Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bloc J - Neuro > Oct4 A2-Seizures and Epilepsy > Flashcards

Oct4 A2-Seizures and Epilepsy Flashcards

1
Q

anatomy of seizures

A
  • originate in the cortex
  • cortical neurons are arranged in 6 layers
  • dz to cerebral cortex can cause seizures
  • dz that damage other parts of the brain do NOT cause seizures
  • stroke involving cortex = risk of seizures
  • stroke involving brainstem or cerebellum = no risk of seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

seizures def

A

abnormal, COORDINATED, discharge of a group of neurons in the brain that has been allowed to continue unchecked
this group, region where it’s located = seizure focus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when does a seizure lead to clinical symptoms

A
  • the seizure focus spreads to adjacent neurons and neurons in other regions
  • get clinical manif when area involved is large enough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

clinical manif of seizures

A

various combinations of transiently altered awareness or behavior in the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

common acquired causes of seizures

A
  • strokes

- brain tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

principle of why seizure happens

A
  • damage to inhibitory neuron (inhibit the excitatory neurons)
  • leads to too much firing of excitatory neurons
  • this damage to inhibitory neurons can be acquired (stroke, brain problem, metabolic effects, etc.)
  • seizures can also have a genetic cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

focal (partial) seizures def

A
  • one group of seizures that ARE NOT GENETIC
  • focal manifestations
  • with or without impaired awareness (altered consciousness)
  • manifestations depend on fct of cortical region of origin (or region to which epileptic activity spreads)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

focal seizure without impaired awareness is what (also called SIMPLE PARTIAL)

A
  • abnormal mvmt
  • can look at their mvmt, notice it’s happening
  • can talk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

focal seizure with impaired awareness is what (also called COMPLEX PARTIAL)

A
  • abnormal mvmt
  • can’t talk
  • can’t respond
  • WITHOUT complete loss of consciousness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

consequence of focal (partial) seizure originating in the left motor cortex

A

get abnormal movements on the right side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

consequence of focal (partial) seizure originating in the parietal cortex

A

abnormal sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

types of cortical areas and resulting effects that you can get in seizures (type of symptoms)

A
  • primary cortical areas (motor, sensory, auditory, visual)

- association cortical areas (for further processing of primary sensory data or the formulation of motor plans)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are generalized seizures

A

arise simultaneously from both hemispheres of the brain (NOT focal. something wrong with the whole brain)
-2 subtypes: primary and secondary generalized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

primary generalized seizure def

A

generalized at onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

secondary generalized seizure

A
  • begin as focal seizures

- then become generalized (epileptic activity spreads to involve both hemispheres)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

two common forms of generalized seizures + other one

A
  • generalized tonic clonic seizures (grand mal seizures or big seizures)
  • absence seizure (petit mal seizure)
  • myoclonic seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

generalized tonic clonic seizures def

A

can be primary or secondary generalized tonic-clonic seizure
stereotypical progression
1. vocalization (loud cry)
2. tonic stiffening
3. clonic movements (jerky mvmts). steps 2 and 3 last 1-2 min
4. prolonged post-ictal period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

absence seizure (petit mal) def

A
  • minimal motor manifestation (like lip smacking, slightly turning the head
  • stop and stare for 5-10 seconds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

myoclonic seizure def

A
  • a type of primary generalized seizure
  • arises from both hemispheres
  • the FINDINGS LOOK focal (sudden, brief, single jerk of one body part) but really, the jerks are seen bilaterally, in any body region, although not simultaneously)
20
Q

aura def

A
  • subtle symptoms that a person may experience at onset of a PARTIAL seizure (focal)
  • are PART OF THE ONSET of seizure of the seizure OR can exist alone
  • odors, visual symptoms, rising sensations in the chest or abdomen, strong sense of déjà vu
21
Q

prodrome def

A

something that happens in HOURS or DAYS before a seizure that the patient relates to their seizures. ‘‘I knew I was going to have a seizure because…’’

  • are usually more vague sx (fatigue, decreased concentration, etc.
  • IS NOT part of the seizure
22
Q

in what dz do auras and prodromes also both exist (note: in epilepsy, auras are only in focal seizures)

A

migraine headaches

23
Q

complex partial seizure (focal with impaired awareness) vs absence (petit mal) seizure (generalized) clinically

A

can both look similar

  • complex partial = not aware but conscious, eyes open, can be standing
  • absence = eyes roll upwards, facial expression drops, still conscious
24
Q

absence seizure charact

A
  • generalized

- usually genetic

25
Q

primary generalized tonic-clonic seizure possible cause

A

could be genetic epilepsy

26
Q

secondary generalized tonic-clonic seizure possible cause

A

something focally wrong with the bain (bc the seizure started as focal)

27
Q

steps to take care of pt with seizure

A 
take care of pt
-prevent from injuring themselves (recovery position, do not touch their mouth)
-if >2 min or ANY doubt = call 911
describe the event
-observe
-note time of start and end
-note responsiveness
*not true that they can suffocate on their tongue*
28
Q

what is status epilepticus

A

a seizure activity that lasts continuously for >5 min

  • ONLY seizure type that is BAD for the brain is a PROLONGED GENERALIZED TONIC-CLONIC SEIZURE
  • needs emergency tx according to specific protocols
  • textbook def = continuous seizure activity for >30 min or recurrent seizure activity without regaining consciousness, for >30 min*
29
Q

what is epilepsy

A

occurence of two or more seizures in an individual, with the understanding that there is an ongoing risk of recurrence

  • last part is imp bc in certain circumstances (like low blood Na, hypoglycemia, extreme sleep deprivation, alcohol withdrawal), anyone can have seizures but if remove these circumstances, seizures should stop
  • epilepsy = risk of seizures without these factors*
30
Q

some factors that can provoke seizures in someone who doesn’t have epilepsy (meaning no longer at risk of seizures if remove these factors)

A
  • fever
  • acute injury
  • certain meds
  • alcohol withdrawal
  • certain metab problems like hyponatremia
31
Q

provoking factors of seizures in someone who has epilepsy

A

seizures are either

  • unprovoked
  • provoked by factors that DON’T cause normally provoke seizures in a healthy individual (like mild sleep deprivation and hyperventilation) + if you remove these abnormal provoking factors, pt still at risk of seizures
32
Q

what is an epileptic syndrome

A

classif of seizures based on combination from these two factors
-localization related or generalized
-genetic, structural/metabolic, unknown factors
*many seizure types in each broad category
FOR EXAMPLE: 1. generalized genetic 2. localization-related structural

33
Q

why classify pts in epileptic syndromes

A

it determines the tx and prognosis

34
Q

how to classify a pt in a a specific syndrome

A

use multiple info sources

  • age of onset
  • FHx
  • neuro exam
  • type of seizure (or types): possible to have many types in one pt
  • EEG and imaging findings
35
Q

(NOT ON EXAM) what epileptic syndrome in

  • onset in teens
  • FHx nothing
  • neuro exam normal
  • seizure type GTC
A
  • juvenile myoclonic epilepsy, a form of generalized epilepsy with GTCs, myoclonic jerks and, sometimes, absence seizures
  • thought to be caused by a genetic mutation
  • so GENERALIZED GENETIC*
36
Q

(NOT ON EXAM) what epileptic syndrome in

  • onset in teens
  • FHx nothing
  • neuro exam normal
  • seizure type GTC with focal onset (pt describes an aura)
  • EEG focal epileptic activity in left temporal lobe
  • MRI could show mesial temporal sclerosis
A
  • temporal lobe epilepsy, a form of localization-related epilepsy
  • known to be specifically a secondary generalized seizure bc of hx (aura and then generalized)
37
Q

(NOT ON EXAM) JME vs TLE

A
  • TLE responds poorly to AEDs, surgery can be curative (focal onset)
  • JME responds very well to AEDs. good control with 1 AED
38
Q

spectrum of meds effect in epilepsy

A

goes from

  • compliant + seizure free with one med
  • 3-4 meds, some seizures happening, adverse effects of higher med doses + frustration bc meds don’t work
39
Q

2 imp principles about EEGs

A
  • can’t rely on EEG to DIAGNOSE a seizure (don’t know the cause of an LOC and want to know if was a seizure = CAN’T do that)
  • EEG is one of the defining features of an epileptic syndrome
40
Q

how EEG works

A
  • records summated PSPs from neurons located in OUTER layers of the cerebral cortex
  • usually records interictal epileptic activity (a marker of seizure focus but is NOT a seizure)
  • may record ictal epileptic activity sometimes (an actual seizure)
41
Q

interictal epileptic activity charact

A
  • EEG: certain groups of sharp looking waves with diff amplitudes (EEG looks pretty flat)
  • indicates there is a seizure focus (small group of neurons firing abnormally)
  • this abnormality is present enough to be detected on EEG but NOT enough to cause sx so NO SYMPTOMS
42
Q

ictal activity charact

A
  • means seizure
  • EEG = continuous activity for multiple seconds, many spikes with huge amplitude, mechanisms in the brain eventually shut this down
43
Q

how do you DIAGNOSE seizures

A

clinically, with hx

44
Q

limitations of EEGs

A
  • last 20 to 30 min so won’t always catch epileptic activity and seizures bc these are paroxysmal events
  • EEG is normal in 50% of pts after first seizure (does not rule out seizures)
  • epileptic activity on EEG can be seen in normal people (can not dx that it is a seizure that happened)
45
Q

use of EEG in epilepsy

A
  • help confirm the localization and classify the epileptic syndrome
  • in pts with GTC seizures, can tell if is generalized interictal epileptic activity (primary GTC seizures) or focal interictal epileptic activity (secondary GTC seizures)

Bloc J - Neuro (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions