscles, stiffening

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19
Q

clonic =

A

stiffening and relaxing of muscles alternates repeatedly

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20
Q

atonic=

A

loss of muscle strength

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21
Q

myoclonic=

A

muscle twitching, jerking/spasms

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22
Q

3 vragen bij focal

A

aware or impaired awareness?
motor onset or non motor onset?
progress to bilateral tonic-clonic?

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23
Q

2 vragen bij generalised

A

motor (tonic-clonic or other)?
non-motor (absences)?

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24
Q

unknown 2 vragen

A

motor/non motor?
unclassified? dus niet de other categories fitting of insufficient information

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25
Q

aware during seizure means

A

knowledge of self and environment, consciousness intact

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26
Q

B: epilepsy syndrome classifications 3 soorten hierbij

A

location related
generalised
epilepsy special

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27
Q

location related 3 soorten

A

ideopathic (cause is unknown)
cryptogenic (strong suspicion of cause)
symptomatic (cause is known)

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28
Q

generalised B criteria 3 soorten

A

ideopathic (cause unknown)
cryptogenic (strong suspicion of cause)
symptomatic (cause is known)

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29
Q

epilepsy special

A

-

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30
Q

welke classificatie laat de onset zien

A

alletwee, A en B

31
Q

welke classificatie laat de cause zien

A

alleen B

32
Q

childhood absence epilepsy =

A

generalized idiopathic

33
Q

temporal lobe epilepsy=

A

location related symptomatic

34
Q

bij tumoren waarschijnlijk

A

location related symptomatic

35
Q

hoe heet epilepsy voor flitsen

A

photosensitive epilepsy

36
Q

prevalence photosensitive epilepsy

A

3% of people with epilepsy, dus heel weinig eigenlijk

37
Q

who is affected by photosensitive epilepsy

A

mainly children and teens with generalized epilepsy

38
Q

vb van generalised epilepsy bij teens

A

juvenile myoclonic epilepsy, can be triggered by a lack of sleep

39
Q

Epilepsy is also a classification in DSM-5, ICD-10: Very detailed scoring

A

oke

40
Q

3 motor symptoms of epilepsy

A

o Tonic: Muscle contractions and body movements
o Clonic: Semi-rhytmic muscle movements
o Myclonic spasms: Very short muscle contractions (limbs)

41
Q

autonomic effects of epilepsy

A

seating, flushing

42
Q

visual effects of epilepsy

A

flashes, blurring, scotomas

43
Q

auditory effects

A

ringing, hissing

44
Q

somatosensory effects

A

tingling

45
Q

pre-ictal and post-ictal

A

time before onset of seizure and time after seizure

46
Q

pre-ictal hoe lang

A

several hours to days

47
Q

post-ictal hoe lang

A

several minutes to hours (sometimes days)

48
Q

dus welke periode is korter

A

post-ictal is meestal korter, pre-ictal kan lang duren

49
Q

wat zie je bij pre-ictal vaak

A

behavioural restlessness or other changes in behaviour

50
Q

post-ictal symptoms

A

restlessness
increased appetite/thirst
disorientation
agression

51
Q

door epilepsy increased risk of…

A

psychological, psychiatric and cognitive impairments

52
Q

mowrers two factor model

A

Mowrer’s theory of conditioning according to which
(1) fear is attached to a neutral stimulus by pairing it with a noxious unconditioned stimulus, and
(2) a person learns to avoid the conditioned
stimulus and so extinction of the conditioning
is prevented.

53
Q

mowrer critiques

A

many people with anxiety cannot remember exposure to threatening event. many people with threats do not develop anxiety

54
Q

but explanations for mowers critique

A

does not have to be direct
can also develop via modeling
can develop via verbal instruction (mom afraid of spiders)

55
Q

risk of impairments is determined by 3 clinical factors…

A
  1. stable -> brain anomaly, age of onset, seizure type
  2. dynamic -> frequency, timespan, duration of dyscharges
  3. treatment -> drugs, neurosurgery
56
Q

biopsychosocial mdoel of epilepsy

A
  • Biological: stable/dynamic/treatment factors & it’s cognitive consequences.
  • Psychological: how one deals with having epilepsy and it’s consequences.
  • Social: how one’s environment deals with the person with epilepsy.
57
Q

over welke vorm van epilepsy weten we meer

A

we weten meer over symptomatic than idiopathic (duh)

58
Q

5 symptomen bij beiden idiopathic en symptomatic

A

attention
information processing speed
psychomotor
visuo-spatial skills
executive dysfunctions

59
Q

symptomatic symptoms

A

location is belangrijk:

temporal = memory
frontal = executive functions
parietal/occipital = no specifics

60
Q

psychological consequences of epilepsy

A

depression
anxiety
low self esteem
psychoses
lack of social support
stigma

61
Q

voor heoveel procent is drugs genoeg

A

70%-75%

62
Q

hoeveel van die mensen hebben poly drugs

A

5-10%

63
Q

hoeveel hebben monodrugs

A

65%

64
Q

hoeveel is drug resistant

A

20-30%

65
Q

option voor drug resistance?

A

surgery

66
Q

hoeveel mensen seizure free na surgery

A

70%

67
Q

hoeveel mensen seizure reductions na surgery

A

30%

68
Q

dus hoeveel mensen hebben er iets minder last van

A

iedereen (60% vrij van seizures, 30% seizure reductions)

69
Q

antiepileptic drugs effects psy

A

Cognitive side effects are hard to determine,
but always CHECK what is prescribed

can Impact Quality of Life

70
Q

tonic clonic details

A

These used to be known as “grand mal” seizures and are the ones generally portrayed in the movies. These involve convulsions and are very noticeable. The muscles stiffen, including vocal chords which may cause the person to cry out or groan. A person may lose bladder or bowel control during a Tonic Clonic seizure. A person can also get hurt from falling when having a Tonic Clonic seizure.

71
Q

complex focal seizures

A

These types of seizures can start with an aura which might allow time to get to
a safe place. The person having a Complex Partial Seizure is not aware of their surroundings and can
stare into space, repeatedly tug at their clothing or smack their lips. If they are standing when a seizure
hits, it is possible they will lose their balance and fall leading to a possible injury

72
Q

simple focal seizures

A

These can include motor seizures or sensory seizures. The sensory seizures are
particularly difficult for the person with epilepsy if people (including medical professionals) are not educated about seizures. Sensory seizures can include hallucinations and a feeling of dizziness or spinning which can be extremely uncomfortable

73
Q

absence seizures

A

Absence seizures can last only a few seconds and may go unnoticed. Sometimes it
will seem as if the person is not paying attention or is staring into space. It is very common for parents or teachers who are not familiar with seizures to assume a child having absence seizures is deliberately not
paying attention. This is not the case. Complex Absence Seizures can include various movements such as blinking or chewing.

74
Q

myoclonic seizures

A

These seizures are characterized as brief, jerks of movement or twitching. Sometimes there are several at once but generally there is only one that lasts a second or two.

Clinical & Neuropsychology (29 decks)

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